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YEAR 4 SEMESTER 2 DIAGNOSTIC IMAGING > Abdominal-finished > Flashcards

Abdominal-finished Flashcards

1
Q

How should you view the normal abdominal film?

A

Film R (right side) marker opposite to the viewer’s left side.

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2
Q

What is the general order you should look at an abdominal film?

A 
Order:
1- Once over (glance making sure all the structures you would expect to be there) 
2- Liver and Spleen  
3- Psoas shadows 
4- Renal contours and position (wont see much of kidney normally)
5- Abdominal calcification 
6- Intestinal gas pattern
7- Bones
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3
Q

What are the three types of frontal projection of a Normal Abdominal film?

A
  • Kidney, Ureter and Bladder (KUB)
  • Intravenous pyelogram (IVP)
  • PA Abdomen
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4
Q

What is a “KUB” study used for? How is it performed?

A

Kidney, Ureter and Bladder

  • AP scout film
  • Performed upright or recumbent
  • Highlights calcification of stones in GB, kidneys, ureters etc.
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5
Q

What is an IVP study used for? How is it performed?

A

Intravenous pyleogram

  • Contrast study of kidneys, ureters and bladder
  • Timed study (fill, excrete)
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6
Q

Why is a PA Abdomen X-ray done? How is it performed?

A
  • For soft tissue detail; liver, gallbladder, spleen

- Performed upright and recumbent

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7
Q

Lateral projection x-ray of abdomens are done why?

A
  • Used for accurate location of lesions seen frontally

- Gives visualisation of pre sacral space

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8
Q

Normal anatomy expected in abdominal x-ray expected in retro-peritoneal organs?

A

-Kidney, ureters, adrenal glands, duodenum, ascending and descending colon, pancreas.

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9
Q

Normal anatomy expected in abdominal x-ray expected of Right upper quadrant organs?

A

-Liver, gallbladder (in upright position), upper portion of ascending colon, hepatic flexure of colon, transverse colon, right kidney and right adrenal gland.

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10
Q

Normal anatomy expected in abdominal x-ray expected of Left upper quadrant organs?

A
  • Spleen, pancreatic tail, stomach, transverse colon, splenic flexure descending colon, left kidney and adrenal gland.
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11
Q

Normal anatomy expected in abdominal x-ray expected of right lower quadrant organs?

A
  • Caecum, appendix, ascending colon, right ovary, right ureter
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12
Q

Normal anatomy expected in abdominal x-ray expected of left lower quadrant organs?

A
  • Descending colon, left ovary, left ureter mid-line abdominal structures: duodenum, pancreatic tail and head, small bowel and aorta.
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13
Q

Normal anatomy expected in abdominal x-ray expected of right pelvic structures?

A

-Lower portion of caecum, appendix, right ovary, and right ureter.

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14
Q

Normal anatomy expected in abdominal x-ray expected of left pelvic structures?

A

-Sigmoid colon, left ovary, left ureter

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15
Q

Normal anatomy expected in abdominal x-ray expected of midline pelvic structures?

A

-Uterus, prostate gland, bladder, sigmoid colon, rectum

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16
Q

In a double-contrast image what do the positive parts of the film look like and indicated?

A

-Opaque = barium

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17
Q

In a double-contrast image what do the negative parts of the film look like and indicated?

A
  • Dark = air
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18
Q

What is crohns disease?

A
  • Regional enteritis. Most common in the distal ileum, proximal colon. However, it may occur anywhere in the GIT.
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19
Q

What is the common age that crohns is diagnosed?

A

-Peak age of incidence is usually between 14-24 years of age.

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20
Q

Does crohns have a familial tendency?

A

-Yes

21
Q

What is the clinic presentation/common pattern of crohns?

A
  • Usually displays one of four common patterns of regional enteritis:
    1. Inflammation
    2. Obstructive (stenosing)
    3. Combined (inflammation and obstruction)
    4. Abdominal fistulas and abscesses

Acronym: (I, OBS, See (C), Fistulas)

22
Q

What type of study is done for suspected crohns?

A
  • Demonstrated by a barium study

eg barium enema

23
Q

What is the radiological appearance of crohns in a barium study?

A
  1. Dilated lumen (most severe in distal jejunum)
  2. Abnormal muscle folds (thinned, thickened or absent)
  3. Hypersecretion of fluid in lumen (flocculated barium)
  4. Transient intussusception (telescoping of bowel gives coiled spring appearance on barium study)
24
Q

Ulcerative colitis is?

A

Chronic inflammatory and ulcerative condition of colonic mucosa

25
Q

Clinical presentation of Ulcerative colitis?

A

-Cramp abdominal pain and bloody diarrhoea

26
Q

What is the radiological appearance Ulcerative colitis when complicated by toxicity?

A
  • When complicated by toxicity see:
    • Paralysed segment of colon,
    • Toxic dilation
      - Acute toxic megacolon
27
Q

What might you see in the radiological appearance Ulcerative colitis?

