Radiographic Imaging in Abdomen and Pelvis
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Foregut structures: Liver, spleen and stomach/pancreas
Immediate: Large colon, renal structures, descending colon.
Lower abdominal pelvic cavity: hindgut, some midgut and some pelvic structures. Mostly gut tubes.
Gut divided in 4 hindgut regions:
1. Foregut supplied by celiac trunk( from 12 thoracic vertebra)
2. Midgut: Superior mesenteric artery( First lumbar vertebra)
3.) IMA from third lumbar vertebrae.
Upper abdomen: Foregut
Lower part: Cecum, descending colon, small intestine, pelvic structures.
GI anterior to uorgenital structures.
Intraperitoneal organs: Ventral to retroperitoneal organs.
The descending aorta becomes the abdominal aorta at the 12 thoracic vertebra. Aorta comes through the diaphragm at the aortic hiatus.
L4 where the abdominal aorta bifurcates into the common iliac arteries.
IVC forms at the LV5.
Caval hiatus at TV5.
Hepatic portal venous system: Anterior to caval venous structures.
Hepatic portal vein: Splenic + SMV posteriorly to the neck of the pancreas.
The aorta bifurcates at T5. The inferior vena cava forms one level below than the aorta does.
Nutcracker pathology: Aneurism in 1st segment of SMA compresses the left renal and the 3rd part of duodenum.
Anorexia causes compression of left renal vein and 3rd part of the deudenum due to loss of fat tissue.
Duodenum appears as a C shape in radiographs.
Jejunum located in the left side of abdomen; Ileum over the right side. Physical appearance of the jejunum is like a fuzzy teddy bear.
Hindgut starts on the splenic flexure, contains descending and sigmoid colon.
Midgut is where the hepatic flexure, ascending colon and transverse colon is located.
IVC( right); Descending aorta( left)
Hepatic veins drain blood from the liver to the IVC and then to the heart.
Spleen is located at the 9-10th level of the rib cage
Hepatic portal vein is posterior to the neck of the pancreas.
At t12 level: Aorta becomes abdominal aorta.
Portal vein located dorsal to the pancreas.
Large colon has large pockets of air.
L1 is the trans pyloric plain.Kidneys appear and the SMA appears as a bold spot.
At the L2 level, we have the kidneys.
On the left side, the testicular vein drains into the renal vein on males.
On small intestines, there are no air pockets.
At L2-L3: We have the quadrates lumborum and Psoas major.
At L4 the aorta divides into common iliac arteries. The Psoas major becomes a bigger muscle. The ureter appears anteriorly to the psoas muscle. Femoral nerve( laterally) and obturator nerve(medially) can be seen.
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