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Clinicals
Image Analysis - Abdomen - KUB
| Question | Answer |
|---|---|
| Abdominal Cavity Structures 1-9: | 1. Stomach 8. Pancreas 2. Large Intestine 9. Kidneys 3. Small Intestine 4. Liver 5. Gallbladder 6. Adrenal Glands 7. Spleen |
| Pelvic Cavity Structures: 1. 2. 3. 4. | 1. Sigmoid Colon of Large Intestine 2. Urinary Bladder 3. Reproductive Organs 4. Rectum |
| Right Upper Quadrant Structures 1-9: | 1. Liver 2. Gallbladder 3. Head of Pancreas 4. Duodenum 5. Right Adrenal Gland 6. Right Colic Hepatic Flexure 7. Proximal Right Ureter 8. Right Adrenal Gland 9. Right Kidney |
| Left Upper Quadrant Structures 1-8: | 1. Stomach 2. Tail of Pancreas 3. Spleen 4. Left Kidney 5. Left Adrenal Gland 6. Left Proximal Ureter 7. Left 1/2 of Transverse Colon 8. Left Colic Splenic Flexure |
| Right Lower Quadrant Structures 1-7: | 1. Ascending Colon 2. Appendix 3. Right half of Bladder 4. Cecum of Large Intestine 5. Distal Right Ureter 6. 2/3rds of Ileum of Small Intestine 7. Right Ovary |
| Left Lower Quadrant Structures 1-6: | 1. Descending Colon 2. Left 1/2 Urinary Bladder 3. Distal Left Ureter 4. Left Ovary 5. Sigmoid Colon 6. 2/3rds of Jejunum of Small Intestine |
| Double-walled membranous sac | Peritoneum |
| Internal lining, adheres to organs | Visceral |
| Outer lining, adheres to the Abdominal and Pelvic walls | Parietal |
| A potential space between two linings | Peritoneal Cavity |
| Intraperitoneal Structures 1-8: | 1. Liver 2. Gallbladder 3. Spleen 4. Stomach 5. Jejunum 6. Ileum 7. Cecum 8. Transverse and Sigmoid Colon |
| Retroperitoneal Structures 1-9: | 1. Pancreas 2. Ureters 3. Kidneys 4. Inferior Vena Cava 5. Duodenum 6. Ascending and Descending Colon 7. Proximal Rectum 8. Adrenal Glands 9. Abdominal Aorta |
| Infraperitoneal Structures: 1. 2. 3. | 1. Distal Rectum 2. Urinary Bladder 3. Reproductive Organs |
| Patient with a Long and Broad Abdomen | Hypersthenic |
| Patient with a High, Wide, and Transverse Stomach | Hypersthenic |
| Patient with a Gallbladder that is High and Lateral in the RUQ and Round shaped | Hypersthenic |
| Patient with a Colon that is High in the Abdomen and extends around the Periphery | Hypersthenic |
| Patient with increased muscle tone and has a motility that empties quickly | Hypersthenic |
| Patient with an Average body build | Sthenic |
| Patient that has a J-shaped Stomach which is as wide above as it is below | Sthenic |
| Patient that has a Gallbladder that lies to the right at the level of the Elbow and is pear shaped | Sthenic |
| Patient that has a Colon the extends around the periphery | Sthenic |
| Patient with average muscle tone and motility that empties normally | Sthenic |
| Patient with an Abdomen in a slender body build | Hyposthenic |
| Patient who has a Stomach that is Long and Narrow and sags near the Umbilicus into the Pelvic Cavity | Hyposthenic |
| Patient who has a Gallbladder that is lower in the Abdomen and closer to the Spine | Hyposthenic |
| Patient who has a Colon that extends around the periphery but lower in the Abdomen withy more in the Pelvic Cavity | Hyposthenic |
| Patient with decreased muscle tone and slow motility | Hyposthenic |
| Patient with an Abdomen in an extremely skinny build, malnourished | Asthenic |
| Patient who has a Stomach that sags below the Umbilicus into the Pelvic Cavity; Collapsed above and expanded below | Asthenic |
| Patient who has a Gallbladder that sits low at the level of Iliac Crest, vertical in shape and frequently lies over the Spine. | Asthenic |
| Patient who has a Colon that folds on itself occupying a low and medium position in the Pelvic Cavity | Asthenic |
| Patient who has poor muscle tone and a motility that is very slow to empty | Asthenic |
| Location of Xiphoid Process and what is it used to locate | T9-T10 used to locate Midsagittal and the Superior Anterior portion of the Diaphragm - Superior most portion of the Abdomen |
| Location of Iliac Crest and what is it used to locate | L4-L5 CR is directed to this level for most Projections of the Abdomen |
