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Module 14 > Imaging the Emergency Patient > Flashcards

Imaging the Emergency Patient Flashcards

1
Q

what are common traumatic injuries (6)

A
  1. pneumothorax
  2. pulmonary contusion
  3. pleural effusion (fluid)
  4. ascites
  5. diaphragmatic rupture
  6. fracture/luxations
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2
Q

identify the normal structures of the thorax (7)

A
  1. trachea
  2. cranial vena cava
  3. main stem bronchi
  4. bronchi
  5. pulmonary vessels
  6. caudal vena cava
  7. diaphragm
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3
Q

what are the criteria of imaging modalities (5)

A
  1. readily available
  2. conscious or mild sedation
  3. rapid
  4. minimal stress/not invasive
  5. easy to interpret (quality of image)
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4
Q

what are the prioritized areas

A
  1. thorax
  2. abdomen
  3. spine
  4. head
  5. limb
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5
Q

what is the effect of over exposure

A

too dark

lack of contrast

misdiagnose a pneumothorax

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6
Q

what are the effects of under exposure

A

too white

too little differentiation

misdiagnose abdominal fluid

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7
Q

what are anatomic artefacts

A

skin fold/lines

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8
Q

what should you normally see in the thorax (5)

A
  1. heart
  2. diaphragm
  3. trachea
  4. lungs (blood vessels)
  5. thoracic wall (ribs, sternum, vertebrae)
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9
Q

what should you look for to identify abnormalities

A
  1. loss of normal structure
  2. loss of normal architechture
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10
Q

what are traumatic lesions that can happen in the thoracic wall (4)

A
  1. diaphragmatic rupture
  2. fractured ribs
  3. fractured or dislocated sternum
  4. flail chest
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11
Q

what are some traumatic lesions that occur to the intrathoracic cavity (6)

A
  1. pneumothorax
  2. pulmonary contusion
  3. pneumomediastinum (cervical, pharyngeal?)

(1-3 more common)

  1. pleural effusion (hemothorax, chylothorax)
  2. cardiac tamponade (pericardial effusion)
  3. lung lobe torsion

(4-6 less common)

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12
Q

how does a pneumothorax present on radiograph (3)

A
  1. heart raised from sternum
  2. retraction of lung lobes –> free gas between lung and thoracic wall & loss of vascular markings peripherally
  3. increased lung opacity
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13
Q

what is occuring here

A

pneumothorax

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14
Q

what is occuring here

A

pneumothorax

free gas with no pulmonary markings

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15
Q

what are lung bulla/blebs

A

permanent air filled space within the lung –> lung trauma not clinically significant but if pop can lead to development of pneumothorax

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16
Q

what are the signs of a tension pneumothorax (4)

A
  1. heart raised from sternum
  2. retraction of lung lobes –> loss of vascular markings peripherally
  3. diaphragm pushed caudally –> diaphragm flat or concave
  4. increased intercostal spaces
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17
Q

what is a tension pneumothorax

A

air pressure is continually increased that can be developed in the lung paranchyma emergency

diaphragm flattened appearance

rounded chest

very poor gas exchange –> imminent danger for animal

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18
Q

what is the appearance of pulmonary contusions

A

lung has soft tissue opacity –> blood, edema

commonly seen but not always with pneumothorax

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19
Q

what is shown here

A

pulmonary contusion

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20
Q

how does pleural effusion appear on radiograph

A
  1. loss of cardiac shadow (DV, lateral if marked/severe effusion)
  2. retraction of lung lobes (soft tissue opacity in pleural space, outlines lungs, interlobar fissures, leaf or scalloped edges)
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21
Q

what is shown here

A

pleural effusion

may see faint lines running between intercostal spaces

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22
Q

how does a diaphragmatic rupture show on radiograph (6)

A
  1. can’t see diaphragm
  2. gas filled tubes of intestines in thorax
  3. abdomen is missing small intestine loops –> empty abdomen
  4. displaced/absent falciform fat
  5. cranial displacement of pylorus
  6. loss of diaphragmatic line

+/- pleural effusion

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23
Q

what is shown here

A

diaphragmatic rupture

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24
Q

how does pneumomediastinum show on radiograph

A
  1. visible contents of mediastinum

may track under skin

  1. tracheal/esophageal perforation
  2. cervical/pharyngeal wound

air building up in mediastinum space –> increased visibility of structures here (vascular structures)

