ABDO Flashcards
(24 cards)
Patient prep
- remove metal artefacts
- women bra
- LMP
Centring point
Midline of patient
Approx level of iliac crest & include pubic symphisis
Collimation /AOI
- superior = diaphragm
- inferior = pubic symphysis
- lateral = soft tissue borders
Abdominal pelvic regions
Right hypochondriac region Epigastric region Left hypochondriac region Right lumbar region Umbilical region Left lumbar region Right iliac region Hypogastric region Left iliac region
Abdo quadrants
RUQ
LUQ
RLQ
LLQ
Supine projection
Spine In midline
Spinous process down centre
Sacrum centred in pelvic inlet
Clinical indication for AXR
Acute conditions = bleeding per rectum, faecal vomiting,
Bowel obstruction/ perforation
Urinary calculi
Bowel ischaemia
Acute scenario ?
CT
Supplementary projections
Cross renal proj = diaphragm, upper kidneys
Bladder proj = lower area, symphysis pubis, base of bladder
RUQ
Liver
Kidney (right lower than left cause of liver)
Sufficient contrast ?
Bony and soft tissue structures visible
Outline of psoas muscle
Biliary colic
Abdominal pain
Pain felt in centre of abdo, right side under ribs, spread to shoulder blade
Pain= constant, not relieved by vomming/passing wind/toilet
Triggered = sometimes by eating fatty foods
Pancreatitis = inflammation of Pancreas
Gall stones
Imbalance of chemical makeup of bile in gallbladder
Bile= liquid produced by liver to help digestion
Cause= high levels of cholesterol in GB / waste product bilirubin
Chemical imbalance - cause tiny crystals to develop in bile, grow into solid stones over years
Renal Calculi
KIDNEY STONES
more common in men than women
Symptoms are only caused if = stone is stuck in kidney, travel down to ureter & cause infection
Symptoms = lower back pain, felt in groin, testicles & scrotum, Pain In abdo, feeling restless
Dysuria = pain urinating Haematuria= blood in urine
Vascular calcification
Calcification = hardening to tissue/other material
Mineral deposits on walls of arteries and veins
Alterable risk factors = high BP, high BC, low density lipoprotein, smoking, obesity, diabetes
Non alternate factor = age, gender, genetics
AAA abdominal aortic aneurysm
& size of AAA’s
Abdominal aorta, left & right common iliac arteries = calcified
Ultrasound of abdo
Normal Aorta = < 3cm
Small AAA = 3-4.4
Medium AAA = 4.5-5.4
Large AAA= 5.5 +
Phleboliths
VEIN STONES
calcification In venous structures
Common in pelvis = mimic ureteric calculi
Appearance = focal calcifications with radiolucent centre ( distinguish between kidney stones)
Small bowel obstruction
Radiographic feature =
Dilated loops of small bowel
Central dilated loops
CT= more sensitive demonstrate 80% of cases
Cause = acquired or congenital (born) Acquired = compression, luminal
Most common = adhesions,
Developing countries = hernias most common
Large bowel obstruction
Adulthood = most common cause = colonic cancer typically in sigmoid
Second most common = diverticulitis (inflammation) sigmoid colon
Pneumoperitoneum
Gas within the peritoneal cavity
Erect chest x ray = most sensitive for detection of intraperiotneal gas. Large volume present = may be superimposed over normal aerated lung with lung markings
=subdiaphragmatic gas
Hepatomegaly
Enlargement of liver !
Cause = alcohol, liver disease, malignancy m, congestive cardiac failure
Ascites
Abnormal accumulation of fluid in peritoneal cavity
75% of those with this have cirrhosis (liver lacking proper functioning)
Horseshoe kidney
Renal fusion
Bottom part fuse together
Male kidney susceptible to trauma & renal calculi
Complications arise = poor drainage
Abdominal / pelvic masses
Seen as Displacing bowel
Unless calcified= hard to see, mass have same density as surroundings. I
