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NME COPY > Imaging of the Abdominal Viscera > Flashcards

Imaging of the Abdominal Viscera Flashcards

1
Q

Is radiography or CT more accurate in abdominal imaging?

A
  • CT
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2
Q

What are the 4 key benefits of using X-ray imaging?

A
  • cheap and quick
  • easy for patient
  • high spatial resolution (good for bone)
  • low radiation dose
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3
Q

What are the 2 key negatives of using X-ray imaging?

A
  • poor contrast resolution (poor for soft tissue)
  • 2D imaging (superimposes structures)
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4
Q

What are the 3 key benefits of using CT scanners?

A
  • quick and widely available
  • cross sectional images instead of 2D
  • high contrast resolution (good for soft tissue)
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5
Q

What are the 2 key benefits of using CT scanners?

A
  • radiation dose
  • IV Contrast die increases risks
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6
Q

What are the 3 key benefits of ultrasound in imaging?

A
  • cheap, quick, no radiation
  • cross sectional images
  • offers US guided interventions
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7
Q

What are the 2 key negatives of ultrasound in imaging?

A
  • operator dependent
  • saved images are only a snapshot of examination
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8
Q

What are the 3 key benefits of MRI in imaging?

A
  • contrast resolution
  • specific applications (e.g. small bowel)
  • no radiation
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9
Q

What are the 4 key negatives of MRI in imaging?

A
  • limited availability
  • patient experience (duration, claustrophobia)
  • expense
  • magnet / contrast die risks
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10
Q

Where should the X-ray cover in an abdominal X-ray?

A
  • pubis bone up to diaphragm
  • ilias of hips
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11
Q

In an abdominal X-ray should patients inhale or exhale on an X-ray?

A
  • image is captured during exhalation
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12
Q

If a patient presents with abdominal pain only, is an X-ray, CT or ultrasound more appropriate?

A
  • erect ultrasound or CT
  • not an X-ray
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13
Q

If a patient has a clinical obstruction, would an abdominal X-ray be suitable?

A
  • yes
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14
Q

If a patient has an acute exacerbation of inflammatory bowel disease, would an abdominal X-ray be suitable?

A
  • yes
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15
Q

If a patient has a -alpable mass in the abdomen, would an abdominal X-ray be suitable?

A
  • yes, but only specific cases
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16
Q

Constipation is generally not an indication for an abdominal X-ray. What patient group with constipation would an abdominal X-ray be suitable for?

A
  • elderly patients
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17
Q

In acute and chronic pancreatitis is an abdominal X-ray always suitable?

A
  • not always
  • suitable in specific circumstances
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18
Q

If a patients has a sharp or potentially poisonous foreign body inside the abdomen, is an abdominal X-ray always suitable?

A
  • yes
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19
Q

If a patients has a suspected smooth and small foreign body (e.g. battery) trapped in the abdomen, is an abdominal X-ray always suitable?

A
  • yes
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20
Q

If a patients has a suspected blunt or stab injury in the abdomen, is an abdominal X-ray always suitable?

A
  • yes
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21
Q

Solid organs and tissue can be detected on an abdominal X-ray. What are the key solid organs we should be able to identify?

A
  • liver
  • kidneys
  • ilios muscles
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22
Q

When using abdomainl X-rays, what makes it difficult to identify all the organs of the abdomen?

A
  • trapped gas in organs
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23
Q

Some organs in an abdominal X-ray can be identified due to the prescence of gas or calcification. What are some key hollow organs that we may be able to identify on an abdominal X-ray?

A
  • stomach
  • small and large bowel
  • gall bladder
  • urinary bladder
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24
Q

What are a few of the anatomical landmarks that need to be included on an abdominal X-ray?