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25
Q

how is pericardial effusion best diagnosed

A

ultrasound

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26
Q

what does ability to identify organs depend on

A
  1. presence of intra-abdominal fat
  2. presence of gas in GI tract
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27
Q

what is aFAST and what are the 4 points

A

4 point check

  1. diaphragmohepatic: aiming up to liver
  2. splenorenal (dorsally on left)
  3. cystocolic (ventrally in front of pubis)
  4. hepatorenal (right side dorsally, kidney and back of liver)
28
Q

how does peritoneal fluid appear on radiograph (4)

A
  1. organs not visible
  2. loss of serosal detail (loss of SI wall, only lumenal gas)
  3. pot belly
  4. displacement of small bowel may suggest organ of origin
29
Q

what is shown here

A

peritoneal fluid

30
Q

what does presnece of peritoneal fluid appear on ultrasound

A

anechoic between organs

31
Q

what does presence of peritoneal fluid indicate

A

rupture of liver (hemoabdomen), spleen, bladder (uroabdomen), GI tract (septic peritonitis)

32
Q

what would gas +/- fluid in the abdomen indicate

A

rupture of GI tract

33
Q

what is shown here

A

peritoneal fluid in abdomen

34
Q

what causes peritoneal gas

A

GI rupture

35
Q

what is shown here

A

peritoneal gas

lat decubital horizontal –> air under abdominal wall

36
Q

what does peritoneal gas & fluid indicate

A

peritonitis

37
Q

what is shown here

A

peritonitis

loss of detail –> free fluid highlighting of caudal surface of diaphragm

38
Q

how does GDV appear on radiograph

A
  1. rotated stomach
  2. dilated SI (smurf hat, popeye arm)
39
Q

how does a spleen hematoma appear on ultrasound

A
  1. large mass
  2. anechoic areas
40
Q

what is shown here

A

spleen hematoma

41
Q

what is shown here

A

spleen hematoma

42
Q

how does urinary rupture appear on radiograph

A
  1. +/- ascites (free fluid)
  2. +ve contrast (air runs risk of embolism)
43
Q

what is shown here

A

urinary rupture

44
Q

how does a urinary rupture appear on ultrasound

A

anechoic area around organ

45
Q

what is shown here

A

urinary rupture

46
Q

what are the sources of urinary rupture

A

bladder

urethera

ureter/kidney

47
Q

what occurs on contrast radiograph with a urinary rupture

A

contrast extravasates

48
Q

what trauma can occur to the axial skeleton

A
  1. ribs & sternum
  2. head & spine
  3. fractures
  4. dislocations
49
Q

what is shown here

A

rib fractures

50
Q

what is flail chest

A

number of ribs each with 2 fractures –> move paradoxically with respiration

51
Q

what is shown here

A

flail chest

collapsing in chest wall moves in when inhale

52
Q

what is shown here

A

sternum fractures, dislocations

53
Q

what is shown here

A

spinal dislocations

displacement of T11 to T12

54
Q

what is shown here

A

spinal dislocation

55
Q

what trauma can occur to the head

A

hematoma

hemorrhage

fracture

56
Q

wha trauma can occur to the appendicular skeleton

A

fracutres

dislocations

fracture dislocations

57
Q

what is occuring here

A

chip fracure with gas under skin –> open

58
Q

what is occuring here

A

open fracture –> gas under skin –> infection

59
Q

what is occuring here

A

misalignment with C1 and C2 with bone fragments

60
Q

what is occuring here

A

retraction of lung lobe with free gas

pneumothorax

increased opacity of lung lobe

pulmonary contusion

free gas under skin emphysemia

61
Q

what is occuring here

A

marked subcutaneous air

tracheal wall highlighted –> pneumomediastinum

heart shadow raised from sternum & gas beneath

caudal lobes collapsed from thoracic wall

black area (gas) around lobes –> pneumothorax

lobes increased in soft tissue opacity –> contusion

avulsion of rib 7

62
Q

what is occuring here

A

straight white line –> artefact

in good body condition –> subcut and falciform fat

poor abdominal detail –> fluid

suspicious gas in peritoneal cavity –> ruptured viscus

peritonitis

63
Q

what is occuring here

A

vessels in mediastinum obvious

air tacking along aorta into abdomen

tracheal wall defined (normal lumen surface only)

trachea elevated

cardaic shadow is wider (4ic) & taller than normal, football shaped –> margins sharp –> pericardial effusion

64
Q

what is shown in this US

A

cardiac lumen and wall surrounded by large anechoic area –> pericardial effusion

65
Q

what is shown here

A

loss of serosal detail

gas gap betweein diaphragm and liver

free gas bubbles retroperitoneally & in region of small bowel

Module 14 (29 decks)

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