| Location of the Anterior Superior Iliac Spine (ASIS) and what is it used to locate | S1-S2 The prominent anterior portion on the Iliac Wing, used as a secondary positioning landmark for the AP Projection of the Abdomen |
| What is the level of Symphysis Pubis and what is it used to locate | Level of Coccyx - must be included on Abdomen images (KUB) to ensure that the area of the Urinary Bladder is included on the image - the junction between the two pubic bones |
| What is used as an alternative to palpating Symphysis? | The Greater Trochanters which are also at the same level as Symphysis Pubis |
| What is the body habitus adaption made in positioning when doing an AP Abdomen on a Hypersthenic patient? | 2 exposures typically made crosswise (T-shot)(one landscape one portrait at Lakeview). 1st Projection the bottom of IR is placed at Symphysis - 2nd Projection the bottom of IR is placed 1-inch below the top of the 1st Projection |
| KUB Abdomen - Clinical Indications: 1. 2. 3. | 1. Rule out Renal Calculi (stones) in Kidney, Ureter, or Bladder (additive 2. Rule out Renal Cysts (appears as fluid filled density) 3. Extrinsic and Intrinsic masses of the Kidneys |
| A partial or complete blockage of the flow of Intestinal contents | Bowel Obstruction |
| Air within the Small Intestine usually indicates | A Bowel Obstruction |
| Air in the Jejunum is usually visualized as what? | A stack of coins lying on its side |
| Physical Causes of a bowel obstruction such as fibrous adhesions, Crohn's Disease, colon cancer, Intussusception, or a Volvulus are what type of an obstruction? | Mechanical |
| What are the two types of Bowel Obstructions? | Mechanical and Adynamic |
| An obstruction of the bowel due to loss of voluntary movement or lack of peristalsis - chemical, electrolyte, mineral imbalances, complications of abdominal surgery, decreased blood supply to Intestines, infections, or use of medications such as narcotics | Adynamic or non-mechanical obstruction |
| Free air in the Peritoneal Cavity is caused by a rupture or _______ in the GI Tract, which will rise to the highest point in the Abdomen which is where? | Perforation; Above the Liver and below the right Hemidiaphragm |
| Stones or Calculi on an image appear as (renal Calculi)? | Small white masses |
| Largest solid organ in the body lying under the Diaphragm in the RUQ | Liver |
| Functions of the Liver: | 1. It produces bile which mechanically breaks down fats 2. Regulates blood glucose levels 3. receives digested nutrients from the Small Intestine via the Portal Vein and detoxifies them for further use in the body 4. Produces blood plasma products |
| Two Major Lobes of the Liver 1. 2. Two Minor Lobes of the Liver 1. 2. | Major 1. Right Lobe 2. Left Lobe Minor 1. Caudate Lobe (posterior and superior) 2. Quadrate Lobe (posterior and inferior) |
| Separates the Right and Lobes of the Liver and attaches the Liver to the anterior Abdominal Wall - consists of two closely knit layers of Peritoneum | Falciform Ligament |
| Hexagonal shaped units comprised of Liver cells (Hepatocytes), the Functional unit of the Liver | Liver Lobule |
| Pear-shaped organ located on inferior surface of the Liver | Gallbladder |
| What Quadrant is the Gallbladder located? | RUQ |
| Structures of the Gallbladder consist of: 1. 2. 3. 4. | 1. Fundus 2. Neck 3. Body 4. Cystic Duct |
| The Gallbladder receives bile from the Liver through the ______ ______ _____ (of the Liver), which join the ______ ______ of the Gallbladder where bile is stored until needed for fat digestion | Common Hepatic Ducts; Cystic Duct |
| Functions of the Gallbladder: 1. 2. 3. | 1. Storage of bile from the Liver 2. Concentration of bile by absorption of water through it's wall 3. Release of bile occurs by contraction of the hormone cholecystokinin (which is released into the bloodstream from the duodenal bulb) |
| What are Gallstones formed by? | Hardened deposits of digestive fluid |
| Where is the Pancreas Gland located? | Retroperitoneal; Central portion of Abdomen, posterior to the Stomach, within the C-Loop of the Duodenum |
