Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Clin Lab > HEENT > Flashcards

HEENT Flashcards

1
Q

What ending will be found on traditional x-ray studies to help you know it is an x-ray?

A

“graphy”/ “gram”

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is a “wet read” of an imaging study, in current terms?

A

Start initial review of images when time is critical, followed by more in-depth interpretation. Early/preliminary

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are the basic densities of tissues on x-rays and CTs, and what do they look like on imaging?

A

5 basic densities of tissues on X-rays:Air, Fat, Soft tissue/fluid, Calcium, Metal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What does air look like on imaging?

A

Least dense, appears mostly black.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What does fat look like imaging?

A

slightly gray

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What does soft tissue and fluid look like on imaging?

A

slightly gray

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What do bones/kidney stones/ gallstones look like on imaging?

A

white, more dense

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What do metals look like on imaging?

A

most dense, appears brightest on X-ray- white

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are the types of contrast used with x-rays? What are the major possible adverse effects?

A

Contrast highlights structures that may be hard to distinguish otherwise. Types of contrast:
1. Oral: Barium (GI tract)- crossover with shellfish and iodine allergy so be careful. Air- Contraindicated in bowel perforation. Water soluble (iodinated)
2. IV (water soluble)
3. Inhaled
4. Rectal (enema). Barium. Air. Double Contrast: like the picture below. It shows an apple core sign which is usually a sign of colon cancer.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are the risks, uses of x-rays?

A

radiation exposure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are the benefits of x-rays?

A

easy, fast, cheap

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are the limitations of x ray?

A

hard to see soft tissues changes, multiple views needed to see 3D relationships

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are the common uses of x-rays?

A

CXR, Abd x ray, skeletal x ray, soft tissue foreign body, fluoroscopy, mammograms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Describe fluoroscopy and its primary uses.

A

Rapid series of x-rays projected on a screen and forms a video
1. Visualization of movement- typically a swallowing study like GI tract (contrast)
2. Visualization of anatomy. Joint injection- gets harder with pts with arthritis. Lumbar puncture- 2 people have to have tried and failed to do this. Angiography (contrast)- heart caths. Genitourinary studies (contrast)- Vesicoureteral reflux (VUR) reflux

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Describe what a Hounsfield unit is

A

Each image=thousands of pixels. Each pixel is assigned a Hounsfield unit based on attenuation. Hounsfield units: -1000 to +1000

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

give typical Hounsfield units (HU) for air

A

-1000 HU

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

give typical Hounsfield units (HU) for water

A

Water= 0

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

give typical Hounsfield units (HU) for bone

A

+400 to +600

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

give typical Hounsfield units (HU) for organs and fat and metal

A

Lung: -600 to -400 HU and Fat -100 to -60 HU Soft tissue= +40 and +80 Metal:+1000 HU

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Describe what a CT “window” is. What are the typical windows used in clinical practice?

A

In PACS, can adjust how HU are displayed in order to see different tissues better. Common Windows: Bone (+400), Lung ( -600), abdomen (+150) and brain (+40)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Describe the orientation of the typical CT image

A

Left side of the picture is the right side of the patient. As if you are standing at the foot of the bed. Initial images are in axial plane. Axial images can be post-processed to give sagittal and coronal views

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Describe the types of contrast used with CT scans

A

Contrast: Water soluble (iodinated). Can be given IV, oral, or rectal. Oral/rectal-enhance GI structures. IV-enhance soft tissue structures and blood vessels use for cancer, abscess, or infection. IV affects the kidneys. Anyone with poor kidney function, we run the risk of sending them into dialysis. If they are already on dialysis it doesn’t matter. Don’t use: active bleeding (toxic to tissue), looking for stones, looking for fractures.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What are the risks for using or not using contrast

A

acute kidney injury, more likely with underlying kidney disease. To reduce the risk, we can over hydrate our patients and wait 24-48 hours between administration.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What are the contraindications for using contrast?

A

decreased renal function. Iodine allergy/shellfish allergy. To reduce risk of allergic reaction, can antihistamines and steroids prior to giving contrast. Can order CT scans- w/ or w/o contrast, CT Angiography-specialized view of blood vessels

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Describe the risks of CT scans

A

increased radiation exposure, contrast risks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What are the benefits of CT?

A

fast, good visualization of soft tissues and bones, easier to see 3D relationships

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What are the limitations of CT?

A

less readily available, more expensive, size issue- 350 pound weight limit.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Describe the common uses of CT scans

A

brain/spinal cord imaging, chest, abd. Pelvis, blood vessels, bone evals

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

What are some newer uses for CT?

