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Radiography 1 > Abdomen > Flashcards

Abdomen Flashcards

1
Q

palpate the abdomen

A
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2
Q

label the abdomen diagram

A
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3
Q

what are the functions of the GI system

A

ingestion, digestion, secretion, absorption, excretion (defecation)

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4
Q

fill out the digestion table

A
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5
Q

what are the stripy areas in an abdominal xray

A

rugae

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6
Q

what are the stripy bits in the large intestine

A

haustra

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7
Q

what does gas look like in xrays

A

not completely black, but a dark grey

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8
Q

where is gas usually found

A

stomach, rectum, sigmoid colon, large intestine
sometimes the small intestine
shouldn’t be anywhere else

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9
Q

what is a normal level of air fluid in the colon

A

2-3 loops

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10
Q

true/false, the large intestine is peripheral

A

true

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11
Q

is it normal to see air/fluid in the large intestine

A

no

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12
Q

what are abnormal findings in abdominal radiographs

A

extra luminal air (outside lumen): forms a crescent beneath diaphragm
calcification: chronic pancreatitis, endpoint of inflammation
organ size: liver, dilated bowel loops, distended bowl loops

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13
Q

is it important to also take chest radiographs

A

yes because the issue can start in the chest and present as abdominal pain/discomfort

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14
Q

what is the function of the oesophagus

A

peristalsis - transport of bolus by relaxation to swallow it and contraction to propel it

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15
Q

what is the purpose of the lower oesphageal sphincter

A

to stop regurgitation from the stomach (tensioned at rest)

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16
Q

common physiological pathologies of the oesophagus

A

dysphasia
excessive gastroesophaegeal reflux

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17
Q

what causes dysphasia

A

neurologic disorders
structural lesions
psychiatric disorders
resection
radiation fibrosis
medications

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18
Q

what does dysphasia lead to

A

deyhdration, malnutrition, pneumonia

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19
Q

how are oesophageal disorders diagnosed

A

contrast radiography, endoscopy, fluroscopy

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20
Q

is the oesophagus under voluntary or involuntary control

A

voluntary in the upper third (cervical), and then involuntary

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21
Q

what are common mechanical pathologies of the oesophagus

A

GORD

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22
Q

what is GORD

A

gastro-oesophageal reflux disease

gastric acid & pepsin begin to move into oesophagus and can cause necrosis of oesophageal mucosa and oesophageal stricture (e.g. scar tissue, narrowing, blockage)

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23
Q

what is the clinical presentation of GORD

A

acid reflux
ear infections
hoarse voice = issues with vocal chords
can lead to adenocarcinoma

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24
Q

what is GORD sometimes mistaken for

A

myocardial infarction (chest pain)

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25
Q

what causes GORD

A

weakening/malfunction of oesophageal sphincter and stomach begins to prolapse through diaphragmatic oesophageal hiatus

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26
Q

how can you diagnose GORD

A

CT (particularly for neoplasia concerns), barium study

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27
Q

what is an oesophageal stricture

A

narrowing or tightening of the oesophagus that causes swallowing difficulty

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28
Q

what is causes oesophageal stricture

A

intrinsic diseases that narrow the lumen through inflammation, fibrosis or neoplasia

extrinsic diseases that cause lymph node enlargement

diseases that disrupt peristalsis & lower sphincter function

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29
Q

how is oesophageal stricture diagnosed

A

barium studies

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30
Q

what causes oesophageal obstruction

A

progression of stricture, injury, tumour growth, food & foreign bodies

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31
Q

what is achalasia

A

failure of LES to relax resulting in impaired peristalsis & dysphagia

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32
Q

does the stomach contain rugae

A

yes

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33
Q

what are common stomach pathologies

A

ulcer, carcinoma

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34
Q

what causes ulcers

A

failure of stomach wall to protect against pepsin

risk factors are helicobacter pylori, NSAIDs by long term use because they decrease secretion mucus secretion which protects the lining

