Part 1 Flashcards
basic routine abdominal film is called
plain film of the abdomen
how is a plain film of the abdomen taken?
recumbent, A-P
what should a plain film of the abdomen entail?
symphysis pubis or slightly below
KUB stands for?
kidney, ureter, bladder
what are the other primary views of the abdomen?
A-P upright
special procedures that can help where plain film can’t
ultrasonography contrast medial studies CT angiography nuclear medicine and MRI fiber optics
tissue we can usually see because of water density outlined by oil density
kidneys (upper, lower poles and lateral borders) spleen (lower and maybe a little medial) liver (lower border) bladder (upper and lateral borders) psoas muscles (lateral borders)
reasons we may not be able to see the water dense tissues with oil density around it
blurred from patient motion
superimposed gas and fecal material
adjacent fluid (blood, pus and other fluids)
abscence (congenital or surgical)
larger than normal structures mean that..
they are engorged, tumorous or swollen
overdeveloped
smaller than normal structures mean that..
they are underdeveloped
atrophied
hypersthenic
rarest type
more transverse and highly placed organs
asthenic
second rarest
giblets hang very low and are mostly in the pelvic region
hyposthenic
second MC
innards are long and low in the abdomen
sthenic
MC
RUQ
liver
right kidney
right psoas
hepatic flexure
LUQ
spleen
left kidney
left psoas
splenic flexure
RLQ
lower part of right psoas
cecum
right part of bladder
LLQ
left part of bladder
sigmoid colon
descriptive terms for features of calcifications based on what things look like
conduits punctate granular clumped ringed/rimmed/dense at periphery laminated irregular in density cloudy homogeneously dense
conduits
track or tubular
linear streaks
paralleling or bulging
punctate/stippled
small-scattered densities
granular
very fine puncatate
clumped
packed close together
ringed/rimmed/denser at the periphery
yeah
laminated
concentric rings internally
irregular in density
internal structure has varying densities/lucencies
cloudy
hazy
ill-defined density
homogeneously dense
same density through out it (looks solid
describe terms for shape and border
homogeneously dense descriptive terms
smooth irregular/peaked indistinct/ill-defined well defined round/oval linear/curvilinear
atherosclerosis of the aorta etiology
unknown, lunked to elevated cholesterol and triglycerides
smoking, HTN and diabetes have a stong influence
what does atherosclerosis of the aorta appear as on xray?
2 parallel lines (conduit, track, tram track appearane
track is usually discontinuous, may be continuous in advanced cases
diameter of the normal aorta
1 inch in diameter
1/2 the size of the vertebra behind it
what population usually has atherosclerosis of the aorta?
50s and up
what are the classifications of aneurysms
location
shape
true or false
location of aneurysm
ascending,arch, descending, thoracic, abdominal
shape of aneurysm
fusiform or saccular
true aneurysm
dilation of artery including the intimal layer
false aneurysm
dissection causing dilation of the arterial layers external to the intima due to intimal tears
what is a risk factor for false aneurysms?
HTN
aneurysms are usually caused by?
atherosclerosis
85% of patients are female or male that get aneurysms?
male
what ethnicity are those who get aneurysms normally?
caucasian
AAAs occur at what age usually?
60-80
what percents of aneurysms show a calcific rim?
75-86%
are aneurysms usually fusiform or saccular (eccentric)?
fusiform
fusiform
gradual widening
saccular
abrupt bulge that is usually asymmetrical
what is the usual location for an aneurysm?
L2-4
between the renal and common iliac arteries
AP view it will e to the left of the spine
what is considered dilated for an aneurysm?
3cm
what size of aneurysms usually apt to rupture?
> 5cm
7cm usually do rupture
how might a rupture be indicated on a radiograph?
marked change in location of calcific plaques on a follow-up film
soft tissue mass
loss of psoas muscle or kidney shadow
are aneurysms usually symptomatic or asymptomacit?
asymptomatic
wha can the pains be for an aneurysm?
low back pain
abdominal pain
flank pain
presence of pain indicates pending rupture
what are the clinical findings for an aneurysm?
bruit over or near the dilation
aneurysms are plapable in 90%
decreased pedal pulse
what might you see on a film with a commmon iliac artery atherosclerosis and anerysm?
AP film- diverging tracks of calcification over L4-sarum or a ring when seen on end
anterior to the spine on lateral film
narrower plaeuing than aorta
describe splenic artery atherosclerosis
wavy contour, tortuous males over 50 more often occurs than aneurysms in females pregnancy increases rupture rate almost all sacular isolated rim
phleboliths
calcified venous thrombi
where are phleboliths usually found?
pelvic rim below ischial spines
in hemangiomas of soft tissue structures
what should you suspect if phleboliths are not in the pelvic rim or are midline?
enlarging mass
what else can shift phleboliths inferiorly or lateralyy?
distended bladder
