Obrien -Abdominal radiography Flashcards
In which projection does the diaphragm appear as a 3 domed structure in dogs, DV OR VD?
VD
-appears flattened on DV view in dogs
- in cats is flat on both projections
Which of the following is NOT a sub lumbar muscle?
A) Psoas major
B) Psoas minor
C) Iliopsoas
D) Quadratus lumborum
Answer = A
Where does the quadratus lumborum muscle insert?
Wing of the ilium
Left and right triangular ligaments of the liver connect _______ to _______.
Lateral lobes of liver to diaphragmatic crura
What are the atomic numbers (Z) of iodine & barium?
Iodine = 53
Barium = 56
What are 2 ddx for hepatomegaly, renomegaly, & peritoneal effusion in abdominal radiographs in a cat?
Lymphosarcoma or FIP
Which 5 cranial nerves are responsible for supplying the motor impulses necessary for normal swallowing?
CrN 5, 9, 10, 11, & 12
Which is the most frequent tumor of the pharyngeal region?
A) Thyroid carcinoma
B) Lymphoma
C) Tonsillar squamous cell carcinoma
D) None of the above
Answer = C
T or F, in lateral contrast radiography of the esophagus, in dogs (compared to/different from cats) the terminal thoracic esophagus appears as cone with the apex in the oral direction?
False.
The cone appearance of the terminal esophagus is correct but this is seen in CATS not dogs
In cases of chronic esophagitis, the mucosal surfaces tend to be choose (smooth or rough) and _______-shaped with apex of the stenosis in a _____direction.
Smooth mucosal surface
Cone -shaped
Apex in aborad direction
Smudging or indistinctness of barium coating the esophagus may be suggestive of what condition?
Esophageal ulceration
In an esophageal diverticulum, which portion of the wall is affected?
A) serosal
B) submucosal
C) muscularis
D) mucosal
Answer = D
An esophageal traction diverticulum tends to be localized, thick-walled & results from what?
Results from adhesion & contraction of the esophageal wall due to a periesophageal lesion (e.g. paraesophageal abscess)
An esophageal pulsion diverticulum is a result of what?
Pulsion diverticulum is a result of mucosal protrusion due to increased intraluminal pressure. (E.g. secondary to PRAA)
-Think Pulsion, Protrusion of mucosa, increased intraluminal Pressure
Weakness of the muscular layer may predispose to this type of diverticulum
T or F, there is usually a large pressure gradient between the stomach and terminal esophagus at the GE junction?
FALSE. Usually NOT a significant pressure gradient between
Fistula formation between the esophagus & respiratory tract (esophagotracheal, esophagobronchial, or esophagopulmonary) results from _____?
Injury to esophageal wall secondary to the presence of a foreign body.
Terminology depends on the level of communication with the respiratory tract
Which of the following is NOT a function of gastrin?
A) Stimulates gastric acid & pepsin secretion
B) Growth of gastric mucosa
C) Contraction of pyloric sphincter
D) muscular contraction of stomach
Answer = C
Which of the following is NOT a function of gastrin?
A) Stimulates gastric acid & pepsin secretion
B) Growth of gastric mucosa
C) Contraction of pyloric sphincter
D) muscular contraction of stomach
Answer = C
Describe what causes Zollinger-Ellison syndrome & what are the C/S associated with this condition?
Results from excessive gastrin secretion (caused by multiple endocrine adenomas)
-Rugal thickening, ulceration mainly duodenal, diarrhea, & steatorrhea
Enlargement of the ______lobes of the liver displaces the pylorus caudally.
Right lobes displace pylorus caudally.
Left liver lobe enlargement displaces the fundus/body caudally.
The diameter of the fundus & proximal body of a normal canine stomach on RLR should be _______ intercostal spaces in width & approximately ____times as wide as the pyloric portion.
Should be < 3 ICS
2x as wide as pylorus
Describe the most common direction of rotation and movement of the canine stomach during a GDV?
Clockwise rotation
In a typical 180° torsion, the pylorus/ proximal duodenum first move VENTRALLY then cranial to the body of the stomach. pylorus continues to migrate from right to left past midline (due to stretching of hepatoduodenal ligament, creating a fold in the stomach). The pylorus is then located DORSAL to the esophagus and gastric fundus on the LEFT side of the abdominal cavity
Which type of contrast agent should be considered for radiolucent gastric foreign bodies?
