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CT & MRI > CT Application 5 Trauma > Flashcards

CT Application 5 Trauma Flashcards

1
Q

FAST

A

Focused Assessment with Sonography for Trauma

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2
Q

why CT is the undisputed gold standard

A
  • immediate access
  • high spatial res, specificity, sensitivity
  • low scan time
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3
Q

FAST rapidly identifies free fluid in ___

A

abdomen / pericardium / pleural space

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4
Q

hemopericardium

A

blood in heart

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5
Q

hemoperitoneum

A

blood in peritoneal cavity

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6
Q

what is the initial assessment of trauma patients

A

FAST

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7
Q

advantages of FAST US

A

BANG
- beside imaging
- available
- no radiation
- guides insertion tubes & catheters

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8
Q

disadvantages of FAST US

A

LOL
- Limited visualization in big patients or GI gas accumulation
- Operator dependent
- Low reproducibility

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9
Q

advantages of x-ray

A

ABC
- available
- beside imaging
- cheap

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10
Q

disadvantages of x-ray

A

RPL
- radiation
- patient must hold still
- limited specificity & sensitivity

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11
Q

advantages of MRI

A

SHN
- SST visualization
- high sensitivity & specificity
- no radiation

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12
Q

disadvantages of MRI

A
  • not easily available
  • long duration
  • costly
  • contraindicated with metal implants
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13
Q

advantages of CT

A

EVC
- Evaluates multiple organs
- Visualizes pathologies beyond XR & US
- Contrast medium enhances evaluation

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14
Q

disadvantages of CT

A
  • radiation
  • allergic reactions
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15
Q

types of errors in trauma imaging

A

input, intention, execution

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16
Q

causes of errors made in trauma imaging

A

TIMU
- time critical decisions with concurrent tasks
- incomplete history
- mass causalities
- unstable patients

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17
Q

GCS

A

glasgow coma score

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18
Q

what is GCS used for

A

summary to determine impaired consciousness extent of patients but less detailed

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19
Q

what does GCS assess

A
  • eye opening
  • verbal response
  • motor response
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20
Q

CT trauma preparation

A

triage > transfer > ct scan

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21
Q

what is the IV access for trauma patients

A

18G & 22G cannula

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22
Q

what is checked at triage phase of patient prep

A
  • FAST Scan
  • IV access
  • creatinine & eGFR
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23
Q

c4 injury leads to

A

complete paralysis below neck

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24
Q

c6 injury leads to

A

partial paralysis of upper & lower limbs

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25
Q

t4 injury leads to

A

paralysis below chest

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26
Q

L1 injury leads to

A

paralysis below waist

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27
Q

what injuries lead to paraplegia

A

T4 & L1

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28
Q

what injuries lead to tetraplegia

A

C4 & c6

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29
Q

complete lesion defined as

A

no sensation / motor injury in lowest part of spinal cord S4/5 and no motor function at least 3 levels below spinal cord injury

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30
Q

incomplete lesion defined as

A

some sensation or voluntary movements below level of spinal cord injury

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31
Q

CT head indication

A

assess for traumatic brain injury

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32
Q

CT C-Spine indication

A

CXR AP & Lateral C-spine inconclusive

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33
Q

CT thorax & abdomen pelvis indication

A

patient hemodynamically stable & need to find active bleeding source

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34
Q

scan region for CT head

A

base of skull > vertex

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35
Q

scan region for CT cervical spine

A

craniocervical junction > T1

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36
Q

scan region for CT thorax abdomen

A

thorax and/or abdomen

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37
Q

algorithm for CT head

A

brain SST & skull

38
Q

algorithm for CT cervical spine

A

bone

39
Q

algorithm for CT thorax abdomen

A

SST, Lung, Bone

40
Q

CTA

A

CT angiography

41
Q

how does CTA work

A

CT + IV contrast to visualize blood vessels anatomy & flow to diagnose vascular diseases

42
Q

purpose of CTA

A
  • detailed visualization
  • diagnosis
  • pre & post operative use
  • non-invasive alternative
43
Q

aneurysms

A

outward bulge of blood vessel wall

44
Q

stenosis

A

narrowed blood vessels = lower blood flow

45
Q

occlusions

A

blood vessel blockage

46
Q

embolisms

A

blood vessel blocked by blood clot

47
Q

conventional diagnostic angiography is used for

A

interventional procedures unless tiny vessels to be studied due to invasiveness

48
Q

magnetic resonance angiography provides excellent diagnostic quality for patients with ___

