Useful lecture for Allied Health Professionals, Radiological Technologists, Medical Students and Nurses

1. Radiographic Anatomy
Abdomen
Awais Qayyum
BS MIT, MS HCM
Demonstrator Radiology Technology
Khyber Medical University
Institute of Paramedical Sciences
Peshawar, Pakistan
awais.ipms@kmu.edu.pk

2. Anteroposterior Radiograph-AP
• Only the more important features seen in a standard
anteroposterior radiograph of the abdomen, with the
patient in the supine position.
• Examine the radiograph in a systematic order

6. 1. Bones
• In the upper part of the radiograph, the lower ribs
are seen. Running down the middle of the
radiograph are the lower thoracic and lumbar
vertebrae and the sacrum and coccyx.
• On either side are the sacroiliac joints, the pelvic
bones, and the hip joints.

8. • This casts dome-shaped shadows on each side; the
one on the right is slightly higher than the one on the
left
2. Diaphragm

9. • On either side of the vertebral column, the lateral borders of the
psoas muscle cast a shadow that passes downward and
laterally from the 12th thoracic vertebra.
3. Psoas muscle
4. Liver
• This forms a homogeneous opacity in the upper part of the
abdomen.
5. Spleen
• This may cast a soft shadow, which can be seen in the left 9th
and 10th intercostal spaces.

10. • These are usually visible because the perirenal fat surrounding
the kidneys produces a transradiant line.
6. Kidneys
7. Stomach and
intestines
• Gas may be seen in the fundus of the stomach and in the
intestines. Fecal material may also be seen in the colon.
8. Urinary bladder
• If this contains sufficient urine, it will cast a shadow in the
pelvis.

14. Hepatomegaly

15. Radiographic Appearances
of the Gastrointestinal Tract

16. Stomach
• The stomach can be demonstrated radiologically by
the administration of a watery suspension of barium
sulfate (barium meal).
• With the patient in the erect position, the first few
mouthfuls pass into the stomach and form a triangular
shadow with the apex downward.
• The gas bubble in the fundus shows above the fluid
level at the top of the barium shadow.

17. • As the stomach is filled, the greater and lesser
curvatures are outlined and the body and pyloric
portions are recognized. The pylorus is seen to move
downward and come to lie at the level of the third
lumbar vertebra.
• Fluoroscopic examination of the stomach as it is filled
with the barium emulsion reveals peristaltic waves of
contraction of the stomach wall, which commence
near the middle of the body and pass to the pylorus.
The respiratory movements of the diaphragm cause

20. Duodenum
• A barium meal passes into the first part of the duodenum and
forms a triangular homogeneous shadow, the duodenal cap,
which has its base toward the pylorus.
• Under the influence of peristalsis, the barium quickly leaves the
duodenal cap and passes rapidly through the remaining
portions of the duodenum.
• The outline of the barium shadow in the first part of the
duodenum is smooth because of the absence of mucosal folds.
In the remainder of the duodenum, the presence of plicae
circulares breaks up the barium emulsion, giving it a floccular

23. Jejunum and Ileum
• A barium meal enters the jejunum in a few minutes
and reaches the ileocecal junction in 30 minutes to 2
hours, and the greater part has left the small intestine
in 6 hours.
• In the jejunum and upper part of the ileum, the
mucosal folds and the peristaltic activity scatter the
barium shadow
• In the last part of the ileum, the barium meal tends to

25. Large Intestine
• The large intestine can be demonstrated by the administration
of a barium enema or a barium meal. The former is more
satisfactory.
• When the large intestine is filled, the entire outline can be seen
in an anteroposterior projection.
• The characteristic sacculation are well seen when the bowel is
filled, and, after the enema has been evacuated, the mucosal
pattern is clearly demonstrated.
• The appendix frequently fills with barium after an enema.

29. Biliary Duct
• The bile passages normally are not visible on a radiograph.
• Their lumina can be outlined by the administration of various
iodine-containing compounds orally or by injection.
• When taken orally, the compound is absorbed from the small
intestine, carried to the liver, and excreted with the bile. On
reaching the gallbladder, it is concentrated with the bile.
• The concentrated iodine compound, mixed with the bile, is now
radiopaque and reveals the gallbladder as a pear-shaped
opacity in the angle between the right 12th rib and the vertebral
column.

32. Radiographic Appearances
of the Urinary Tract

33. Kidneys
• The kidneys are usually visible on a standard anteroposterior
radiograph of the abdomen because the perirenal fat
surrounding the kidneys produces a transradiant line.
Calyces, Renal Pelvis, and Ureter
• Calyces, the renal pelvis, and the ureter are not normally visible
on a standard radiograph. The lumen can be demonstrated by
the use of radiopaque compounds in intravenous pyelography
or retrograde pyelography.

34. • With intravenous pyelography, an iodine-containing compound
is injected into a subcutaneous arm vein. It is excreted and
concentrated by the kidneys, thus rendering the calyces and
ureter opaque to x-rays.
• When enough of the opaque medium has been excreted, the
bladder is also revealed.
• The ureters are seen superimposed on the transverse
processes of the lumbar vertebrae.
• The three normal constrictions of the ureters (at the junction of
the renal pelvis with the ureter, at the pelvic brim, and where
the ureter enters the bladder) can be recognized.

38. ASSESMENT

42. References
Text Base Content is copied from:
Snell's Clinical Anatomy by Regions - Wolters Kluwer
Image Courtesy:
https://radtechonduty.com
https://radiopaedia.org
https://jaypeedigital.com