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VETM 445 > Abdomen radiographs > Flashcards

Abdomen radiographs Flashcards

1
Q

tell me about the minimum legal standard for abdomen views and the best clinical practice

A

min. legal: 2 views = R or L lateral AND VD or DV
best practice: 3 views (R and L lateral, and VD)

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2
Q

tell me about the technique used for abdominal radiographs. why?

A

High mAs, low kVp
due to low inherent contrast in abdomen, we want to lower kVp to increase the contrast as much as we can.

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2
Q

tell me how you should position a patient for abdominal radiographs, including best practice for views and what to include in each view.

A

straight patient with extended limbs, image taken on expiration
3 views (R lat, L lat, VD)
include all of diaphragm to greater trochanter of femurs (back to perineum is even better)

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3
Q

tell me about the special position Cross Table

A

animal in dorsal recumbency, plate against R/L side of abdomen, radiograph across cranial ventral portion of abdomen

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4
Q

tell me about the special position Spoon

A

if you straighten the back lags on lateral view, you get a better view of the bladder

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5
Q

tell me about the special position “tucked pelvis”

A

bring back legs into body on lateral view
allows visualization of caudal pelvic urethra and distal urethra

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6
Q

what are some causes of decreased serosal detail? (i.e the serosal borders of the organs in the peritoneal/retroperitoneal space are less easily visualized)

A

peritoneal fluid
inflammation
decrease intra-abdominal fat
young animals generally less than 6 months
carinomatosis

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7
Q

what does increased serosal detail usually mean? what should you do?

A

pneumoabdomen/pneumoretroperitoneum
immediate sx

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8
Q

what are some causes of pneumoabdomen?

A

normal post sx (up to 4 weeks)
perforated intestines
abdominal wall trauma
perforated abscess
gas-forming bacteria

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9
Q

tell me what organs are visible and not visible in the cranial ventral zone of the abdomen

A

visible: stomach, liver
not visible: gallbladder, pancreas, lymph nodes

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10
Q

tell me what organs are visible and not visible in the cranial dorsal zone of the abdomen

A

visible: R kidney, spleen, stomach, liver
not visible: adrenals, portal vein, CdVC

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11
Q

tell me what organs are visible and not visible in the ventral middle zone of the abdomen

A

visible: spleen, SI, omentum
not visible: Lymph nodes

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12
Q

tell me what organs are visible and not visible in the dorsal middle zone of the abdomen

A

visible: L kidney, desc. colon, SI, cecum
not visible: ovaries, ureters, lymph nodes, CdVC

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13
Q

tell me what organs are visible and not visible in the caudal ventral zone of the abdomen

A

visible: prostate, urinary bladder
not visible: uterus, lymph nodes

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14
Q

tell me what organs are visible and not visible in the caudal dorsal zone of the abdomen

A

visible: rectum, desc. colon
not visible: ureters, lymph nodes

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15
Q

tell me the indications behind a radiographic GI workup

A

high yield (chronic vomiting, palpable abdominal mass)

low yield (acute vomiting, diarrhea, weight loss, abdominal pain, lethargy)

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16
Q

tell me some causes of vomiting. what should be high on your ddx?

A

pyloric outflow obstruction, bowel obstruction, gastroenteritis, pancreatitis, toxicosis, biochemical alterations

foreign body of obstruction will be the most common reason abdominal radiographs are made

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17
Q

vomiting vs regurgitation… ???

A

vomiting: forceful expulsion of gastric content, stomach or lower is the problem
regurgitation: passive, usually assoc. with esophagus

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18
Q

tell me about timing for gastric emptying. how long do you have to fast a patient to expect an empty stomach?

A

gastric emptying time can vary b/t 8-24 hours depending on a variety of factors
fast patient for 24 hours for empty stomach

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19
Q

The appearance of the stomach varies between the _____ of the patient. This is caused by a shift in ____ and ____ distribution. ____ will settle in the dependent region by gravity and ____ rises to the independent portion. ___ and contrast are easy to see, _____ can be difficult to see because it can efface with adjacent organs.

A

position
fluid, gas
fluid, gas
gas, fluid

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20
Q

tell me about the normal location of the stomach.

A

either perpendicular to the spine, parallel to the ribs, or somewhere between those angles
adjacent to liver

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21
Q

with stomach radiographs, why is it important to take both lateral views?

A

on L lateral, gas rises to pyloric portion and fluid settles in fundus and body
on R lateral, gas rises to fundus and body, fluid settles in pyloric portion

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22
Q

you find a foreign body in a radiograph. if clinical signs allow, what should you do?

A

repeat radiographic in 1-3 days to reveal if foreign body is moving. if moving, then it reduces clinical significance.

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23
Q

in gastric dilation, what could the stomach be dilated by? what is the most common? what does a dilated stomach look like on radiograph?

A

gas, fluid, ingesta, foreign material
most common is food engorgement
enlarged but normal shape

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24
Q

Gastric dilation and volvulus:
1. what is present in the stomach?
2. where is air from?
3. typical signalment?