Negative contrast
Gastric mucosal erosion or ulceration produces what type of appearance with positive contrast administration?
Irregular, patchy barium coating
Normal appearance is a smooth, thin, uniformly dense layer of barium on the gastric wall
T or F, organic iodine compounds induce hypermotility of the GIT thereby reducing the time required for upper GI contrast study?
True
Space-occupying gastric lesions (e.g. FBs) have what appearance on positive contrast studies?
Radiolucent filling defects surrounded by barium
What is the characteristic sign of pyloric hypertrophy causing pyloric stenosis on positive contrast gastrography in a dog?
Contrast seen extending within concentrically narrowed and elongated pylorus -identified as a “beak” or “string” sign (produced by contrast material in narrowed pyloric sphincter) or “tit” sign (convex bulging silhouette of the lesser curvature)
Pyloric dysfunction is predisposed in which cat breed?
Siamese
What are the 3 radiographic changes seen with inflammation/hypertrophy of the pyloric submucosa & mucosa?
1) Irregular mucosal surface
2) Prominent mucosal folds of the pyloric canal that extend into the sphincter
3) Haziness of contrast- mucosal interface
Which of the following radiographic signs is NOT associated with gastric ulceration?
A) Radiating mucosal pattern
B) outpouching of wall beyond the gastric lumen
C) Beak or tit sign associated with regional lumen hypertrophy
D) Prolonged gastric transit with rapid intestinal transit time
Answer =C (beak and tit sign seen with pyloric stenosis)
Signs of gastric ulceration:
- outpouching of wall beyond lumen or ulcer crater
- rigid wall appearance next to crater
- decreased diameter of pyloric region & straightening of pylorus and fundus
- radiating mucosal pattern
- abnormal mucosal folds
- Prolonged gastric transit with rapid intestinal transit time
- signs of peritonitis if ulcer perforated
In comparison to benign ulcers, malignant ulcers tend to ___?
A) both exhibit a Hampton line
B) be located centrally if found in the region of a gastric tumor
C) have a regular shape with a smooth floor
D) have a shallow depth & wider width
Answer = D
-Hampton line represents the mucosa at the margin of the ulcer, usually radiolucent & seen in benign ulcers
- malignant ulcers seen eccentrically within a tumor
- malignant ulcers are irregularly shaped with nodular floor
Peyer’s patches are located in what region(s) of the gastrointestinal tract in dogs & cats, respectively?
A) both in duodenum
B) Dog - duodenum; Cat - duodenum, jejunum
C) Dog - duodenum; cat - jejunum, ileum
D) dog - duodenum, jejunum; cat -ileum
Answer = C
Low volume, high frequency stools with excessive amounts of mucus and red blood are cardinal signs of ____ bowel disorders that produce diarrhea.
Large bowel diarrhea
_______ appear as radiolucent lines and produce a partial obstruction within the small intestine on a UGI.
Small intestinal parasites (e.g. Ascarids)
With partial mechanical obstruction, maximum distension occurs _______(orad/aborad) to the obstruction and the width of the bowel lumen tends to progressively _____(imcrease/decrease)more orad to the obstruction.
Proximal; decrease
What two vitamin deficiencies may result in radiographic functional ileus?
A) Vitamin B & D
B) Vitamin B & K
C) Vitamin K & A
D) Vitamin A & D
Answer = B
T or F, nutritional hyperparathyroidism can result in constipation?
TRUE. thought to be related to impaired contractility of muscle secondary to hypercalcemia
Enlargement of colonic diameter beyond ______is indicative of chronic large bowel dysfunction?
1.5x the length of L7
Megacolon secondary to spinal abnormality is a common congenital disorder in which cat breed?
Manx cats
T or F, nutritional hyperparathyroidism can cause increased large bowel diameter?
True
Which of the following does NOT cause megacolon?
A) Nutritional hyperparathyroidism
B) FeLV
C) Lead poisoning
D) Congenital hypothyroidism
Answer = B
Neurologic control of the large bowel is primarily through which two nerves?
Pudendal & pelvic nerves
In regards to large bowel innervation, which most accurately describes the function of the nerves?
