Question 1

What CR centering should be used for a dorsal decubitus projection of the abdomen (if the diaphragm is to be included)?

Accepted Answer

The CR should be centered 2 inches (5 cm) above the iliac crest for a dorsal decubitus projection of the abdomen if the diaphragm is to be included. This is because the diaphragm is located at the level of the 10th thoracic vertebrae, which corresponds to the level of the inferior aspect of the rib cage. Therefore, by centering 2 inches (5 cm) above the iliac crest, the entire diaphragm can be included in the image.

Question 2

A patient comes to radiology with possible bleeding within the abdomen.The patient is unable to stand or sit for any projections.Which of the following projections would be most effective in demonstrating fluid within the abdomen for this patient?

Accepted Answer

The answer of A patient comes to radiology with possible...

Question 3

A radiograph of a supine KUB on an obese patient reveals that the symphysis pubis is cut off along the bottom of the radiograph.The top of the left kidney is also cut off along the top of the radiograph.What modifications does the technologist need to make for the repeat exposure?

Accepted Answer

Using two cassettes in portrait orientation, one centered lower and one centered higher, will ensure that both the top of the kidneys and the symphysis pubis are included in the radiographs.

Question 4

A radiograph of an anteroposterior (AP) abdomen demonstrates elongation (widening) of the left iliac wing and narrowing of the right iliac wing.Which one of the following positioning errors produced this radiographic outcome?

Accepted Answer

The elongation of the left iliac wing and narrowing of the right iliac wing indicates that the patient was rotated towards the left side, resulting in a left posterior oblique position.

Question 5

Why is the left lateral decubitus preferred over the right lateral decubitus abdomen for an acute abdomen series?

Accepted Answer

The left lateral decubitus position is preferred over the right lateral decubitus position for an acute abdomen series because in the left position, any intraperitoneal air will be visualized along the lower liver margin. This is because the liver is higher on the right side of the body, and gas within the peritoneal cavity will rise to the highest point. By placing the patient in the left lateral decubitus position, any gas in the peritoneal cavity will migrate to the left side, allowing the lower liver margin to be better visualized. This can aid in detecting abnormalities such as free air or fluid within the peritoneal cavity.

Question 6

A patient is in the intensive care unit after abdominal surgery.The surgeon is concerned about a possible perforated bowel.The patient cannot stand or sit.Which of the following positions will best demonstrate any possible intra-abdominal free air?

Accepted Answer

The left lateral decubitus position is best for demonstrating free air in the abdomen when the patient cannot stand or sit, as it allows air to rise and be visualized against the liver on an X-ray.

Question 7

Which of the following factors must be followed for an AP erect abdomen projection?

Accepted Answer

For an AP erect abdomen projection, the patient should be upright for a minimum of 5 minutes before imaging to allow gas to rise and the bowel to settle, resulting in better visualization of abdominal organs. Collimating to the level of ASIS may be necessary for proper positioning, but it is not a factor specific to this projection. A higher kV technique may be used for larger patients or to minimize scatter radiation, but it is not a requirement for this projection. Increasing the SID to 72 inches may help reduce magnification, but it is not practical in most clinical settings and not necessary for this projection.

Question 8

Why is the PA projection of the abdomen less desirable for a KUB than the AP projection?

Accepted Answer

The PA projection places the kidneys farther from the image receptor compared to the AP projection, which can result in less detailed images of the kidneys due to increased distance and potential magnification.

Question 9

Which of the following conditions can produce a dynamic bowel obstruction?

Accepted Answer

All of the given conditions can produce a dynamic bowel obstruction. 
Fibrous adhesions can result from previous abdominal surgeries or infections, and they can cause the bowel to become tangled and twisted, leading to obstruction. 
Crohn's disease is a chronic inflammatory condition that can cause narrowing and strictures in the bowel, which can lead to obstruction. 
Intussusception is a medical emergency in which one portion of the bowel telescopes into another portion of the bowel, causing an obstruction. All three of these conditions are examples of dynamic bowel obstruction, which means that the blockage is caused by a physical barrier in the bowel that can change in size or shape over time.