A
  1. fluid and gas, mostly a gaseous distention of the stomach
  2. aerophagia (not likely bacterial)
  3. large, deep chested dogs (eg. Great Dane)
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25
Q

tell me what happens to hte stomach during a GDV

A

as stomach dilates, fundus/greater curvature rotate clockwise when viewed from caudal to cranial, and lie against the ventral abdominal wall

the pylorus shifts dorsally, cranially, to the left

gastrosplenic ligament tends to draw spleen with volvulus

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26
Q

what view(s) do you need to diagnose a GDV?

A

typically, only right lateral

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27
Q

what are the radiographic signs of GDV?

A

marked gastric distension
displacement of pylorus
compartmentalization of stomach

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28
Q

tell me the positions of the small intestine

A

duodenum lies along right lateral body wall, most fixed portion of intestine
jejunum and ileum are moveable throughout abdomen, usually distributed evenly

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29
Q

tell me the normal dimensions of small intestine in dogs and cats

A

dogs: <2x 12th rib, <1.6x L5 body
cats: <2x L4, <12mm

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30
Q

how do you see functional ileus on radiographs

A

diffuse marked small intestine dilation

31
Q

what are the ddx for functional ileus

A

enteritis, peritonitis, electrolyte imbalance, secondary to drug therapy (ex. opiod), pain, distal mechanical obstruction

32
Q

what is another name for mechanical ileus? where are the 3 locations of mechanical ileus?

A

physical obstruction
intraluminal, mural, extramural

33
Q

tell me about the classic appearance of intestines with a linear foreign body. what is there a risk of? where else should you always check?

A

bunching, plication, pleating, comma/crescent/teardrop-shaped gas bubbles
risk of perforation
always check under tongue

34
Q

tell me about the normal diameter of the large intestine

also, what 3 structures are visible on radiograph?

A

no more than 1.5x length of L7

cecum, colon (all 3 parts), rectum

35
Q

in a large intestine impaction/dilation, what is happening? why is there increasing radiopacity? eventually, what happens radiographically?

A

accumulation of feces due to obstruction of diminished function
increases due to water reabsorption
generalize enlargement of colon

36
Q

what are 6 ddx of large intestine impaction/dilation?

A

idiopathic, stricture, spinal anomalies, neuromuscular disorders, perineal hernias, congenital (ex. atresia ani)

37
Q

megacolon:
1. in cats, often ____.
2. also there is _____ megacolon

A
  1. feline idiopathic megacolon
  2. acquired
38
Q

what is gastric pneumatosis and how does it manifest on radiograph?

A

gas within gastric wall
very high specificity focal necrosis of gastric wall

39
Q

pneumatosis coli: what is it? what can it be secondary to?

A

gas in colon walls (?)
secondary to severe ulcerative colitis, foreign body

40
Q

what are the 3 neoplasias of the colon that we should know?

A

carcinoma, polyps, granuloma

41
Q

colonic torsion:
1. what is the typical signalment?
2. clinical signs

A
  1. young-middle aged dogs (medium in large breeds), many have a hx of GIT disease
  2. vomiting, abdominal discomfort or depression, diarrhea, tenesmus, anorexia
42
Q

what is a pneumocolonogram and why is it used?

A

contrast study using air to confirm location of large intestine
ex. you don’t know if a FB is in the SI or LI, so you do this to see where the LI is to differentiate between the two and see where the FB is

inject 1-3 ml/kg air into rectum using red rubber tube, take X-rays right away

43
Q

tell me about intestine special study (contrast), including the contrast used, how commonly it’s used, why it’s used, how to prep patient for it, when to take radiographs, and expected results

A

contrast used: barium (more common) or iodine (less common)
not used commonly, more replaced by US
why: eval motility and disturbances in transit (obstruction)
prep: NPO 12-24hrs, no meds/sedatives, stomach tube, barium 10 ml/kg
radiographs: immediate 4 view after barium intro
- 15 later, R lat and VD
- 30-60 mins later, R lat and VD
- hourly until barium detected in colon

expected results: 15 mins duodenum, 30 mins jejunum, 1-2 hours stomach emptied, 6 hours jejunum emptied

44
Q

the 6 lobes of the liver are ____ on radiographs.

A

indistinguishable

45
Q

with hepatomegaly, what does it look like radiographically? hepatomegaly can be ___ or ____.

A

rounding or blunting of caudal ventral margin
extension of liver beyond costal arch
caudal displacement of gastric axis

generalized or regionalized

46
Q

Microhepatia:
1. what is it?
2. what happens to gastric axis?
3. associated with…?

A
  1. small liver
  2. gastric axis tipped cranially
  3. portosystemic shunt, microvascular dysplasia, hepatic fibrosis/cirrhosis, normal anatomic variation
47
Q

what is cholelithiasis and how does it manifest on US and radiographs?

A

gallbladder stones (essentially)
US: hyperechoic mass in gallbladder
RG: diffusely enlarged liver ?????

48
Q

what is choledocholithiasis? is it significant? can be secondary to what? risk of what with this?