A
  • diaphragm
  • L4 vertebral body
  • iliac crest
  • left and right flanks
  • sacrum and superior pubic ramus
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25
Air can be observed in the small and large bowels, but is this when the bowels are dilated or non-dilated?
- non dilated only
26
On abdominal X-ray imaging what should be contained within the large and small intestines?
- small = fluid and gas - large = stool and gas
27
What are haustra in the GIT?
- small segmented pouches of the bowel - separated by the haustral folds - formed by circumferential contraction of the inner muscular layer
28
Are haustra present in the small and large bowel?
- no - large bowel only
29
What is the function of haustra in the colon?
- peristaltic contracts - avtivated by chyme prescence
30
What are valvulae conniventes, also known as plicae circulares of the GIT?
- folds within the mucousa of the intesintes - smaller than Haustra
31
Are valvulae conniventes, also known as plicae circulares present throughout the GIT?
- no - just small intestines
32
Can solid faeces be found throughout the GIT?
- no - generally just the large intestines
33
On an X-ray, where are the small and large intestines located visually?
- small intestines = centrally - large intestines = peripherally
34
Is the large or small bowel longer, and why is this?
- small bowel is longer - important for digestion and absorption
35
Does the large or small bowel have more loops?
- small bowel has more loops
36
Does the large or small bowel have a larger diameter loop?
- large bowel has larger loops - large = _+_ 5cm - small = \<3cm
37
In the image below, are we looking at the small or large intestines, and how do we know?
- small intestines - centrally located - contains valvulae conniventes running full width of bowel - does not exceed 3mm diameter – if normal
38
In the image below, are we looking at the small or large intestines, and how do we know?
- large intestines - peripherally located - haustra present, do not cover full width of bowel
39
What is circled on the X-ray present in the large bowels?
- faeces and air - present in left upper quadrant - middle near pelvis where rectum is
40
In terms of malignancy, what is one of the reasons why a CT of the abdomen may be requested?
- suspected tumour - staging (T.N.M) - determine if its operable
41
Is a CT scan recommened in patients with supsected liver and pancreatic disease?
- yes - shows liver cirrhoisis and pancreatitis
42
Why can CT scans of the abdomen be useful in patients who may have an obstrutction?
- identify location of obstruction - identify potential cause of obstruction
43
If a patient has been involved in trauma to the abdomen, why would a CT scan of the abdoment be useful?
- assess damage - bleeding
44
Why can CT scans of the abdomen be useful diagnostically?
- identify where to take biopsy from
45
In the CT scan below, what do the black circles depict?
- gas in the bowels - could be an obstruction caused by cancer obstruction
46
What is a bowel CT colonoscopy?
- bowels are inflated with CO2 - CT imaginging is then captured
47
What are the benefits of using CT colonoscopy?
- able to replace barium enemas can assess for strictures/ Ca (carcinoma) of the colon - minimally invasive and low dose - comparable accuracy to optical colonoscopy
48
What imaging modality is being used in the image below?
- CT colonoscopy
49
Who are the most common clinicians who may recommend an MRI of the abdomen?
- hepatologists - gynaecological - urologist (prostate)
50
What is MRI enterography?
- used to investigate GIT - a painless, noninvasive, and radiation-free medical imaging test - patients consume a contrast die - contrast die detected by MRI
51
What is MRI cholangiopancreatography (MRCP)?
- imaging using MRI to create 3D image - imaging of the biliary tree and pancreatic ducts is performed - gall bladder stones can be seen on the image
52
What is a sonographer?
- expert who performs ultrasounds
53
When is an ultrasound useful by clinicians?
- when studying solid GIT organs - jaundice, gallbladder disease, abdominal bloating, mass
54
Do ultrasound generally get performed in one place?
- no - generally transverse and longitudinal
55
The image on the left shows a healthy gallbladder, what do the 2 oval shapes represent in the image on the right?
- gallbladder stones
56
In the abdominal X-ray below what can we see and what could be a likley cause of this?
- large bowel obstruction - descending bowel - could be a mass
57
What does perforation mean?
- loss of integrity of the bowels - commonly known as bowel rupture - air is present outside the bowel
58
The image below demonstrates a patient with a perforated bowel. What do the blue and orange arrows depict and what are other signs that may be useful?
- patient is distended - blue = air inside bowel outlining the lumen (normal finding) - orange = outer surface of bowel visible due to air outlining
59
What is riglers sign?
- a sign of pneumoperitoneum (air in peritoneum) - gas is visible inside and outside of the bowel wall
60
Why can an erect chest X-ray be useful in a patient with a suscpected perforation?
- generally performed post abdominal surgery - useful to detect a thin crescent of air - present under the right hemidiaphragm and above liver - can be normal post surgery, if not this is abnormal
61
What does the image below depict, that would not normally be present on a normal X-ray?
- calcifications - yellow depict calcification in kidenys (likely kidney stones) - red depicts calcification in gallbladder (gall stones)
62
What imaging modality is this image and what is depicted in the abdominal image below?
- X-ray - aortic aneurysm
63
What imaging modality is this image and what is depicted in the abdominal image below?
- CT with contrast - aortic aneurysm

NME COPY (61 decks)

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