| Structures of the Pancreas: 1. 2. 3. 4. | 1. Head (within C-Loop of Duodenum) 2. Neck 3. Body 4. Tail |
| The Pancreas is unique as it is both an ______ and ______ Gland | Endocrine and Exocrine |
| Functions of the Endocrine portion of the Pancreas: 1. 2. | 1. Produces Insulin and Glucagon through the Islets of Langerhorns - controls glucose levels in the body 2. Ductless portion of the gland whose secretions goes directly into the bloodstream |
| Functions of the Exocrine portion of the Pancreas: 1. 2. | 1. Produces Enzymes which chemically break down fats for use in the body 2. Composed of clusters of cells known as Acini 3. Enzymes → descending Duodenum via Pancreatic Duct/Duct of Wirsung → Merges with Common BIle at Ampulla of Vater (Desc. Duodenum) |
| The flow of enzymes from the pancreas into the Descending Duodenum through the Ampulla of Vater is controlled by what? | Sphincter of Oddi |
| Structures of the Biliary Tree: 1. 2. 3. 4. | 1. Right and Left Hepatic Duct 2. Common Hepatic Duct 3. Cystic Duct 4. Common Bile Duct |
| The opening that enters the Descending Duodenum, where the Common Bile Duct and the Pancreatic Duct (Duct of Wirsung) enter. | Ampulla of Vater |
| The Liver produces bile which ________ breaks down fats | Mechanically |
| The Exocrine portion of the Pancreas produces enzymes which ________ breakdown fats | Chemically |
| A muscle that controls the flow of bile into the Descending Duodenum | Sphincter of Oddi |
| The most expanded portion of the Digestive System | Stomach |
| 3 Main Structures of the Stomach: 1. 2. 3. 4. | 1. Fundus - expanded balloon portion (Anterior & Lateral - underneath Left Hemidiaphragm) 2. Body (Corpus) - Large Central Portion (Greater and Lesser Curvatures) 3. Pylorus - Most distal portion (Ulcers most commonly found here) 4. Pyloric Antrum |
| Shape and Location of the Stomach | "J-Shape" - Location dependent on body habitus (Typically the LUQ) |
| Unique characteristic of the Stomach | Collapses upon itself when it is empty into folds called Rugae |
| Function of the Stomach | 1. Serves as a large "mixing bowl" - forms partially digested food into a liquid mass (Chyme) 2. Gastric Glands secrete Pepsin and Hydrochloric Acid - breaks down Carbs and Proteins 3. Stomach wall has a mucous membrane which protects the wall from acid |
| The Internal Lining of of the Stomach has numerous Longitudinal Folds called _______, (Stomach collapses on itself and forms these folds when empty) and consists of a ______ ______ for protection of the wall of the Stomach against ______ ______. | Rugae; Mucous Membrane; Hydrochloric Acid |
| Layers of the Stomach: 1. 2. 3. | 1. Mucosa - Inner Layer 2. Submucosa - Middle Layer 3. Muscle - Outer Layer |
| Partially digested food that has been formed into a liquid mass | Chyme |
| Where does the Fundus lie in respect to the Body of the Stomach? | The Fundus lies posterior to the Body of the Stomach |
| Proximal and shortest portion of the Small Intestine | Duodenum |
| The Duodenum is the shortest segment of the small intestine measuring ___ inches in length | 10 |
| Unique Characteristic of the Duodenum - Forms a "____-Shaped Loop from its connection with the ______ to its junction with the ______, the ______ lies within and is called the "______ __ ___ ______." | C; Stomach; Jejunum; Pancreas; Romance of the Abdomen |
| Location of the Duodenum | Retroperitoneal - RUQ |
| The Ascending Duodenum ascends left side of the Abdomen to join with the Jejunum at what junction and what is the junction called? How is the junction held in place (suspended by)? | Duodenojejunal Junction; Angle of Treitz, Ligament of Treitz |
| Parts of the Duodenum in order: 1. 2. 3. 4. | 1. Duodenal bulb (Stomach side) 2. Descending Duodenum (receives Common Bile and Pancreatic Ducts) 3. Transverse or Horizontal Duodenum 4. Ascending Duodenum (meets the Jejunum at the Angle of Treitz) |
| 3 Portions of the Small Intestine: 1. 2. 3. | 1. Duodenum 2. Jejunum 3. Ileum |