A

mineralization of biliary tree
commonly incidental
secondary to chronic cholangiohepatitis
future risk of biliary obstruction

49
Q

what is the most common cause of space occupying lesion in mid-ventral abdomen?

A

spleen (abnormal)

50
Q

what causes splenomegaly?

A

anesthesia/sedation, infiltrative disease, torsion, IMHA, extramedullay hematopoiesis, venous congestion

51
Q

can you normally see adrenal glands on radiographs?

A

no

52
Q

can you see the pancreas normally on radiographs?

A

no

53
Q

describe the normal anatomy of the pancreas and where it sits in the abdomen

A

right limb: resides in the mesoduodenum
body: adjacent to the cranial duodenal flexure
left limb: resides in the deep leaf of the greater omentum

54
Q

tell me about some radiographic signs of pancreatic disease. what view can you see these best in?

A

seen best in VD
usually localized to R cranial quadrant of abdomen in dog
L cranial quadrant - left limb of pancreas b/t stomach and spleen in cat
increase ST opacity in R cranial dorsal quadrant (dog and cat), L cranial quadrant (cat), or both
widening of the gastroduodenal angle

55
Q

what are some indications for imaging kidneys?

A

incontinence, hematuria, polyuria, oliguria, urolithiasis, ureteral obstruction, abnormal palpation, renal function testing

56
Q

tell me about the normal locations of the kidneys

A

retroperitoneal (surrounded by fat)
L kidney more caudal
R kidney can be obscured, lays in renal fossa, becomes silhouetted

57
Q

tell me about normal kidney sizes

A

compared to L2:
dog: 2.5-3.5x
cat: 2.4-3x

58
Q

if kidneys are larger, but have normal shape and marination, what are some things that may be happening?

A

compensatory hypertrophy, round cell neoplasia, hydronephrosis, amyloidosis

59
Q

if kidneys are larger, have irregular shapes, and weird margins, what are some things that may be happening?

A

neoplasia, hematoma, cyst, abscess

60
Q

if kidneys are smaller, irregular shapes, and weird margins, what are some things that may be happening?

A

end stage renal disease
dysplasia

61
Q

if kidneys are normal sized, but irregular shaped and weird margins, what are some things that may be happening?

A

infarction, abscess, chronic pyelonephritis, polycystic renal disease

62
Q

tell m about excretory urograms

A

contrast agent (water soluble iodinated injected IV)
circulates and concentrates and excreted by kidneys
time correlates with image (nephrogram = 2min; pyelogram = 20 min; cystogram = 40 mins)

ensure hydration deficits are corrected in patient, enemas and fasting, and maintain an IV catheter in case renal function declines due to contrast medium (rarE)

contraindications: azotemia and dehydration. can perform if correct dehydration

63
Q

tell me about cystography

A

positive contrast (bladder rupture, confirming location, space occupying luminal masses)
negative contrast (rarely used, ectopic ureters, risk of air embolism)
double contrast (free objects in centre of image, mural lesions offset)

64
Q

tell me the 4 types of bladder stone compositions and whether they are radiopaque or not

A

cystine: not
urate: not
phosphate: radiopaque
oxalate: radiopaque

CUP O’

65
Q

a normal radiographic bladder ______ rule out a bladder mass or stones (does/does not)

A

does not!!!

66
Q

you need ____ view(s) to assess urethra completely (how many views)

A

multiple

67
Q

tell me about normal prostate in radiographs

A

generally not visible in castrated dogs
normal size, intact male = 70% of width of pelvic inlet
don’t confuse with bladder!

68
Q

enlargement of the uterus could mean….?

A

pyometra
mucometra
hydrometra
early pregnancy

69
Q

tell me about the radiographic signs of pyometra and what view this is best seen in

A

view: VD
tubular ST opacities along caudal lateral body walls
tubular ST opacity bt colon and bladder on lateral (not always seeN)
displacement of SI cranially
loss of serosal detail in caudal abdomen

70
Q

tell me about mineralization of the fetuses of dogs and cats (like how many days post breeding?)

A

dog: 42 days post breeding
cat: 38 days post breeding

71
Q

tell me about pregnancy evals in dogs (with dates)

A

uterine enlargement detectable radiographically ~30 days after ovulation
spherical enlargements at location of gestational sacs identifiable in uterus 30-40 days after ovulation
uterus becomes involuted and can be rechecked ~38-45 days postpartum

72
Q

tell me about pregnancy evals in cats (with dates)

A

uterine enlargement detectable radiographically 25-30 days of gestation
fetal mineralization ~38 days post breeding

73
Q

what is the earliest time for sonographic assessment of pregnancy ?

A

25-30 days of gestation
the closer to 30 days of gestation, the more likely a heartbeat can be detected

74
Q

what are radiographic findings of fetal death?

A

small misshapen skull
fetuses smaller than the others
straitening of the spine (contraction of epaxial musculature)
emphysema and gas within vasculature

75
Q

in relation to dystocia, what can radiographs be helpful for?

A

finding out fetal causal factors, including position relative to pelvic canal, postpartum for retained fetus

VETM 445 (8 decks)

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