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)Right ____________ 2)Epigastric 3)Left Hypochondriac 4)Right Lateral (Lumbar) 5)_______________ 6)Left Lateral (Lumbar) 7)Right Inguinal (Iliac) 8)____________ (Hypogastric) 9)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.