| Middle segment which forms 2/5ths of the Small Intestine | Jejunum |
| Jejunum Quadrant location | LLQ |
| The lining of the Jejunum has finger-like projections called ______, What is the function of these projections? | Microvilli; absorb digested particles through blood capillaries which eventually lead to the Portal Vein of the Liver |
| What is the function of the Portal Vein (Liver) | Brings nutrients from the blood capillaries of the Microvilli to the Liver for further detoxification before blood enters the Circulatory System for use in the body |
| When the Jejunum is filled with Barium, it appears _______ due to the _______ | Feathery; Microvilli |
| Function of the Jejunum | Primarily responsible for the absorption of digested nutrients into the blood stream |
| Distal or 3rd portion that comprises 3/5ths of the Small Intestine | Ileum |
| Function of the Ileum of the Small Intestine | Serves as a passageway for waste material into the Large Intestine - it is the smallest in diameter |
| Quadrant location of the Ileum | RLQ |
| The Ileum ends here with it's junction with the Cecum of the Large Intestine - visualized radiographically to ensure the entire Small Intestine has been examined. | Terminal Ileum (TI) |
| A small muscular valve which controls the flow of Intestinal contents between the Ileum and Cecum | Ileocecal Valve |
| Structures of the Large Intestine from Proximal to Distal (9): | Cecum → Ascending Colon → Right Colic Hepatic Flexure → Transverse Colon → Left Colic Splenic Flexure → Descending Colon → Sigmoid Colon → Rectum → Anus |
| Longitudinal bands which pull the Large Intestine into pouches | Taenia Coli |
| Pouches in the Large Intestine | Haustra |
| Functions of the Large Intestine: 1. 2. 3. | 1. Absorption of Water, Vitamins k, B, and Amino Acids 2. Elimination of gas and fecal material produced in the process of Digestion 3. Absorption of Inorganic Salts |
| The Large Intestine begins in the _____ _____ ______ at the _____ and ends at the _____ which is the terminal portion of the Large Intestine | Lower Right Quadrant; Cecum; Anus |
| Kidneys extend from ______ to ______ | T11-L3 |
| Kidney Location | Retroperitoneal - Right and Left Upper Quadrants - between Xiphoid Process and Iliac Crest |
| The Superior and Inferior borders of the Kidney are called? | Poles |
| Renal Blood Supply: a. b. | a. Right and Left Renal Artery: Enters at the Hilum of Kidney and supplies Arterial blood to the Kidneys b. Right and Left Renal Veins: Filtered blood leaves Kidney via the Hilum and join the IVC → Deoxygenated filtered blood to Heart |
| Blood flow through the Nephron: 1. Unfiltered blood.... 2.Once Filtered.... | 1. Unfiltered blood from Renal Artery is brought to Nephron by the Afferent Arteriole Vessel 2. Once filtered, blood leaves Nephron via Efferent Arteriole Vessel which eventually brings the filtered blood to the Renal Vein |
| Functional Unit of the Kidney | Nephron |
| Three vital functions of the Nephron: 1. 2. 3. | 1. Filtration 2. Reabsorption 3. Secretion |
| Serves as the entrance and exit points of the Kidneys | Hilum |
| The outer layer of fibrous tissue that covers the Kidney | Renal Capsule |
| Beneath the outer covering of the Kidney, two layers which form the Parenchyma of the Kidney: 1. 2. | 1. Cortex 2. Medulla |
| Outer layer of tissue forming the periphery of the kidney - composed of the Nephrons | Cortex |
| Inner layer of the Kidney, consisting of collecting tubules, which empty into striated cones called the Renal Pyramids | Medulla |
| Triangular shaped structures, with their bases facing the Cortex and their Apices within the Medulla - composed of a collection of tubules that converge at an opening called the Renal Papilla | Renal Pyramids |
| Hollow flattened tubes which the Renal Papilla drain into | Minor and Major Calyces |
| ____ to ____ Minor Calyces unite to form ___ to ___ Major Calyces | 4-13; 2-5 |
| The Major Calyces converge to form the? | Renal Pelvis |
| Expanded funnel-like structure that becomes continuous with the Ureter | Renal Pelvis |