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35
Q

how is gastric ulcer (heliocbacter pylori) diagnosed

A

breath test for increased CO2

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36
Q

what is the purpose of the small intestine

A
  • digestion by enzymes from pancreas
  • absorption of digested nutrients & fluids
  • neutralisation of gastric acid
  • solubilisation of lipids by bile salts
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37
Q

what percentage of nutrient absorption occurs in the small intestine

A

90%

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38
Q

what causes small intestinal obstruction

A
  • postoperative adhesions (most common)
  • hernia
  • crohn disease
  • tumour
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39
Q

what is a small intestinal obstruction

A

proximal dilation due to accumulation of air secretions

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40
Q

what does a small intestinal obstruction look like in an xray

A

air in small intestine
no air in large intestine e.g. a blockage
pilcae are further apart

41
Q

where are SI obstructions often located

A

intraluminal = bowel lumen (foreign bodies & gallstones)
intramural = bowel wall due to crohn’s, neoplasia, stricture, anastamoses
extraluminal = adhesions, surgery, volvulus

42
Q

what is a volvulus & what does it lead to

A

twisting of the mesentery in which blood vessels are located

leads to ischaemia

high fatality rate

43
Q

how do you identify blockages in the SI

A

xray, CT for exact location

44
Q

what is the string of pearls sign

A

small bubbles of gas in small intestine

45
Q

what is intussusception

A

segment of intestine telescopes into ajoining section causing obstruction

46
Q

what are the consequences of intussusception

A

necrosis, due to blood vessels, so requires urgent treatment

47
Q

how is intussusception diagnosed

A

contrast enema

48
Q

what is crohn’s disease & where does it occur

A

any part, mainly illium, but occurs in patches
looks like abcesses and ulcers

49
Q

what is the difference between CD & ulcerative colitis

A

CD is an idiopathic chronic inflammatory disease that can affect any part of the GIT from mouth to anus

it occurs in patches

UC causes inflammation & ulcers in the superficial lining of the large intestine (mucosa)

50
Q

how is CD investigated

A

contrast studies (can’t be done with perforated bowel)

CT - helps differentiate CD & UC

51
Q

what is the function of the large intestine

A

absorb water from indigestible material (fibre), expulsion of waste products, vitamin production from bacteria

52
Q

what are pathologies of the LI

A

diverticulosis
obstruction/dilation
tumour
inflammation

53
Q

what is diverticulosis

A

small pouches commonly found in the colon that form from defects in the smooth muscle walls of intestine

common in > 70 yrs and diet related

mostly asymptomatic

54
Q

what is a large intestine obstruction & is it an emergency

A

yes it’s an emergency

55
Q

what causes LBO (large intestinal obstruction)

A
  • neoplasia e.g. ovary, colon, pancreas, lymphoma
  • volvulus
  • post operative adhesions
  • strictures
  • hernia
56
Q

what is an ileus

A

low gut motility, don’t need to do much, dissolves in 2-3 days

57
Q

what is a sign of volvulus in an xray

A

distended inverted U-shaped colonic loop e.g. a large black pouch

58
Q

what should be distinguished from LBO

A

LBO

59
Q

what causes ileus

A

abdominal surgery

60
Q

what is bowel cancer

A

malignant polyps in the bowel

benign polyps are common

61
Q

how is bowel cancer screened

A
  • occult blood (e.g. blood in stool), not always positive for bowel cancer but indicates need for colonoscopy
  • colonoscopy
62
Q

what is AP supine

A

patient is supine & lying on back

63
Q

what is the function of the liver

A

filtration of blood draining digestive tract, metabolism of protein, carbs, lipids, chemicals, production of plasma proteins, bile salts, excretion of cholesterol & bilirubin

64
Q

how is the liver supplied with blood

A

hepatic artery & hepatic portal vein

65
Q

what does the portal vein do

A

carry blood from GIT & spleen to liver

has multiple anastomoses with systemic venous system

66
Q

what is bilirubin

A

broken down haemoglobin, conjugated in the liver

67
Q

why is faeces brown

A

bilirubin

68
Q

is bilirubin water soluble

A

no

69
Q

what are the pathologies of bilirubin

A

too much = jaundice, too much rb breakdown, or not being conjugated properly
too little =