A) Sacral nerve - external anal sphincter innervation
B) Pudendal nerve - sensory afferent & motor efferent to colon & rectum
C) Pelvic nerve - external anal sphincter innervation
D) A & B
E) B &C
Answer = E
Pudendal &pelvic nerves control large bowel intervention
Proper preparation & execution for a positive contrast barium enema includes all of the following except:
A) cold or soapy water enema 6 hours prior to radiographic exam
B) Administration of a parasympathomimetic drug (e.g. atropine) if a large volume of gas is present in the colon
C) patient in right lateral recumbent
D) rotation of the patient into left lateral recumbency & elevation of the cranial 2/3 of the body in cases of a double contrast study
Answer = A
Cold/soapy water should NOT be used because it results in colonic spasticity. Use warm water or isotonic saline instead.
Histiocytic ulcerative colitis is seen in what breed of dog?
Boxers
Annular strictures of the large bowel commonly occur in the ______ or ______ and often cause megacolon.
Terminal colon or rectum
What are the 3 most common tumors of the canine colon?
Leiomyosarcoma
Lymphosarcoma
Adenocarcinoma
Neoplasia within the colon commonly causes what type of lesions?
Strictures or annular lesions producing a “napkin-ring” appearance, megacolon, luminal narrowing, bowel wall rigidity, & mucosal surface irregularities
With cecal inversion, what is the radiographic appearance on a positive contrast barium enema?
Accordion pleating
The gastric impression is in which lobe of the liver?
A) left medial
B) left lateral
C) quadrate
D) caudate
Answer =B
Portal venous pressure is approximately ____mmHg.
10 mmHg
FIP can result in concomitant enlargement of ___ & _____?
A) spleen & liver
B) kidney and spleen
C) kidney & liver
D) abdominal lymph nodes
Answer = C
Fatty infiltration of the liver, kidney, and emphysematous cystitis are a triad of findings commonly associated with what disease?
Diabetes mellitus
During hepatic angiography, numerous tortuous, “corkscrew-shaped” hepatic arteries are seen. What is the primary differential?
Hepatic fibrosis/cirrhosis
Hepatic portal venous gas has what appearance and location?
Tubular/branching appearance
Peripheral location
Versus pneumobilia which has a central location and is more likely rounded
What are the 4 major organs of the reticuloendothelial system?
Liver
Bone marrow
Spleen
Lungs
Splenic torsions occur in which direction?
Counterclockwise
Nephrocalcinosis can result from all of the following underlying disease conditions except which?
A) Chronic pancreatitis
B) Cushing’s
C) Ethylene glycol poisoning
D) hyperparathyroidism
E) all the above
Answer = A
Nephrocalcinosis can result from any disease which causes hypercalcemia
T or F, a normal nephrogram can occur in the presence of severe renal disease?
True
Absence of a nephrogram can be due to renal disease or non-renal disease (e.g. heart failure), but if underlying renal disease is suspected, what broad category of disease should be considered?
A) extra renal obstruction
B) intra renal obstruction
C) loss of nephrons
D) all the above
Answer = C
T or F, an Increased nephrogram opacity may result from obstruction, renal vein thrombosis, and heart failure?
False.
Not heart failure; but renal obstruction, renal vein thrombosis, & hypotension
Increased opacity is due to an increased reabsorption of sodium & water in the proximal tubules and a slowed rate of tubular fluid flow
The presence of contrast medium in the proximal renal tubules is known as the ______phase and occurs ______ after contrast administration.
Nephrogram phase
7-10 seconds
During the pyelogram phase , contrast medium is present in the _____and _____.
Renal collecting system (diverticula & pelvis) & ureters
_______ may be recognized radiographically by the presence of a normal nephrogram on immediate radiographs and no pyelographic phase.
A) Neoplasia
B) intrarenal obstruction
C) hypotension with acute renal failure
D) severe glomerular disease
Answer = C
With renal dysplasia, hypoplasia, or dysgenesis, what abnormalities of collecting system can be seen?
A) collecting system larger than normal with extension of the diverticula peripherally toward the margin
B) collecting system smaller than normal with decreased extension toward the margin
C) asymmetric dilation and narrowing of the collecting system with variable peripheral extension
D) no collecting system abnormalities
Answer = B
On contrast urography of a dog’s kidney you see bilateral filling defects within the pelvis and irregular filling of the diverticula. The remainder of the renal parenchyma appears normal. What is the most likely DDX?
A) Renal neoplasia
B) Systemic hypotension
C) Primary glomerular disease
D) Infectious pyelonephritis
Answer = D
_______ is the most common primary renal tumor in the dog.
______is the most common primary renal tumor in the cat.
Carcinoma
Lymphoma
Which is more accurate for evaluation of ureteral uroliths, rupture, obstruction, inflammation, neoplasia, dilation, & ectopia - intravenous urography or retrograde cystourethrography?
