abdomen radiographs

nerpreaon o Abdomna Radograph (Pan Xray Abdomen) or MBBS Sudens CompeencyBased Learnng Objecves and Learnng Pons (As per NMC CBME Currcuum) Topc Sysemac nerpreaon o Pan Abdomna Radographs Targe Learners MBBS Phase / Phase Students Duraon 6090 mnutes NMC Compeency Agnmen Ths sesson s agned wth the competencybased currcuum of the Natona Medca Commsson and ntegrates radodagnoss wth anatomy physoogy pathoogy medcne surgery pedatrcs emergency medcne and obstetrcs The student shoud be abe to: Descrbe the ndcatons and mtatons of pan abdomna radography Assess the technca quaty of an abdomna radograph dentfy norma radographc anatomy of the abdomen Appy a systematc approach to mage nterpretaton Recognze common abdomna pathooges and surgca emergences Correate radographc fndngs wth cnca presentaton Communcate fndngs usng approprate radoogca termnoogy Learnng Objecves 1 Knowedge Doman (Cognve) At the end of the sesson the student shoud be abe to: Expan the ndcatons for abdomna radography dentfy dfferent abdomna radographc projectons: Supne AP abdomenErect abdomen Left atera decubtus abdomen Descrbe radaton safety prncpes and approprate use of abdomna Xrays Assess mage quaty ncudng: Patent postonng Coverage from daphragm to pubc symphyss Exposure adequacy Moton artefacts Recognze norma abdomna anatomy vsbe on pan radographs 2 Sks Doman (Psychomoor) The student shoud be abe to nterpret an abdomna radograph usng a sysemac ABCDE approach A Ar Gastrc ar bubbe Sma bowe gas Large bowe gas Recta gas Free ntrapertonea ar (pneumopertoneum) Porta venous gas Pneumoba B Bowe Assess: Dstrbuton of bowe gas Sma bowe Large bowe Dataton Arfud eves Obstructon eus Vovuus C Caccaon dentfy cacfcatons nvovng: Kdneys UretersBadder Gabadder Pancreas Lymph nodes Vascuar cacfcaton Appendcoth Pheboths D Dense Organs and So Tssues Evauate: Lver sze Spenc enargement Rena outnes Psoas margns Soft tssue masses Organ dspacement E Everyhng Ese Assess: Bones Spne Pevs Hp jonts Lower rbs Foregn bodes Surgca cps Tubes and catheters 3 Aude and Communcaon Students shoud: nterpret radographs n a structured manner Avod dagnosng beyond the radographc fndngs Correate magng fndngs wth cnca examnaton Recognze stuatons requrng urgent surgca referra Apprecate the mtatons of pan radography and know when further magng s ndcatedSpecc Learnng Oucomes The student shoud correcty dentfy: Norma Fndngs Norma bowe gas pattern Gastrc funda ar Coon wth haustra markngs Sma bowe wth vavuae connventes Lver shadow Speen Kdneys Psoas musce margns Badder outne Lumbar vertebrae and pevc bones Common Abnormaes Gasronesna Sma bowe obstructon Large bowe obstructon Paraytc eus Vovuus (sgmod and caeca) Feca oadng Toxc megacoon Pneumopertoneum Urnary Trac Rena cacu Ureterc cacu Vesca cacu Nephrocacnoss Hepaobary Gastones (when radopaque) PneumobaPorta venous gas Pancreas Chronc pancreatts wth pancreatc cacfcaton Vascuar Aortc cacfcaton Aneurysma cacfcaton So Tssue Organomegay Abdomna mass Asctes (ndrect sgns) Muscuoskeea Vertebra fractures Pevc fractures Hp pathoogy Foregn Bodes Swaowed foregn body Surgca cps ntrauterne contraceptve devce (UCD) Feedng tube Ureterc stent DoubeJ (DJ) stent Nephrostomy tube Radographc Sgns Sudens Shoud Recognze Rgers sgn (doubewa sgn) Footba sgn (massve pneumopertoneum)Coffee bean sgn (sgmod vovuus) Strng of pears sgn (sma bowe obstructon) Thumbprntng (bowe wa edema) Sentne oop Coon cutoff sgn Red Fag Fndngs (Mus No Mss) Students shoud mmedatey recognze: Free ntrapertonea ar Hghgrade bowe obstructon Cosedoop obstructon Sgmod vovuus Caeca vovuus Toxc megacoon Large abdomna aortc aneurysm cacfcaton Radopaque ureterc stone causng obstructon Foregn body causng obstructon or perforaton Suggesed Reporng Forma Students shoud earn to report n the foowng order: 1 Patent dentfcaton 2 Projecton (supne erect decubtus) 3 Technca adequacy Bowe gas pattern 5 Presence or absence of free ar 6 Sod organs and soft tssues 7 Cacfcatons 8 Bones 9 Medca devces or foregn bodes 10 Overa radoogca mpresson Key Learnng Pons Aways assess mage quaty before nterpretaton Use a consstent systematc approach (ABCDE) for every abdomna radographDstngush sma bowe from arge bowe based on anatomca ocaton and mucosa fod pattern Examne for free ntrapertonea ar n the erect chest or erect abdomna radograph whenever perforaton s suspected Assess bowe caber dstrbuton of gas and arfud eves together when evauatng obstructon Carefuy nspect the kdneys ureters badder vascuar structures bones and soft tssues for cacfcatons or other abnormates Recognze that a norma abdomna radograph does no excude sgnfcant ntraabdomna pathoogy Correate radographc fndngs wth the patents hstory physca examnaton and aboratory nvestgatons Understand when addtona magng such as utrasonography or CT s more approprate Suggesed Teachng Mehods (CBME) nteractve ecture wth annotated radographs Smagroup casebased dscussons Probembased earnng usng common emergency scenaros mage nterpretaton workshops OSCE statons focused on abdomna radograph nterpretaton ntegrated teachng wth surgery medcne pedatrcs and emergency medcne Assessmen Mehods (NMC Agned) Mutpechoce questons (MCQs) Structured shortanswer questons (SAQs) Objectve Structured Cnca Examnaton (OSCE) Spotter examnaton wth abdomna radographs Casebased dscusson (CBD) Drect observaton of mage nterpretaton usng a structured checkst Epeced Oucome By the end of the sesson an MBBS student shoud be abe to assess the technca adequacy of an abdomna radograph appy a structured nterpretaton method dentfy norma anatomy recognze common and emergency radographc abnormatesunderstand the strengths and mtatons of pan abdomna magng and communcate fndngs ceary usng standard radoogca termnoogy n keepng wth the competencybased expectatons of the Natona Medca Commsson MBBS currcuum