| The Central Region of the Medulla which consists of the Renal Pelvis, Calyces, and the Major Renal blood Vessels | Renal Sinus |
| Major Renal Blood Vessels | Right and Left Renal Artery - Right and Left Renal Vein |
| Functions of the Kidney: 1. 2. 3. | 1. Remove waste products and excess fluid 2. Regulate concentration of Water, Sodium, Potassium, and electrolytes within body to maintain balance 3. Make hormones that help control blood pressure and stimulate bone marrow which make red blood cells |
| Two tubes, which urine passes through by means of peristalsis from the Kidneys to the Urinary Bladder | Ureters |
| Junction where the Ureters enter the Bladder at it's posterolateral border | Ureterovesical Junction (UVJ) |
| Distal portion of the Urinary System - narrow muscolo-membranous tube lying at the floor of the Bladder which conveys urine from the Bladder to the exterior of the Body for elimination | Urethra |
| The two sphincter muscles that surround the Urethra | Internal and external sphincter |
| What type of control is the Internal Sphincter of the Urethra under? | Involuntary |
| What type of control is the External Sphincter of the Urethra Under? | Voluntary |
| What is a distinct characteristic of the Male Urethra? | Common to both the Urinary and Reproductive System |
| How long is the Male Urethra? | 7-8 inches |
| 3 parts of the Male Urethra: 1. 2. 3. | 1. Prostatic Urethra - 2. Membranous Urethra - Shortest portion 3. Cavernous Urethra - longest portion |
| 3 points of constriction along the path of the Ureters (common site for Kidney Stones) 1. 2. 3. | 1. Where the Ureter crosses the Pelvic Brim 2. Ureterovesical Junction (UVJ) - Bladder entrance 3. Ureteropelvic Junction (UPJ) - Kidney Hilum |
| Structures of the Urinary Bladder (two portions): 1. 2. | 1. Detrussor Muscle 2. Trigone |
| Smooth muscle of the Bladder which expands when it is full | Detrusor Muscle |
| Inverted triangle in the Bladder where the Ureters enter at the base and the Urethra exits at the Apex - the UVJ is at the base of this triangle | Trigone |
| The Kidneys are part of which Body System? | Endocrine |
| Due to its attachment to the Diaphragm, the Kidneys move how much on inspiration and how much when going from supine to recumbent? | I inch - Inspiration 2 inches - from supine to recumbent |
| Bony Structures of the Abdominopelvic Cavity: 1. 2. 3. 4. | 1. 5 Lumbar Vertebrae 2. Sacrum 3. Coccyx 4. Pelvis |
| The Lumbar Spine have large _____-shaped bodies | Bean |
| Structures of the Lumbar Spine: 1. 2. 3. 4. | 1. Body 2. Transverse Processes 3. Spinous Processes 4. Vertebral Foramen |
| A tuft of capillaries formed by small branches of the Renal Artery - filters the blood from the Afferent Arteriole | Glomerulus |
| A double walled membranous sac surrounding the Glomerulus, allows protein free plasma called Glomerular Filtrate to pass through its membrane into the Efferent Arteriole | Bowman's Capsule |
| How many Lumbar Spine are there? | 5 |
| Largest Lumbar vertebral body? | L5 |
| What are the Transverse Processes formed by? | The junction of the Lamina and Pedicles |
| The Square Central Portion of the Lumbar Spine? | Body |
| What Bone bears the weight of the body? | L5 |
| Length and Location of the female Urethra? | 1 1/2 inches; passing behind the Symphysis Pubis |
| Function of the Urinary Bladder? | Hollow, muscular organ which serves as a reservoir for urine |
| Kidneys form _____-____ degree angle with the Midsagittal Plane due to the Kidneys lying on the _____ _____ | 20-30; Psoas Muscles |
| Urination or Voiding | Micturation |
| 2 wing-like structures extending laterally from the body of the Lumbar Vertebrae? | Transverse Processes |
| Large, thick and blunt processes which lie almost horizontally and posteriorly to the body of the Lumbar Vertebrae - has a palpable tip | Spinous Processes |
| On either side, forms the Spinous Process - lie posterior to the Pedicles and Transverse Processes, part of the Lamina and Pars Articularis | Lamina |