Intravenous urography
What of the following 2 disease conditions cause cranial bladder displacement?
A) lower UT obstruction
B) prostatic disease
C) distal colonic neoplasia
D) uterine enlargement
Answers = B & D
Colonic neoplasia usually causes ventral displacement
Inguinal hernias cause _______bladder displacement and perineal hernias cause ________bladder displacement.
A) ventral; caudal
B) cranial; caudal
C) caudal; caudal
D) ventral; dorsal
Answer = A
Mucosal bladder ulcers are manifested radiographically with a double contrast cystogram as ______.
Clumps of contrast medium adherent to mucosal surface
In differentiating neoplasia from chronic urinary cystitis, neoplasia usually has what appearance and with chronic cystitis changes are frequently localized to the ____________ region.
Neoplasia is usually more locally extensive and protrudes into the lumen creating a convex filling defect.
Chronic cystitis is localized to the craniventral bladder.
What is the radiographic appearance of acute cystitis?
Changes usually not present with the exception of a small contracted bladder.
_______ is the most consistent radiographic finding with diabetes mellitus and may be seen in conjunction with either or both generalized _________ and _______enlargement.
Emphysematous cystitis
Renal & hepatic enlargement
T or F, hypertrophic osteoarthropathy has been associated with bladder neoplasia?
True
Which of the following is NOT a radiographic sign associated with malignant bladder neoplasia?
A) Abrupt tapering between the periphery of a filling defect and the normal bladder wall
B) Broad sessile base with either an irregular/ulcerated surface in epithelial neoplasia or smooth surface with mesenchymal neoplasia
C) Ureteral reflux, ectasia, or stasis
D) bladder wall thickening in association with and adjacent to an attached filling defect
Answer = A
A is false because there is a gradual tapering seen between malignant tumor cells at the periphery of a fill of defect and the normal wall.
Remainder of the statements are true.
Increased bladder wall thickness, decreased distensibility, and wall calcification are also seen with neoplasia
Two radiographic signs of patent urachus are ______ and _________.
Urinary bladder elongation and a pointed apex
T or F, both urachal cysts and rascal diverticula can be identified with positive contrast cystography.
False.
Urachal diverticula can but urachal cysts cannot.
Vesicoureteral reflux is more common in what age of patients, younger or older?
Younger.
Young dogs appear to have a shorter intravesical ureter with a proportionately larger diameter which enters the bladder somewhat perpendicularly. As the animals grows/matures the ratio of the length to diameter of the intravesical ureter increases and it enters the bladder in a more oblique direction creating a “flap like” valve effect
Intramural versus extraluminal urethral filling defects may be distinguished by which characteristic of urethral wall displacement?
A) both have outward displacement
B) both have inward displacement
C) both have inward displacement, but intramural lesions may have a gradual angulation into the lumen while extraluminal lesions usually have sharp borders into the lumen
D) both have inward displacement, but intramural lesions may have sharp angulation into lumen while extraluminal lesions usually have gradually tapering borders into the lumen
Answer = D
Intramural defects also usually have irregular margins while extraluminal defects have a smooth margin
T or F, the urethral wall is displaced with intraluminal lesions such as blood clots, calculi or air bubbles.
False, no wall displacement is identified however filling defects are seen with positive contrast
Match the following embryonic structure witt their respective organs
1) metanephros
2) mesonephros
3) metanephric ducts
A) Wollfian/mullerian structures
B) Adult kidney
C) ureters
Metanephros -> adult kidney, 1 matches with B
Mesonephros -> ureters??
Metanephric ducts -> wolffian/mullerian ducts
Fetal ossification on radiographs is seen as early as _____days in cats and _______days in dogs.
35-39 days in cats
41-43 days dogs
What are 3 radiographic signs of fetal death?
1) overlap/overriding of calvarial structures (parietal, frontal, occipital bones) called the Spalding sign
2) Loss of fetal flexion (should normally be C shape with mandibular shaft resting on sternum and all appendages in complete hyperflexion)
3) Intravesicular/intracavitary/perifetal free gas
Prostatic enlargement causes displacement of the colon and bladder in which directions?
Bladder displaced cranially and ventrally
Colon displaced dorsal