Question 10

A patient comes to radiology with a clinical history of pneumoperitoneum.The patient is able to stand and lie recumbent.Which one of the following projections will best demonstrate the severity of this condition?

Accepted Answer

Pneumoperitoneum is the presence of air in the peritoneal cavity. An AP erect abdomen is the best projection to demonstrate the severity of pneumoperitoneum as it allows the air to rise and collect in the supine position, thus making it more visible on the radiograph. Other positions may not be as effective in demonstrating the condition.

Question 11

A patient comes to radiology with a clinical history of a possible abdominal aortic aneurysm.Which of the following abdominal projections would best demonstrate this condition?

Accepted Answer

The dorsal decubitus position allows for a lateral view of the abdomen, which can help in visualizing the abdominal aorta and any potential aneurysm.

Question 12

A patient enters the ED with a possible perforated duodenal ulcer.The patient is ambulatory.Which of the following projections will best demonstrate free intraperitoneal air in the abdomen?

Accepted Answer

An erect PA chest X-ray is often used to detect free air under the diaphragm, which indicates the presence of free intraperitoneal air due to a perforated ulcer.

Question 13

Which of the following conditions is NOT considered a clinical indication for an acute abdominal series?

Accepted Answer

A kidney stone is a specific condition that would be better evaluated with a specialized imaging modality such as CT or ultrasound, rather than a plain radiographic study like an acute abdominal series. The other three conditions listed (obstruction, infection, intra-abdominal mass) can potentially be detected or suspected with an acute abdominal series.

Question 14

A patient enters the ED with a possible ascites.The patient is ambulatory.Which one of the following projections of the acute abdomen series will best demonstrate this condition?

Accepted Answer

The AP erect position is best for demonstrating free air under the diaphragm or air-fluid levels, which can be indicative of ascites, as it allows any fluid in the abdomen to settle and air to rise, creating a clearer image of the separation between fluid and air.

Question 15

A dorsal decubitus abdomen is ordered on a patient.The patient is placed on his back on a cart.The CR will enter the left side of the patient with the patient's right side against the image receptor.What type(s) of marker(s) should be used?

Accepted Answer

Using right and decubitus markers will clearly indicate the position and side of the patient, and help with proper orientation of the image.

Question 16

To ensure that the diaphragm is included on the erect abdomen projection, the top of the image receptor should be at the approximate level of the:

Accepted Answer

The top of the image receptor should be placed at the level of the axilla to ensure that the diaphragm is included in the erect abdomen projection.

Question 17

Ileus is the formal term for:

Accepted Answer

Ileus refers to a condition where there is a partial or complete blockage of the intestines, leading to a disruption in the flow of intestinal contents. This can cause symptoms such as abdominal pain, bloating, nausea, and vomiting. It is different from a perforated bowel (A), bleeding in the abdomen (B), or free air in the peritoneal cavity (D).

Question 18

Which of the following clinical indications would suggest the need for a dorsal decubitus abdomen position?

Accepted Answer

A dorsal decubitus abdomen position is typically used for imaging of aneurysms, umbilical hernias, and calcification of the aorta. This position allows for optimal visualization of these structures.

Question 19

Where must the CR be centered for an AP supine projection of the abdomen as part of the acute abdominal series?

Accepted Answer

The CR must be centered at the level of the iliac crest for an AP supine projection of the abdomen as part of the acute abdominal series. This is where the greatest concentration of abdominal organs is located.

Question 20

Which of the following landmarks is often easier to palpate to locate the lower abdomen on the obese patient?

Accepted Answer

The answer of Which of the following landmarks is often...

Quiz 3: Abdomen

What CR centering should be used for a dorsal decubitus projection of the abdomen (if the diaphragm is to be included) ?