70
Q

what are liver pathologies

A

metastatic tumor
primary tumour
cirrhosis
trauma
vascular obstruction

71
Q

what is a primary tumour

A

tumour developed in the organ itself

72
Q

what are liver primary tumours caused by

A

repeated replacement of cells due to hep C, alcohol use, NAFLD

73
Q

what is a hepatic carcinoma

A

primary tumour in the liver

74
Q

how are hepatic carcinomas diagnosed

A

ultrasound

75
Q

how do metastases occur in the liver

A

since it is a primary filtration site, it also filters tumour cells

76
Q

what is cirrhosis & what does it look like on a CT

A

scarring as a result of chronic damage

can also be caused by blockage of hepatic arteries

on a CT: lobulated margins, varices

77
Q

what is a common cause of death from abdominal trauma

A

liver rupture, because there is a massive blood supply to the liver

78
Q

what causes vascular obstruction in the liver e.g. of the portal vein

A

cirrhosis, hepatic malignancy

79
Q

what is collateral circulation

A

diversion of blood due to blockage

80
Q

what does collateral circulation cause

A

oesophageal varices

they’re not designed for that amount of blood so there is a high risk of haemorrhage

81
Q

how is vascular obstruction diagnosed

A

ultrasound

82
Q

what is the gallbladder

A

storage, concentration & release of bile salts

83
Q

describe the connection of the liver to the gallbladder and descending part of the duodenum

A

from the liver there are the right & left hepatic ducts
they form and become the common hepatic duct

from the gallbladder there is the cystic duct
it forms with the common hepatic duct to become the bile duct

the bile duct and main pancreatic duct connect into the duodenum

84
Q

what are gallbladder pathologies

A

gallstones, inflammation

85
Q

what are gallstones, are they symptomatic

A

no asymptomatic

formed form abnormal bile composition, mainly caused by cholesterol or pigment

western countries mainly get cholesterol (diet related)

pigment is mainly due to chronic biliary infection from calcium bilirubinate

86
Q

what is cholelithiasis

A

gallstones

87
Q

why can’t you see cholesterol gallstones in an xray

A

cholesterol is not radio-opaque

88
Q

what is cholecystitis & the 2 types

A

acute inflammation of gallbladder wall, usually following obstruction of the cystic duct by stone

  1. gas from emphysematous cholecystitis (bacterial)
  2. clacification from carcinoma
89
Q

how is cholecystitis investigated

A

ultrasound

90
Q

what are the main factors that determine whether gallstones form

A

cholesterol secreted by liver cells, relative to bile salts
gallbladder stasis
obesity
diet
rapid weight loss
pregnancy
drugs

91
Q

what is the function of the pancreas

A

exocrine function and production & secretion of proteases, lipases & amylase

endocrine is insulin & glucagon

92
Q

on what anatomical side is the tali of the pancreas

A

left (right on image) tail ends at spleen

93
Q

how is the pancreas evaluated

A

size, swelling indicates inflammation
shrinkage, indicates chronic infl. due to scar tissue formation
masses at the head (common bile duct) and tail (spleen)

94
Q

what are pancreas pathologies

A

inflammation & tumours

95
Q

what is prognosis for acute pancreatitis & causes

A

glands heal with no real effect or change
caused by alcohol, gallstones, drugs

96
Q

what is prognosis for chronic pancreatitis & causes

A

recurs intermittently causing functional & morphological damage

visible signs of clacification on radiographs

97
Q

how is pancreatitis diagnosed

A

ultrasound, CT in severe cases

98
Q

how is pancreatic cancer found

A

very hard to detect, found by CT, very common but lowest 5 year survival rate

can only really see it when it’s a large size

Radiography 1 (13 decks)

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