A

virtual colonoscopy, virtual bronchoscopy, 3D reconstruction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Describe the process used in MRI to get signals from the body

A

Magnetic Resonance Imaging. No radiation. Uses strong magnetic field using protons is tissues are forced into alignment with the magnetic field. Pulsed radiofrequency signals push protons (more=more protons, = brighter images) out of alignment. When radio signal stops, protons return to alignment with magnetic field- emit a signal as they realign-detected by the scanner and strength of signal depends on relative amount of protons in the tissue. Computer processing of signals yields images.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Describe the differences between T1 and T2 images

A

Signals are detected at different time intervals after the radio signal ends. T1: shorter interval T2- longer interval. Protons in fat realign faster than protons in water. T1 images-fat is bright and T2 images- fat and water are bright. T2 images usually processed to remove signal from fat-highlights water. Compare T1 and T2 images to detect areas with increased water. Increased water= edema, likely from cell damage. Other types of images: FLAIR: fluid attenuated inversion recovery. Diffusion weighted. In T1- gray matter shows up gray because it is surrounded by myelin which contains fat. In T2, they have a mass and swelling. This is where pathology is gonna show up best. SX with the mass: headache, issues with movement, balance issues, nausea, worse at night and in the morning, especially for several days in a row. If it is on their left, it will affect the right side of the body.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Describe the risks of MRI scans

A

strong magnet + metal in the body, contrast risks. No one with a pacemaker can have an MRI.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

What are the benefits of MRI?

A

no radiation, good visualization of nervous ligaments and tendons (ACLs), good visualization of masses.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

What are the limitations of MRI?

A

less readily available, much more expensive, longer time to obtain images, size issues, anxiety/claustrophobia- small tube and loud- may use ativan oral or IV. some people need to be full on sedated. For 30 mins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Describe the common uses of MRI scans

A

brain and spinal cord imaging, abdomen/pelvis imaging. Ligament/tendon/cartilage/bone imaging. Will show osteomyelitis.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Describe the process used in nuclear imaging scans

A

Uses radioactive isotope. Isotope injected and after time lapse, gamma detector detects concentration of isotope and creates image. Looking for areas of increased concentration or decreased concentration. Example-thyroid. Isotope breaks down to inert substance cleared by the body (urine/stool).
When doing these scans. Consider if the female is pregnant or if they have babies or kids, make sure they are kept away from their kids for awhile so the radioactive isotope can leave their system.

37
Q

What areas are the most concerning for thyroid cancer?

A

cold spots

38
Q

Describe the risks and benefits of nuclear medicine scans

A

Risks: radiation
Benefits: analysis of function

39
Q

What are the limitations of nuclear medicine scans?

A

less readily available, much much more expensive, poor spatial resolution, takes a long time

40
Q

What are the uses for nuclear scans?

A

Thyroid scan, parathyroid scan, bone scan, cardiac stress test (do we need to go in and do a heart cath), Positron emission tomography (PET) scan

41
Q

Describe the process used in ultrasound to obtain images

A

Sound waves transmitted into tissue. Reflected signal detected and turned into image on screen. Transducer- generates sound waves and detects reflected signals, many different shapes and orientations, producing different frequencies of sound.
Higher frequencies- better resolution don’t penetrate deeply, abscesses vs. cellulitis
Lower frequencies-less resolution but penetrate further , appendix
Small transducers on the ribs
Medium on the belly
Transvaginal or transrectal

42
Q

Describe the level of echogenicity seen with different types of tissues, and describe the appearance on the ultrasound image.

A

Different tissues given different amount of reflection
Fluids-minimal reflection-dark area on screen
Bone-maximum reflection- bright area on screen with shadow beyond
Soft tissue- moderate reflection-gray area
Anechoic: no echo because it is air or fluid
Hyperechoic: really dense connective tissue
Isoechoic: liver, kidneys, solid organs
Hypoechoic: blood, not in a vessel

43
Q

Describe how an ultrasound image is oriented on the screen versus the orientation of the transducer

A
44
Q

Describe the risks and benefits of ultrasound scans.

A

Risks: no major risks identified
Benefits: fast, no radiation, can be done at the bedside

45
Q

Describe the limitations of US

A

bone, bowel gas blocks visibility, lower resolution, dependent on operator experience/technique, body habitus

46
Q

Describe the common uses ultrasound scans.

A

Uses: cardiac function, vascular evaluation, soft tissue evaluation, fluid evaluation, fetal evaluation, needle guidance

47
Q

Describe Water view

A

PA view with head titled up. Maxillary sinuses with a better view

48
Q

Describe Caldwell view

A

PA view with head titled down to see the frontal sinuses. Bow to Mr. Caldwell

49
Q

Describe orbital view

A

Similar to Water’s view but shows orbits better- Metal fragments, Orbital floor fracture (muscles can get caught in the fracture limiting movement)

50
Q

Describe a nasal bone view

A

Magnifying the nasal bone

51
Q

Describe a mandible view

A

focus on the mandible

52
Q

Mandible-Panorex

A

@ the dentist or with trauma, widened view and goes all around

53
Q

Cervical Spine AP view

A
54
Q

Lateral view

A
55
Q

Cervical Spine Oblique

A
56
Q

Cervical Spine Odontoid

A

C1 and C2: critical for head support and spinal cord because the skull rests on the top of the atlas

57
Q

Describe what a fracture looks like on an x-ray

A

Fractures are disruptions of the brighter cortex of the bone

58
Q

Describe what sinusitis looks like on an x-ray

A

Sinusitis: look for symmetry of sinuses and fluid It will look cloudy/grey.