| Strong, directed posteriorly from the body of the Vertebrae. Means "Little Foot" in latin. | Pedicles |
| Formed by the Inferior Articular Process of Above vertebral body and Superior Articular Process of the vertebra below - Thought to resemble a Scotty Dog. | Apophyseal Joint |
| Apophyseal Joints are what type of Joint? | `Diarthroidal Gliding Joints |
| What movements do the Diarthroidal Gliding Joint (Apop) allow? | Flexion, Extension, Lateral Bending and Twisting |
| Scotty Dog of the Lumbar Vertebrae: Ear - Nose - Eye - Neck - Front Leg - | Ear - Superior Articular Process Nose - Transverse Process Eye - Pedicle Neck - Pars Articularis Front Leg - Inferior Articular Process |
| L5 is angled ____ degrees in males and ____ degrees in females | males - 30 degrees females - 35 degrees |
| Best demonstrated on an Oblique position of the Lumbar Spine? | Apophyseal Joints |
| Best demonstrated on a Lateral position of the Lumbar Spine? | Intervertebral Foramen |
| What is the Intervertebral Foramen formed by? | The Superior and Inferior notches of the Pedicles of stacked vertebrae |
| What is transmitted through the Intervertebral Foramen? | Spinal Nerves and Blood Vessels |
| What is the Vertebral Foramen formed by? | The anterior portion of the body and the vertebral arch posteriorly |
| What is the Vertebral Foramen's function? | It is used as a tunnel in which the Spinal Cord passes through |
| Structures of the Intervertebral Disk Space: 1. 2. 3. | 1. Nucleus Pulposis 2. Annulus Fibrosis 3. Intervertebral Joints |
| Function of the Intervertebral structures | To provide a cushion between the vertebrae, helping to absorb shock during movement of the Spine |
| Central mass of soft, pulpy, semigelatinous material | Nucleus Pulposis |
| An outer fibrocartilaginous disk which surrounds the Nucleus Polposis | Annulus Fibrosis |
| Located between the Vertebral bodies | Intervertebral Joints |
| What type of Joints are the Joints between the Vertebral Bodies and what is their movement? | Amphiarthroidal - Slightly moveable |
| Largest of the three divisions of the Innominate bones of the Pelvis? | Ileum |
| Location of the Ileum | Superior to the Acetabulum, to its superior margin at Iliac Crest |
| What does the Ileum of the Pelvis consist of: 1. 2. | 1. Body 2. An Ala or Wing |
| The Ileum makes up what portion of the Acetabulum? | 2/5ths |
| The Ilium (roughened area called the Auricular Surface) articulates with the Sacrum to form what Joint and what type of Joint is it? | Sacroiliac Joint (SI) - Amphiarthroidal Joint, Slightly moveable |
| The thinner, more flared superior portion of the Ilium forming the prominence of the Pelvis | Wings or Ala |
| The Superior palpable border of the Ileum - Located at what level? | Iliac Crest, L4-L5 |
| Where is the CR directed when performing an AP Abdomen - KUB Projection? | To the Level of Iliac Crest |
| The Iliac Crest lies between what two prominences? | ASIS and PSIS |
| What is the Vertebral level of the Posterior Superior Iliac Spine (PSIS)? | L3-L4 |
| A sharp prominence on the Lateral surface of the Ilium, secondary positioning landmark for the Abdomen. | Anterior Superior Iliac Spine (ASIS) |
| What is the Vertebral Level of the Anterior Superior Iliac Spine (ASIS)? | S1-S2 |
| Lies inferior and posterior to the Acetabulum and consists of a Body, Spine, Two Rami, and a Tuberosity. | Ischium |
| What is the function of the Ischium? | Supports the body in the seated position |
| The Ischium makes up what portion of the Acetabulum? | 2/5ths |
| Sharp pointed process located at the inferior portion of the Greater Sciatic Notch, where the body of the Ischium extends superiorly to join with the Ilium. | Ischial Spine |
| Unique characteristic of the Ischial Spines? | A unique reference point in childbirth as the narrowest portion of the Pelvic Cavity |
| What are the two Rami of the Ischium? 1. 2. | 1. Superior Ramus 2. Inferior Ramus |
| Ramus that extends downward from the Acetabulum, ending at the Ischial Tuberosity? | Superior Ramus |
