Abdominal Radiology Flashcards
what should be the upper and lower limits of an abdominal film?
upper: diaphragm
lower: brim of pelvis
what is scary about the pancreas?
it can eat itself & other organs
which modes of imaging are better for liver studies?
CT/MRI because its so dense
what are the boundaries for deciding where you want an image in the abdomen?
- superior: diaphragm
- posterior: deep muscles of back
- lateral: abdominal muscles
- inferior: pelvic floor muscles
what are the 9 quadrants of abdominal anatomy?
what are the 4 quadrants of abdominal anatomy?
RUQ, LUQ, RLQ, LLQ
How does autodigestion of the pancreas affect other organs?
When bile starts backing up into pancreatic duct pancreas doesn’t like this and starts autodigestion. When it autodigests it spills out and digests everything else
what is dangerous about bile issues?
bile backs up into pancreas and sets off evil spirits (auto digestion)
which structures are retroperitoneal?
- pancreas
- Head, neck, body–> (everything except tail)
- duodenum (distal 3/4 aka 2nd, 3rd, 4th part of duodenum)
- ascending & descending colon
- rectum
- kidney, ureters(also intraperitoneal), adrenal gland
- abdominal aorta
- Inferior vena cava (IVC)
EVERYTHING ELSE IN ABDOMINAL CAVITY IS INTRAPERITONEAL
Pain from a kidney stone would start where and travel to?
Start in back and travel to lower abdomen due to ureter being (both)
Crampy pain means?
probelm with hollow viscus ex: bladder, bowl, colon
Sharp/Stabby pain means?
problem with solid viscus
what are the 4 most common views for abdominal films?
- supine
- standing
- gravity pulls liquid down and air up= air fluid levels
- cross-table lateral
- Ex: kidney stone vs. gall stone
- decubitus (angle)
what are the 3 characteristics of an adequate abdominal XR (KUB)?
- Include at least the diaphragm to the top of the symphysis pubis
- spinal owl visible
- see SI joints (sacral-iliac)
Things to think about in RUQ?
- Appendix- can be in any quadrant?
- Liver
- Pancreas
Things to think about in RLQ?
- Appendix
- Ovary/testis
Testicle pain in back is known as ?
Referred pain
Things to think about in LUQ
- Appendix
- Liver
Things to think about LLQ?
Ovary/testis
If you don’t see the psoas muscle that usually means there is?
Free fluid or air covering it
what mucosal folds can you see in small vs large bowel?
small: valvulae conniventes
large: haustra
when is it ok to have gas in the small bowel?
never
Are air/ fluid leves a good thing?
- No
- X-rays of the abdomen are important in diagnosing the presence of small bowel obstruction. When obstruction occurs, both fluidand gas collect in the intestine. They produce a characteristic pattern called “air-fluid levels”. The air rises above the fluid and there is a flat surface at the “air-fluid” interface
what does the string of pearl sign indicate?
Mechanical obstruction -large bowel obstruction
If a patient has passed gas lately it usually means its not?
small bowel obstruction
You would automatically assume bowel obstruction if there is ?
small and large bowel gas
what is the coffee bean sign? what does it mean
volvulus - colon begins to twist on itself
is free air in the abdomen ok? What does it usually mean?
never. intervene immediately
- Usually means there is a hole somewhere it shouldnt be
can you see the psoas with ascites?
no psosas shadow- biggest clue
-pt might have liver disease
Can you diagnose hepatomegaly on an X-ray?
no- but it usually looks like liver kissing ilium
what is a common abdominal mass in children?
Wilm’s
what indicates AAA on xray?
>5cm aortic bulge
(shouldnt be greater than 3cm)
Aorta is part intra and retro but where would the pain most likely be?
retro
Why are gallstones so dangerous?
- Prevents bile from leaving
- gall bladder gets stronger and over comes blockage
- pushes stone out into common duct
- stone can go into pancreatic duct and kick start auto digestion
Calcified Uternine Masses occurs when?
body has mass it cant get rid of
Phleboliths
stones in veins- very common
Fecoliths
poop stones – can find them in appendix
what are 2 indications of previous surgery on xray?
staples/clips
hernia (bowel in innapropriate places)
constipation has a what type of appearance?
ground glass appearance
what is the appearance of a severely dilated air-filled small bowel?
coiled spring (slinkey)
what is an early sign of small bowel obstruction on xray?
sentinel loop (gas build up)
- localized dilated bowel ( a lot of times in the ilelus)
- If its in the upper quandrant it might be pancreatitis
- Lower quandrant could be appendcitis
what does bird’s beak sign indicate?
achalasia
what does a string sign indicate?
crohns
what is an intravenous pyleogram?
inject dye and follow it through to kidney- if there is a kidney stone then dye can’t get through
what is a common cause of nephrocalcinosis ?
hyperparathyroid
- Nephrocalcinosis is a disorder in which there is too much calcium deposited in the kidneys. … In this disorder, calcium deposits in the kidney tissue itself. … Nephrocalcinosis is related to, but not the same as, kidney stones (nephrolithiasis).
If a patient has diffuse abdominal pain you should think?
small bowel obstruction
What is the hallmark sign of crohns? Where does it occur?
skip lesions-can occur anywhere
Coin on chest x-ray, what type of view do you need to see if it is on the inside?
lateral view
Diverticulosis is basically ?
Where does it occur?
Chronic constipation
large instestine only
RLQ pain can come from
can come from head of femur
sigmoid volvulus can be caused by?
colon cancer adhesions from surgery