A

adverse reactions to CT contrast

49
Q

disadvantage of magnetic resonance angiography is ___

A

poor resolution on vascular studies and subject image artifacts from metal / blood flow studies

50
Q

which cannula used for CT angiography

A

18G

51
Q

methods to optimize timing of CM injection to enhance images

A

fixed delay, bolus tracking, test bolus

52
Q

fixed delay is __

A

predetermined delay between CM injection & start scan

53
Q

bolus tracking is __

A

scanner continuously monitors ROI till desired enhancement reached from arrival of contrast bolus

54
Q

test bolus is ___

A

small CM injection followed by series of low-dose scans to determine optimal timing for full contrast injection & scans

55
Q

peak enhancement time of pulmonary artery

A

10 - 15s

56
Q

peak enhancement time of arterial phase

A

25 - 40s

57
Q

peak enhancement time of portavenous phase

A

80 - 90s

58
Q

essentials for CTA

A
  • large cannula access (18G/20G)
  • thin slices to reformat MIP images
  • high table speed
59
Q

To ensure proper circulation timing, scanners use either ____ or ___

A

mini test bolus; automatic bolus tracking software

60
Q

data acquisition of CTA

A
  1. scout / topogram
  2. arterial contrast IV injection
  3. CM timing
  4. data acquisition
  5. post processing
61
Q

scan range of CT brain & carotid angiogram

A

aortic arch > vertex

62
Q

pre-monitoring slice ROI of CT brain & carotid angiogram

A

aortic arch

63
Q

scan range of CT aortogram

A

aortic arch > R & L iliac arteries

64
Q

pre-monitoring slice ROI of CT aortogram

A

ascending aorta

65
Q

aortic dissections

A

tear in internal face of aorta causes dissection through laminas & new lumen formation

66
Q

what separates true & false lumina

A

dissection flaps

67
Q

stanford type A aortic dissection

A

flap involves ascending aorta or great vessels

68
Q

problems of stanford type A aortic dissection

A

urgent surgery due to occlusion risk & aortic valve regurgitation / rupture into pericardium

69
Q

stanford type B aortic dissection

A

flap involves descending aorta

70
Q

scan range of CT pulmonary angiogram

A

lung apex > lung base

71
Q

ROI of CT pulmonary angiogram

A

pulmonary trunk

72
Q

scan range of CT coronary arteries angiogram

A

carina > cardiac apex

73
Q

ROI of CT coronary arteries angiogram

A

ascending aorta

74
Q

pre monitoring slice of CT coronary arteries angiogram

A

mid chest near carina

75
Q

problems with CT heart imaging

A
  • max temporal resolution at 125ms
  • ECG trigger/gating
  • prospective trigger
  • retrospective scans
76
Q

prospective sequential ECG trigger

A

ECG signal used to trigger CT scan at selected heart phase which turns on & off during selected phases

77
Q

retrospective ECG spiral

A

acquisition continuous as table moves forward with constant pitch but higher dose

78
Q

prospective triggering

A

step & shoot which starts at preset in R-R internal period

79
Q

pre-monitoring slice of CT angio lower limbs

A

upper abdomen

80
Q

ROI of CT angio lower limbs

A

descending aorta below kidneys

81
Q

___ slices used for MPR & MIP reconstruction

A

thin

82
Q

dual energy techniques

A
  • twin spiral
  • twin beam
  • dual source
83
Q

energy spectra used for dual energy imaging

A

high (150 kV) & low (90 kV)

84
Q

advantage of dual energy compared to conventional CT

A

materials with different elemental compositions can be differentiated and quantified by comparing their CT numbers at
two different energy levels

85
Q

what is gout

A

monosodium urate crystals deposited commonly at 1st MTP joint

86
Q

applications of image guided CT imaging

A

biopsies, drainage, radiofrequency, facet joint corticosteroid injection

87
Q

commonly biopsied areas

A

bone, lungs, liver, kidneys, lymph nodes

88
Q

purpose of CT nerve root block

A

pain management

89
Q

why is CT nerve root block performed compared to spinal surgery

A

minimal invasiveness & lower risk

90
Q

nerve root block involves injection of ___ anesthetic

A

steroid & local

91
Q

complications of image guided CT

A
  • pneumothorax
  • bleeding
  • hemoptysis
92
Q

hemoptysis

A

airway bleeding

CT & MRI (12 decks)

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