Learning outcomes of the laboratory sessions

• To develop and enhance your radiographic and patient

management skills through simulated exercises and self and peer‐
evaluation exercises.
• To develop and enhance your understanding of the effect of exposure
factors, image recorder systems and radiographic positioning on the
radiograph.
• To provide an opportunity for you to practice some non‐routine
(non‐walk‐in patient / “trauma” radiographic techniques.
• To develop and enhance your skills in evaluating phantom and
clinical radiographs.
• To maximise your learning in the laboratory it is expected that you
will have familiarised yourself with the simulated positioning
exercises.

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Abdomen
MRS LABORATORY RULES
GENERAL
The MRS Laboratory will be used to develop pre‐clinical skills and undertake
other medical imaging practicals. The lab is to be thought of a “clinical
environment” and student behaviour must reflect this.
Students MUST obey the directions of supervising staff at all times. Failure to
follow staff directions will result in the student being immediately REMOVED
from the lab and the student will not be given an opportunity to complete any
unfinished lab exercise. That student may also be reported to the Associate
Dean Education of the Faculty of Health for potential misconduct action.
1. Closed in shoes MUST be worn in the lab.
2. Name ID labels MUST be visible and be attached to a clothing item.
3. Eating and drinking are NOT permitted in any area of the lab.
4. Personal items/bags etc. MUST be placed either in the secure lockers in
the lab corridor or in the lab pigeonholes adjacent to the x‐ray rooms.
5. MI student clinical uniforms must be worn for skills assessments.

PERSONAL RADIATION MONITORS (OLSD’S)

1. Students MUST wear their OLSD while in the lab complex.
2. OLSD’s MUST NOT be removed from the lab but MUST be returned to
the storage facility at the end of each practical session.
3. The ONLY time an OLSD is to be removed from the MRS Lab is when
students go on clinical placement.
4. Following clinical placement, students MUST return their OLSD to the lab
in the first week back on campus.
5. OLSD’s are initially provided at no cost to the student. However, if the
OLSD is lost, the student will be charged for a replacement.

X‐RAY ROOMS
1. A maximum of 6 students plus an instructor will be allowed in an x‐ray
room during an x‐ray exposure, if assessed as safe to do so.
2. All personnel in the x‐ray room at the time of exposure MUST be behind
the radiation barrier or, on very rare occasions, UNDER STAFF
DIRECTION, wearing appropriate lead equivalent protective equipment,
e.g. a lead apron and thyroid protector.
3. X‐ray exposures must only be made under the DIRECT SUPERVISION of a
staff member.
Compiled by Assoc Prof Madeleine Shanahan University of Canberra | Radiography of the 3
Abdomen
Radiographic Imaging 1/ 1G Schedule
2022

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Abdomen
Radiography of the Abdomen
Preparatory Exercises
These exercises must be completed PRIOR to attending your
scheduled laboratory
For the following, sketch the resultant radiographic image you would expect to
see. Include short notes to identify the key positioning criteria.

Supine Abdomen
showing the effect of patient’s right hip positioned closer to the IR. (i.e.
mid plane not perpendicular to IR)

Additional Notes:

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Abdomen
Erect abdomen
showing the effect of central ray positioned at iliac crest

Additional Notes:

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Abdomen
Radiography Using the table bucky
1. ROOM PREPARATION FOR TABLE BUCKY
Record the steps required to set up for a table bucky technique in the
laboratory.

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Abdomen
 Projections to be performed in Laboratory

Abdomen: Supine
Abdomen: Erect
Abdomen: Lateral decubitus on a trolley

• For all projections the appropriate side marker must be used.

• Attention to radiation protection is mandatory.
• For all projections appropriate collimation must be utilised.

For our laboratory: with a base exposure for grid

Projection SID kVp mAs
SUPINE 100cm 75 15
ERECT/LAT 100cm 80 20
DEC*

*You need to determine if there is an increase in soft tissue overlying the abdomen. If soft tissue
superimposing increases when patient erect / lat dec then exposure factors are increased.

What patient preparation is required for radiography of the abdomen?

Why is a chest radiograph taken as part of an acute abdomen series?

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Abdomen
Positioning

Abdomen
1. SUPINE ABDOMEN
Patient supine in true A.P. position with mid sagittal plane centred to and
perpendicular to the central long axis of the table. Check for rotation at both
shoulders and ASIS’s. Arms are placed away from trunk.

Central Ray
Region of Interest
Vertical, to midline, at approximately the level of
the iliac crest to include symphysis pubis.

Technical
SID 100 cm.

Respiration Phase
Suspended expiration

Evaluation Criteria
Refer to prescribed textbooks and list key
positioning evaluation criteria

Why is it recommended that abdominal radiographs are taken on

suspended expiration?

What instructions would you give to the patient so that the image is taken
on suspended expiration?

Why does the symphysis pubis need to be included on the supine

abdomen?

Assessment of image quality focuses on soft tissue structures in abdominal

radiography. What soft tissue structures do we expect to see on an
abdominal radiograph?
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Abdomen
 2. ERECT ABDOMEN
Patient A.P. or P.A. erect, either standing or seated, (if seated legs should be parted).
Midsagittal plane perpendicular and in line with central long axis of bucky.
Place arms away from trunk.
Region of Interest
Central Ray
Horizontal, to midline approximately 4-5 cm
above iliac crests.

Respiration Phase
Suspended expiration.

Technical
SID 100 cm.

Evaluation Criteria
As per supine abdomen. However, higher
centring point has been used to include
the diaphragm.

How long should the patient be standing or

seated before you take the image? Why?

Why is it important to note on the image that it

was taken erect?

Why is it important to include the diaphragm on

the erect projection?

How would you determine if the erect abdomen

was taken AP or PA? (think about e.g. the iliac
wings and how they would appear).

If the patient had a small bowel obstruction how

would it appear on this image?

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Abdomen
LATERAL DECUBITUS ABDOMEN
Commonly taken when you cannot obtain an erect projection (patient standing or
seated). Some workplaces are taking lateral decubitus instead of seated (on
trolley) erect abdomen.
1. Antero-posterior (AP) Left lateral decubitus against erect bucky.

Patient lies on their LEFT side on the trolley in true A.P. position,
midsagittal plane perpendicular and centred to IR. The arms are
raised so that they are superimposing the ROI. The knees are flexed
for stability.

Central Ray
Horizontal beam, in the midline of the Region of Interest
patient, approximately 4-5 cm above iliac
crest

Technical
SID minimum 100cm

Respiration Phase
Suspended expiration.

Evaluation Criteria
Refer to prescribed textbook and list key
criteria below

Note lateral decubitus can also be taken PA

Why is the patient, where possible,

positioned on their LEFT side rather than on
their RIGHT side?

How long should the patient be lying on their

left side before you take the image? Why?

Why is the centring for a lateral decubitus

similar to an erect abdomen?

If the patient had a perforated GIT how

would it appear on this image?

Additional notes:

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Abdomen