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Diagnostic Imaging III > Final > Flashcards

Final Flashcards

1
Q

Which organs or structures can be visualized in the normal AP supine abdomen?

A

stomach, colon, spleen, liver, kidney, psoas m., urinary bladder

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2
Q

Can you visualize the GB on a normal AP supine xray?

A

No

exception: 30% of calcium stones show up; cholesterol stones do not appear

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3
Q

Can you visualize the pancreas on a normal AP supine xray?

A

No

exception: calcifications that are seen with chronic pancreatitis and alcoholism

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4
Q

Can you visualize the uterus on a normal AP supine xray?

A

No

exception: calcified leiomyomas

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5
Q

Describe the location of gas and/or barium in the stomach in the recumbent vs. upright positions

A

In both positions gas rises to the top and the barium settles in the bottom

recumbent: the barium looks sloshy & hazy
upright: the barium has a flat fluid line at the top of the stomach or bowel

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6
Q

Describe the appearance of gaseous distention of the small vs. large intestine

A

The small bowel is fine, feathery mucosal folds; many folds, looks like stacked coil or striations

The large intestine has farther apart haustra, it’s larger in diameter, and doesn’t loop as much

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7
Q

A sign seen on a xray that indicates localized ileus from nearby inflammation; a dilation of a segment of the large or small intestines, where the enlargement is > 3 cm

A

sentinel loop

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8
Q

What is the significance of a sentinel loop on an xray?

A

It may aid in localizing the source of inflammation

e.g. a loop in the upper abdomen, it may indicate pancreatitis & a loop in the RLQ may indicate appendicitis

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9
Q

Posterior displacement of the magenblase is suggestive of enlargement in which organ?

A

Liver

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10
Q

What is the magenblase?

A

air bubble in the fundus of the stomach

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11
Q

Are the kidneys normally visible on an AP supine abdomen?

A

Yes, due to perirenal fat

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12
Q

What is the normal orientation and position of the kidneys?

A

located in the retroperitoneal space

the inferior pole is more lateral than the superior; i.e. the angle outwards, laterally

right kidney is at T12-L3 and left kidney is at T11-L2

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13
Q

What does it mean if the inferior pole of the kidneys are angling medially, towards the spinal column?

A

it’s probably a horseshoe kidney

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14
Q

What are the four different types of abdominal calcification patterns?

A

1) Concretions
2) Conduit wall
3) Cystic
4) Solid mass

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15
Q

Kidney stones & phleboliths are examples of __________ type of abdominal calcification

A

concretions

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16
Q

vas deferens calcifications & aortic calcification are examples of __________ type of abdominal calcification

A

conduit wall

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17
Q

aortic aneurism and berry aneurism are examples of __________ type of abdominal calcification

A

cystic

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18
Q

calcified lymph node & uterine leiomyoma are examples of __________ type of abdominal calcification

A

solid mass

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19
Q

A venous calcification in a pelvic vein, typically dense, oval, well-definied

A

phlebolith

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20
Q

Where are phleboliths typically found?

A

arranged around the lateral edge of the bladder

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21
Q

What is does it mean if a phlebolith appears in the midline?

A

there is a chance that a mass (tumor) is pushing it outward

*a phlebolith in the midline is always regarded as abnormal

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22
Q

oval opacity in the pelvic area with a tiny core of lucency

A

phlebolith

23
Q

What is the best method for detecting an abdominal aortic aneurysm?

A

ultrasound is more sensitive to xray; if detected on u/s, the surgeon will do a CT scan to get a better look

*only 50-80% of aaa will have calcifications (which makes the show up on xray)

24
Q

numerou dense, discrete opacities that are across the midline at L1-2

A

pancreatic calcification

25
Q

What is the MC cause of pancreatic calcification?

A

chronic pancreatitis d/t alcoholism

26
Q

cystic teratoma that contains diverse developmentally mature soft tissue

A

dermoid cyst

27
Q

What type of cyst can contain skin, hair, sweat glands, blood, bone, nails, eyes, teeth, etc.

A

dermoid

28
Q

Where is a dermoid cyst found?