| Ramus that curves medially from the Ischial Tuberosity to join with the Inferior Ramus of Pubis? | Inferior Ramus |
| Roughened area that is the most inferior portion of the Pelvis? | Ischial Tuberosity |
| What level is Symphysis Pubis located and why must it be included on the KUB - AP Abdomen image? | Coccyx; the most inferior portion of the Abdomen, ensures that the Bladder has been included on the image |
| The Symphysis Pubis makes up what remaining portion of the Acetabulum? | 1/5th |
| The Symphysis Pubis consists of: 1. 2. | 1. Body 2. Two Rami |
| What is used as a secondary palpable location to the Symphysis Pubis, to save embarrassment to or make the patient more comfortable? | Greater Trochanters which are also located at the level of Symphysis Pubis |
| What is used to located the Midsagittal and and Superior/Anterior portion of the Diaphragm? | Xiphoid Process - T9-T10 |
| What forms the Symphysis Pubis? | The two Rami of the Pubic bones where they meet in the middle |
| What type of Joint is the Symphysis Pubis? | Amphiarthroidal Joint - limited movement |
| What are the two pubic bones separated by that form Symphysis Pubis? | A fibrocartilaginous disk |
| Ramus that extends anteriorly and medially from the body, its superior border has a ridge called the Pectineal line that becomes continuous with the Acruate Line of the Ilium | Superior Ramus |
| Ramus that extends inferiorly to join with the inferior Ramus of Ischium to enclose the Obturator Foramen | Inferior Ramus |
| Below Symphysis Pubis, the Pelvic Rami of Pubis and Ischium form the ______ ______ | Pubic Arch |
| What is formed by the superior portion of Symphysis Pubis anteriorly and the Prominent portion of the Sacrum posteriorly? | The Pelvic Brim |
| The largest Foramen in the Human Skeleton? | Obturator Foramen |
| The Sacrum consists of _____ sacral segments | 5 |
| A concave prominent ridge of bone on the upper anterior margin of the 1st Sacral segment, the most anterior portion of the Sacrum. | Sacral Promontory |
| Located in the Central portion of bone in the Sacrum, decreases in size as it descends inferiorly | The Body |
| Located on each side of the Sacral Bodies, has a large wing-like mass, and is actually fused transverse processes? | Ala |
| Articulation between the Sacrum and Ilium - what type of Joint is this? | SacroIliac (SI) Joints - Amphiarthroidal - limited movement |
| The Sacroiliac (SI) Joints are obliqued at what degree of an angle? | 25-35 degrees |
| Most inferior portion of the Sacrum is called the? | Apex |
| Two small processes located on the inferior aspect of the 5th Sacral segment? | Sacral Cornua |
| What is the opening in the Spinal Canal on the 5th Sacral segment called - the lamina are absent here? | Sacral Hiatus |
| End location of the Spine | Conus Medullaris |
| How many Sacral Foramen are there? | 16 or 8 pair |
| The Coccyx Bone consists of how many fused segments? | 3-5 |
| The Distal portion of the Coccyx bone is called the _____ and the Superior portion is called the ______ | Apex; Base |
| The size of the Coccyx bone? | About the size of a postage stamp |
| How many pairs of Spinal Nerves are there? | 31 Pairs |
| What AEC photocells would be used for an AP Abdomen? | Two outer photocells |
| What Focal Spot size is used for an AP Abdomen? | Large Focal Spot |
| What indicates no motion on an AP Abdomen? | Sharp bony margins of the Ribs and gas margins (Lungs) |
| What indicates no rotation on an AP Abdomen? | Iliac Wings and Obturator Foramen are equal in size and shape |
| How do we know that sufficient kVp was used when analyzing the image of an AP Abdomen? | Sufficient kV ensuring a long scale contrast - visualizing the outlines of the Psoas Muscles. Lumbar Transverse Processes, and Abdmoninal Ribs |
| Breathing Instruction for an AP Abdomen - KUB? | Image is taken on Expiration- raising the Diaphragm and compressing the abdominal organs allows all abdominal contents to be visualized on the image. |
| What SID is used for an AP Abdomen supine - KUB Projection? | 40 inch SID |
