Transcript Chapter 3
Chapter 3 Abdomen Abdominal Systems • Digestive – ___________ – Small and Large Intestines – ___________ – Gall Bladder – Pancreas* The Other Systems • Urinary – __________ – 2 Ureters – Urinary bladder – _________ • Lymphatic – Spleen Peritoneum • Double walled membrane sac – ___________Peritoneum • Attached to abdominal wall – ____________ Peritoneum • Covering an organ – Peritoneal ___________ • Space between parietal and visceral peritoneum Peritoneum • Lubricated for _________ movement – ___________ • Abnormal collection of fluid • ____________of peritoneum – Bind abdominal organs to each other and the walls of the abdomen – Blood, lymph vessels, and nerve supplies Mesentery • _____________peritoneal fold – Extends anteriorly from the posterior abdominal wall – Connects ____________to abdominal wall Mesocolon • ___________ peritoneal • Four parts – ________ – Transverse – _____________ – Sigmoid Omentum • ____________ peritoneal fold • __________Omentum • Extends from lesser curvature to liver • __________ Omentum • Connects transverse colon to greater curvature • Over small bowel and forms an anterior abdominal apron (Fatty Apron) Greater and Lesser Sac • ___________ Sac – Largest portion of peritoneum (peritoneal cavity) • __________ Sac (Omentum Bursa) – Posterior to stomach – Area that the __________ encompasses Retroperitoneal and Infraperitoneal Table on Page ______ • _____________ – Organs behind the peritoneum – Less mobile • _____________ – Organs below the peritoneum Quadrants • Four Abdominal quadrants – Right _________ Quadrant – Right Lower Quadrant – Left __________ Quadrant – Left Lower Quadrant • Important when diagnosing organ involved • ____________Table Regions • “Tic-Tac-Toe” board on the abdomen. • Made by: – Right and left ___________(vertical) • Between ASIS and midsagittal plane – ______________ plane (horizontal) • Level of L1 – _____________ plane (horizontal) • Level of L5 9 Regions 1) 2) 3) 4) 5) 6) 7) 8) 9) Right ____________ Epigastric Left Hypochondriac Right Lateral (Lumbar) _______________ Left Lateral (Lumbar) Right Inguinal (Iliac) ____________ (Hypogastric) Left inguinal (Iliac) ____________ Topographical Landmarks • _______________(T9-10) – Superior portion of abdomen • Inferior Costal Margin (L2-3) – Gallbladder, Stomach • _____________(L4-5) – Mid Abdomen • Anterior Superior Iliac Spine (ASIS) – Slightly inferior Abdomen More Landmarks • Greater ____________ – Off of Femur – Just superior to symphysis pubis • ____________Pubis – Inferior margin of Abdomen • Ischial Tuberosity – Inferior to symphysis pubis Shooting the Abdomen • Remove all clothing with _____________ materials – Buttons – Snaps – Zippers – Underwire • ____________ – Patient probably won’t want to Patient Instructions • Hold breath on _____________ – “Take in a breath, blow it all the way out and hold your ______________” • Hold Still Technical factors • • • • Mid kV range ___________ Short time due to breath hold mA accordingly May need to use ___________ for pediatric patients. Abdominal Series • 3 Way Abdomen – ____________ – ___________ – Upright Abdomen KUB • Plain Film, Flat Plate • K – ____________ • U – Ureters • B - ___________ The KUB • • • • • • • 14 x 17 LW ___________ In Bucky/Grid Patient is ___________ Palpate _____________ Center midline at iliac crest Film must have inferior ribs and Symphysis ___________ Abdomen Anatomy • Muscles seen on X-ray – _____________ • Should be motionless – _____________ • Flanking the Spine AP Erect Abdomen • • • • • • Detects _____________Levels Patient is Erect 40” SID 14 x 17 LW in Bucky CR is midline and __________iliac crest Film must have _________and majority of pelvis. Symphysis pubis not important. Prone Abdomen • • • • Patient is Prone 14 x 17 in Bucky 40” SID CR is midline at _____________ Left Lateral Decubitus LLD • • • • • • For intraperitoneal ____________levels 14 x 17 XW 40” SID Patient in Left Lateral Decub CR directed midline __________iliac crest May need ___________ if patient cannot roll.