A
  • The transverse colon dilates to >6cm’s.

- Lead pipe colon ( contracted, shortened, without haustrations (little sacs are missing), straightened)

28
Q

When is lead pipe colon seen in ulcerative colitis?

A
  • It is seen in late stages of the disease
29
Q

What are polyps?

A
  • A small clump of cells that forms on the lining of the colon or rectum. Smooth or tubular polyps are usually benign, may grow, develop villae and have a risk of malignant degeneration.
30
Q

Where are polyps commonly found?

A

Usually found in the sigmoid colon or rectum.

31
Q

What type of x-ray study would be performed for a polyp?

A

-Barium study

32
Q

What is the radiological appearance of a polyp?

A
  • Rounded filling defects in barium exam.
  • Frondlike rectal filling, defect where we see brush like border of villous adenoma.
  • Filling of a polyp. The contrast remains after the contrast should be gone

-Frondlike = plant

33
Q

What is a Renal or Ureteric Tract Calculi ?

A

-Are hard masses that form in the urinary tract and may cause pain, bleeding, or an infection or block of the flow of urine.

34
Q

What are renal or ureteric tract claculi made up of?

A
  • Most have enough calcium to be seen on film

- Most common calculi composition of calcium phosphate, calcium oxalate, magnesium ammonium phosphate.

35
Q

How are renal or ureteric tract claculi formed?

A
  • Formation is promoted by urinary stasis or infection.

- Often idiopathic.

36
Q

What is the clinical presentation of renal or ureteric calculi?

A
  • Asymptomatic until large enough to cause obstruction, or when passing through ureters.
  • Create agonising ureteral colic.
37
Q

What is the radiological appearance of renal or ureteric calculi?

A
  • May fill renal pelvis and calyces like a cast = staghorn calculus. (results in back flow)
  • Calcific stones in ureter usually are 1-3 mm, round and oval.
  • Those without calcium are located by Intravenous pyleogram (IVP), seen as filing defects.
  • Stones most commonly lodge at ureterovesical junction.
38
Q

What is hepatomegaly?

A

Enlargement of the liver

39
Q

What causes hepatomegaly?

A
  1. Infective: Malaria, glandular fever, hepatitis
  2. Neoplastic: Mets, leukaemia, lymphoma
  3. Haemochromatosis, glycogen storage
  4. Drugs: Alcohol, drug-induced hepatitis
  5. Congenital: Sickle cell, haemolytic anaemia
40
Q

Clinical presentation of hepatomegaly?

A

-Reflect origin of enlargement

41
Q

What is the radiological appearance of hepatomegaly?

A
  • May displace the colon’s hepatic flexure and right kidney downward.
  • May displace stomach backward and to the left (if left lobe of liver is enlarging)
  • Generalised enlargement may elevate the diaphragm
42
Q

What is the main function of the spleen?

A
  • The spleen plays multiple supporting roles in the body. It acts as a filter for blood as part of the immune system.
  • Old red blood cells are recycled in the spleen, and platelets and white blood cells are stored there.
  • The spleen also helps fight certain kinds of bacteria that cause pneumonia and meningitis.
43
Q

what is Splenomegaly?

A
  • Splenomegaly is usually associated with an increased workload (such as haemolytic anaemia) which suggests that it is a response to hyperfunction.
  • It is therefore not surprising that splenomegaly is associated is associated with any disease process that involves abnormal blood cells being destroyed in the spleen.
44
Q

What are some causes of splenomegaly?

A
  • Haemochromatosis
  • Cirrhosis of liver
  • Blocked splenic or portal veins
  • Infections
  • chronic haemolytic anaemia’s
  • Storage diseases
  • Splenic cysts
45
Q

What is the clinical presentation of splenomegaly?

A
  • Sometimes palpable, causes feelings of fulness when eating, upper left quadrant abdominal pain, sometimes splenic friction rub and sometimes epigastric or splenic bruits.
46
Q

What is the radiological appearance of splenomegaly?

A

-The spleen may encroach on the stomach, may depress splenic flexure and may elevate diaphragm.

47
Q

What are reasons you may see TOO MUCH bowel gas?

A
  • E.g. aerophasgia, crohn’s dx, IBS, Diabetes, transient constipation, parasite infections, lactose intolerance.
48
Q

What are reasons you may see TOO LITTLE bowel gas?

A
  • Enlarged abdominal organs
  • Intraabdominal tumor
  • Fluid-filled intestines
  • Gastroenteritis
  • Neurological deficit (with reduced swallowing)
49
Q

What are reasons you would see abdominal gases in the wrong place?

A
  • Pneumoperitoneum from ruptured intestined: ulcer, trauma, cancer enteritis
  • Abcess
  • Pneumatosis intestinalis (pneumatosis of an intestine, that is, gas cysts in the bowel wall. As a radiological sign it is highly suggestive for necrotizing enterocolitis)

YEAR 4 SEMESTER 2 DIAGNOSTIC IMAGING (17 decks)

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