Thorax and Abdomen
2 Abdomen Series
Anatomy
Lumbar spine (5 vertebrae), Anterior superior iliac spine (ASIS), Iliac crest, Psoas muscles, Kidneys, Diaphragms, Symphysis pubis
Projections
Abdomen, AP supine
CR Location
Abdomen, AP supine – CR perpendicular to and directed to center of IR (to level of iliac crest)
Evaluation Criteria
Abdomen, AP supine – Outer margins of ribs equal distance from the spine. Iliac wings are the same shape (no rotation). Symphysis pubis included.
Abdomen, AP upright
CR Location
Abdomen, AP upright – CR horizontal, to center of IR approximately 2 inches (5 cm) above iliac crest (to include diaphragm), which for the average patient places the top of the IR approximately at the level of the axilla.
Evaluation Criteria
Abdomen, AP upright – Outer margins of ribs equal distance from the spine. Iliac wings are the same shape (no rotation). Diaphragms included. Spine should be straight, aligned with center of IR.
Abdomen, Lateral Decubitus
CR Location
Abdomen, Lateral Decubitus – CR horizontal, directed to center of IR, at about 2 inches (5 cm) above level of iliac crest
Evaluation Criteria
Abdomen, Lateral Decubitus – Outer margins of ribs equal distance from the spine. Iliac wings are the same shape (no rotation). Diaphragms included. Spine should be straight, aligned to center of IR.
Abdomen, Dorsal Decubitus
Indications
Abnormal masses, accumulations of gas, air-fluid levels, aneurysms (widening or dilation of the wall of an artery, vein, or the heart)
Calcification of aorta or other vessels
Umbilical hernia
CR Location
Abdomen, Dorsal Decubitus – CR horizontal to center of IR 2 inches (5 cm) above iliac crest and to midcoronal plane
Evaluation Criteria
Abdomen, Dorsal Decubitus – Superimposition of posterior ribs and posterior borders of iliac wings and bilateral ASIS (no rotation). Diaphragms included.
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Hows & Whys of Abdominal Radiography
Why are some abdominal images performed upright?
To look for free air
Which side will free air rise to on an upright abdomen image?
The right
Why?
It is higher.
What structures must be included on an upright abdomen image?
Diaphragms
What is the supine abdomen image commonly referred to as?
KUB
What do the letters stand for?
Kidneys, ureters, and bladder
What structure must be included on the supine abdomen image?
The symphysis pubis
Why?
So you know the entire bladder was included on the image.
Why should abdominal images be performed on expiration?
To raise the diaphragms and allow the abdominal organs to spread out
What are the two triangular shaped muscles on either side of the spine?
The psoas muscles