59
Q

Describe what epiglottitis looks like on an x-ray

A

thumb print sign

60
Q

Describe what a retropharyngeal abscess looks like on an x-ray

A
61
Q

When would you use CT maxillofacial without contrast

A

Trauma to the facial bones

62
Q

When would you use CT maxillofacial with contrast

A

evaluation of masses

63
Q

When would you use CT head without contrast

A

trauma of skull bones

64
Q

When would you use CT head w/o contrast

A

orbital fracture

65
Q

When would you use CT orbits without contrast

A

orbital fracture

66
Q

When would you use CT neck with contrast

A

Eval of masses/swelling. Eval of hoarseness. Eval of dysphagia. Eval of stridor

67
Q

When would you use CT sinuses without contrast

A

evaluation of sinuses

68
Q

When would you use CTA neck

A

Blood vessels

69
Q

Describe the indications for an MRI of the brain

A

Hearing loss (unilateral) weber-rinne-CN8. Vertigo (inner ear/stroke). Eval of masses (stroke, maybe), eval of brain/spinal cord (Neurology)

70
Q

Describe the differences on ultrasound between cellulitis and abscess

A
71
Q

Identify the pathologies

A

Epiglotitis with a thumb print sign

72
Q

Identify the pathologies

A

CT of the sinuses, the left is impacted

73
Q

identify the pathology

A

Retinal detachment

74
Q

Identify the pathology

A

Left tonsil is infected

75
Q

Identify the pathology

A

Hearing loss/vertigo Can happen bilaterally, MIDDLE AGED PERSON (40s). Acoustic neuroma tumor on CN8 unilateral hearing loss

76
Q

Describe the indications and contraindications for nasal and sinus endoscopy

A

Contraindications-relative: trauma (make sure there are no fractures), intracranial infection, bleeding disorder or on blood thinners

77
Q

Describe possible causes and the diagnostic workup for sialadenitis (enlarged salivary gland)

A

enlarged salivary gland (sialadenitis), infection, blocked salivary duct (stone= sialadenolithiasis), Cancer
DX: imaging: CT, MRI, US, biopsy if needed

78
Q

Describe how and when eye pH should be measured

A

Indication: chemical burns. Worry more about alkali stuff Measure between the lower lid and eye. pH paper.
Acidic vs alkali- measure pH in both eyes- measure between lower lid and eye pH 7.0-7.3
Irrigate thoroughly and measure pH at intervals until pH is back to normal

79
Q

Describe how to distinguish conjunctivitis from scleritis

A

Both conditions have hyperemia (engorged vessels) “conjunctiva is injected”
Scleritis- needs ophthalmology eval, much more concerning
Location in eye: conjunctiva, episclera, or sclera phenylephrine solution- shrinks vessels in conjunctiva/episclera see a lot of white a few mins after, but not in sclera

80
Q

Describe the indication and process for fluorescein staining of the cornea

A

Indication: evaluate for cornea abrasions/foreign bodies SX?
Fluorescein=dye that fluoresces with blue light. Normal cornea-evenly distributed. An abrasion/foreign body-fluorescein concentrated at that site. Application: drops or strips

81
Q

Describe the process of tonometry and normal/abnormal finding

A

Screening for increased IOP (yearly eye exam), evaluate eye pain, redness, decreased visual acuity.
General principle: force is used to flatten the cornea, amount of force needed is related to IOP. Normal IOP- 10-20 mmHg. 20 mmHg<glaucoma.

82
Q

What are some contraindications and examples for tonometry?

A

Contraindications: trauma, recurrent abrasions, active infection
Ex: goldman tonometer. Contact made with cornea-anesthetic needed. Force is applied to applanate a specific size/area. Visual lines on apparatus are aligned. Risks: infection and overapplication of force. Even amounts of pressure, line ares even
Air puff tonometer that use air to flatten cornea and the amount of deformation is measured and correlated with IOP. Eyelid: pressure measured thru upper eyelid

83
Q

Orbital cellulitis requires what kind of imgaing modality?

A

CT with contrast

84
Q

Opacification with air-fluid levels on CT is indicative of what?

A

Sinusitis

85
Q

What is the best way to view a retinal detachment?

A

US

86
Q

When evaluating a zygomatic fracture, what imaging modality is best?

A

CT maxillofacial without contrast using a bone window.

87
Q

pulsatile masses need what kind of imaging modality?

A

CT with contrast and angiography

88
Q

Thyroid nodules and malignancies are best viewed with which modality?

A

US of the neck

89
Q

Patietns with a neck mass and history of cancer treatment need what imaging?

A

CT with contrast or CT w/ PET

Clin Lab (2 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions