Clinical Imaging Flashcards
What are the types of single view radiographs you can order? What is most commonly ordered?
- “KUB” (most common)
- Kidneys, Ureteres, Bladder
- supine
- X-ray is anterior (shooting to floor)
- centered more inferior
- AP abdomen (supine)
- X-ray is anterior (shooting to floor)
- should include both diaphragms
- Other names:
- Abdominal “flat plate”
- Portable abdomen radiograph
How can you tell if someone is supine or sitting up in an abdominal X-ray?
- Supine
- gastric bubble toward midline
- Sittin up-right
- the gastric bubble will be right under the diaphragm
- wait 10/15 min before you snap the shot b/c you want the gas to rise
What is the acute abdominal series
- Chest x-ray
- looking for free intraperitoneal air under the diaphramgs, or chest pathology that may be affectign the abdomen, etc
- supine abdomen
- Upright abdomen
- allows search for air-fluid levels in bowel, and better detection of free intraperitoneal air
What can you substitute for a upright abdomen in the acute abdominal series when the patient is debilitated (upright not possible)?
- Left lateral decubitus abdomen
- substitutes for upright view in debilitated patients
- patient needs to maintain position for at least 10-15 minutes
Identify the examples of the different basic radiographic densities:
What is a pattern of search method when looking at an abdomianl radiograph?
“bones, stones, gasses & masses”
When you scan radiograph for “bones, stones, gasses & masses”, what are you looking for with relation to bone?
- arthritic changes
- fracture
- mineralization
- erosion (aggression lesion)
- cancer or infection
What is indicated by the white arrow?
What is shown in the radiograph?
It is an indication of what kind of disease?
ivory vertebra
increased mineralization
metastasis
What is shown near the yellow line?
Is it common to see these on a radiograph?
“Stones” example
“cholelithiasis”
only 10-15% of gallstones calcify enough to be visible on X-ray
What is shown near the yellow line?
Where would you look for these?
Renal LIthiasis
most contain calcium, many are visible… but not all
look for them along the route of the renal calyces sysem
What is sown in the image near the yellow line?
Characterisitics of these structures?
Appendicolith (form of fecolith, coprolith)
Usually 1cm or greater
usually laminated (layers)
associated with appendicitis
associated with appendicitis rupture
What type of stone is shown in the image?
What is the typical shape for these types of stones?
venous stones
donut shaped
resembles ureterlithiasis
What a problem is shown in the image?
aortic calcification
What problem is shown in the image?
aortic aneurysm on a calcified abdominal aorta
Describe this bowel gas pattern
normal bowel gas pattern
What is shown in this image?
a small bowel obstruction
air-fluid levels are at differen theights
This indicates the intestine is trying to push things out “peristalsing, there is just an obstruction”
you can also see “string of pearls on the bottom right”
Describe the bowel gas patterin in the presented image. Is it large or small intestine?
What bowel gas pattern is shown in the image?
abnormal bowel gas pattern
adynamic ileus
a temporary paralysis of motility
failure of passage, but not mechanically obstructed
very common after abdomen surgery
notice- small and large bowel gas
What gas pattern is shown in the provided image?
abnormal bowel gas pattern
“gassless abdomen”
many things can do this – nees further assessment
What gas pattern is shown in the image provided?
abnormal gas pattery
pneumoperitoneum: free air
not always, but think bowel perforation
a dangerous sign
What gas pattern is shown in the image provided?
abnormal gas pattery
pneumoperitoneum: free air
not always, but think bowel perforation
a dangerous sign
Identify the indicated features of the provided radiograph
What gas pattern is shown in the provided image?
abnormal bowel gas pattern
Pneumatosis intestinalis: Gas within the wall of the bowel
not always, but think necrotic bowel
What gas pattern is shown in the provided image?
abnormal bowel gas pattern
portal venous gas: (located more peripheral in the liver)
not always, but think necrotic bowel
a dangeous sign
What gas pattern is shown in the image provided?
abnormal bowel gas pattern
pneumobilia: (located more central in the liver)
not alwasy, bu tusually just post-therapeutic
usually incidental, not signifigant
(rarely, is a fistulat with bowel)
Idenfity the two structures indicated in the photo
Identify the two structures indicated by the photo
What two features are indicated by the photo?
Why would you do a barium study?
Usually in the elderly who have had a stroke
hard tim speaking, swallowing (making their way into the airway & causing pneumonia)
Done with liquid, semi-liquid (pudding), and a solid