| How to locate the Greater Trochanters? | Inverting and Everting the feet and palpating the proximal lateral Femur |
| Xray tube placement for the AP Abdomen? | Vertical - tube centered to the center of the table |
| Image Receptor orientation for an AP Abdomen? | IR Lengthwise (if T-shot is necessary, an additional image is taken with the 2nd in horizontal orientation) |
| Image Selected after entering patient info in the computer | AP Abdomen selection |
| What is done to the table prior to assisting the patient on the table? | Lower the Table |
| How is the patient lying (body positioning) when taking the AP Abdomen - KUB Projection? | Supine Recumbent, arms at sides away from the body, legs extended, Spine and Pelvis aligned, no rotation. |
| Where is the Midsagittal Plane positioned? | Center of Midsagittal centered to the midline of the table |
| CR direction when performing an AP Abdomen - KUB? | Palpate for Iliac Crest, CR is directed Perpendicular to Midsagittal at the level of Iliac Crest |
| Where is the bottom of the IR placed? | at the level of Symphysis Pubis |
| How is the X-ray beam collimated on the AP Abdomen - KUB? | to the size of the Image Receptor - 2nd shot for a T-shot also to size of the Image Receptor, starting 1-inch below the top of the light field of first image. |
| Marker placement for an AP Abdomen? | Right anatomic side marker on the lower right corner of the Image Receptor |
| How is the body centered for the AP Abdomen? | Midsagittal Plane to midline of the table |
| On a Hypersthenic patient, why are two AP projections performed? | To ensure that the entire Abdomen is included |
| What is done upon completing the exam? | Analyze images for medicolegal aspects, anatomical structures, positioning and exposure factors, Annotate image as needed and send out for billing (PACS), provide patient with post-examination instructions, clean and sanitize room for next patient |
| How are exposure factors determined on an image (mAs and kV)? | Sufficient exposure time (mAs) and long scale contrast (kV) visualizes the Psoas Muscle outlines, Lumbar Transverse Processes and Abdominal Ribs |
| How to determine the entire abdomen is demonstrated? | The entire Abdomen should be included from the Lower Liver margin to Symphysis Pubis |
| What is Involuntary motion - which can degrade an xray image? | Body movements outside of your control - heart beat, eye twitch, breathing |
| What is Voluntary motion - which can degrade an Xray image? | Body movement by choice or intent - talking, moving parts, leaning |
| What is Quantum Mottle and corrective actions taken when present on the image? | It is the main and the most significant source of noise caused by insufficient mAs causing noise on an image (appears grainy)- corrected by raising the mA |
| When is a Large Focal Spot used on an image and what does it affect? | Used when a high intensity x-ray beam is required for thicker anatomy (over 10 cm) requiring less detail (extremity) - It effects Spatial resolution - the amount of blur and unsharpness on an image) |
| When is a grid used and what purpose does it serve? 1. 2. 3. | 1. On a part that measures over 10 cm 2. Reduces scatter or noise on an image 3. reduces patient dose |
| When is a KUB ordered by a Radiologist? | Image of the Kidney, Ureters, and Bladder when the Urinary System is to be evaluateds |
| What is a KUB Abdomen? | A general survey of the Abdomen to include shadows of the Kidneys and Symphysis Pubis to ensure the area of the Urinary Bladder is visualized |
| What is magnification? How is it corrected? | enlargement of an objects size and shape - which is equal to image size/object size - SID/OID - increase SID and decrease OID |
| What is distortion and how is it corrected? | A misrepresentation of an objects size and shape - due to divergence of the xray beam - correct by making sure part is centered to the CR beam, the focal spot is the center of the part to be xrayed and the Center of the Central Ray |
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