A

uterus

29
Q

masses that have lucencies within them and might be whirled in appearance, located in the uterus

A

calcified uterine fibroma

30
Q

sharply defined homogenous calcifications located above or in the pubic symphysis

A

prostate calculi

31
Q

What is an injection granuloma?

A

an iatrogenic finding, granulation tissue at the site of an injection

32
Q

a little, softly -opaque circle in the gluteal region

A

injection granuloma

33
Q

What does residual contrast material in the diverticulum look like?

A

“chocolate chip” sign

small pockets of residual material within the diverticulum

34
Q

a struvite (triple phosphate stone) that fills the medullary portion of the kidney…may become so large as to fill the renal pelvis and calyces

A

staghorn calculi

35
Q

What is pneumoperitoneum?

A

presence of air or gas in the abdominal cavity

36
Q

What are some causes of pneumoperitoneum?

A

bowel perforation, peptic ulcer, abdominal surgery, peritonitis, infection, trauma, air entering via the female genital tract

37
Q

What is the percentage of radiolucent vs. radiopaque gallstones?

A

30% are radiopaque d/t calcium content

70% are radiolucent

38
Q

What is the best imaging to look for gallstones?

A

ultrasound (xray isn’t as good b/c only 30% are radiopaque)

39
Q

What is a porcelain gallbladder?

A

calcification of the gallbladder

40
Q

What is the significance of porcelain gallbladder?

A

pt. with this sign have 10-20% chance of developing carcinoma of GB

41
Q

How does hiatal hernia appear on plain films?

A

a magenblase (air bubble) can be seen above the diaphragm

42
Q

What is appearance of (a) ulcer, (b) polyp, (c) diverticuli, on a contrast (barium) study?

A

(a) volcano (a pocket of barium fills ulcer crater); most visible if it occurs in the curvature of stomach but xray isn’t a great modality to visualize
(b) usu. single, circular thing that goes inward twd the lumen of the organ; i.e. intrinsic mass
(c) bunch of pouches going outward twd the abdominal cavity; i.e. extrinsic mass

43
Q

constriction of the large bowel showing up on barium study

A

apple core deformity

(when a mass is filling part of the lumen of a hollow organ it makes the lumen smaller…check a minute later to make sure it’s still there and wasn’t just a snapshot of peristalsis)

44
Q

What usu. causes an apple core deformity?

A

colorectal cancer in the ascending or descending colon

45
Q

When do we see lead pipe colon?

A

ulcerative colitis

46
Q

What is lead pipe colon?

A

distention of the bowel that is so extreme that you can no longer see the mucosal folding

47
Q

What is the coiled spring appearance in small bowel?

A

gaseous distention on the mucosal contour in the SI causing thin mucosal folds; appears on xray as a coiled spring or stacked coins

48
Q

What causes coiled spring appearance?

A

small bowel obstruction

49
Q

What is intravenous pyelogram (IVP)?

A

Contrast material injected into a vein in the pt. arm and travels through blood stream to collect in kidneys & urinary tract, turning those areas bright white on xray

Allows radiologist to view and assess anatomy & fn of kidneys, ureters, and bladder

50
Q

IVP of normally functioning kidneys

A

kidneys will first show signs of dye (bright white), then the ureters, and finally the bladder

51
Q

IVP when there is obstruction from a kidney stone

A

stones will become stuck at jns (e.g. where kidneys drain into ureter, where ureter crosses pelvic bone, ureter-bladder junction), so contrast will only go to point of block and stop & you will see back pressure with dilation of upstream structures

52
Q

What is the percentage of radiolucent vs. radiopaque kidney stone?

A

opaque is much more common (80-90%)

53
Q

Distention of the pelvis and calyces d/t some obstruction

A

hydronephrosis

kidney swells d/t back-up of urine

54
Q

What should you perform a retrograde pyelogram?

A

when the pt. has kidney damage and can’t take the dye through IV

when you need to visualize the GU system, but do not want to stress kidneys by injecting a chemical into circulation

Diagnostic Imaging III (2 decks)

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