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Chest and Abdomen > Part 2 > Flashcards

Part 2 Flashcards

1
Q

what are renal calculi also called?

A

nephroliths, nephrolithiasis, uroliths, urolithiasis, kidney stones

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2
Q

where are renal calculi located?

A

collecting (pelvico-calaceal) system

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3
Q

80-90% of renal calculi are?

A

opaque and probably could be seen on plain film

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4
Q

what do renal calculi look like?

A

small and homogeneously dense structures (no lucent centers)

round, oval, irregular in shape, often with a peak

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5
Q

where are renal calculi located on a lateral film?

A

they ill overlie the spine often over the arch or posteiror aspect of the vertebral bodies

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6
Q

when are renal calculi painful?

A

when they obstruct, can cause LBP

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7
Q

staghorn calculi

A

when calcium may fill calyces and renal pelvis

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8
Q

are ureteral calculi visible?

A

yes, usually

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9
Q

what do ureteral calculi look like? how big are they?

A

homogenous and oval or irregular in shape

1-3 mm, can be up to 5 mm

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10
Q

locations where ureteral stones tend to lodge.

A

L1-3 paraspinally at pelvicoureteral junction
brim of pelvis
within 1 inch of ischial spine superiorlyly at teh vesicoureteral junction (MC)

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11
Q

differences between ureteral calculi and phelboliths

A

phleboliths- below the ischial spines not move much on future films

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12
Q

what can obstruction because of renal calciuli cause?

A

significant pain, hydronephrosis

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13
Q

how soon do stones usually pass?

A

3-4 days

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14
Q

bladder calculi can be overlooked when?

A

they are small, they can be large

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15
Q

what do bladder calculi look like?

A

usuallyround, oval or stellate

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16
Q

what are the usual causes of bladder calculi?

A

urinary stasis (MC)
infection
elderly males

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17
Q

where are bladder calculi located on xray?

A

suprapubic region close to midline

could be found higher or laterally positioned if there is prostatic hypertrophy

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18
Q

nephrocalcinosis

A

appear as small clumps of stippled (punctate) calcifications in the kidney parenchyma
bilateral and widespread

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19
Q

are gallstones visible on xray?

A

not usually

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20
Q

what are more commonly seen in chiropractic offices?

A

gallbladder stones

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21
Q

what do gallstones look like on film

A

multiple stones with faceted (flat) surfaces and a peripheral rim of calcification
can be laminated if old
lucent internal branching cracks filled with nitrogen gas may be seen internally (mercedes benz sign

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22
Q

when do you see a mercedes benz signs?

A

when old stones dehydrate and shrink

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23
Q

where are gallstones located on film?

A

RUQ

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24
Q

when can a patient experience pain with gallstones?

A

small stones pass easily
recurrent cholecystitis
obstruction of a duct
perforation of gallbladder with fistula formation (to duodenu or colon

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25
Q

what is the gas often found in the ducts from gallbladder stones called?

A

pneumobilia

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26
Q

what other disorder can occur from gallstones?

A

peritonitis

a large stone can cause bowel obstruction

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27
Q

what is the worst case senario concerning the gallbladder?

A

cancer

28
Q

describe milk of calcium bile

A

bile that has a lot of calcium
gallbladder looks white
upright films demonstrate a horizontal fluid level

29
Q

what is a petrified gallbladder due to?

A

unknown, maybe cholecysitis

30
Q

describe what you would see on a film with petrified gallbladder?

A

thin linear calcification in the muscular wall or submucosal layer of the gallbladder
pear, ovoid or round shaped
usually cystic duct obstruction, but may not be seen

31
Q

describe pancreastic calcifications seen on film

A

punctate densities in the pancreatic duct

usually located on both sides of the spine (cross midline)

32
Q

what are pancreatic calcifications usually due to?

A

chronic inflammatory process

chronic alcoholics

33
Q

where are adrenal gland calcifications located?

A

paraspinally at L1 level on AP film

lateral film: overly spine

34
Q

pattern of adrenal gland calcifications

A

punctate and cystic- curvilinear or ringed

35
Q

why might someone get adrenal gland calcifications?

A

neonatal hemorrhage (punctate)
post traumatic hemorrhage (punctate or cystic)
TB and histoplasmosis (punctate, TB cystic too)

36
Q

31% of cortical malignancies contain?

A

calcium

37
Q

what do lymph node calcifications look like?

A

small solid calcifications clumped in clusters
irregular and mottled interior
often multiple, could be singular

38
Q

where are the lymph node calcifications usually located?

A

close to psoas muscle on AP

mesenteric nodes are anterior to spine on lateral

39
Q

what are the MC calcific abdominal lymphatics?

A

mesenteric

40
Q

where are para-aortic nodes located?

A

close to the spine at L2-4 (rare)

41
Q

calcified lymphnodes are due to?

A

healed infections (TB)

42
Q

what is the most common region of have lymph node calcifications?

A

hilar region of the chest

43
Q

what are splenic calcifications usually due to?

A

TB, histoplasmosis, maybe brucellosis

44
Q

what do splenic calcifications look like?

A

small, solid, scattered (punctate)

45
Q

what else can appear like a splenic calcification?

A

phleboliths in hemangiomas

46
Q

cystic calcifications of spleen are due to?

A

echinococcal infestation (hydatid disease)
hemorrhage cyst
congenital

47
Q

hepatic calcifications look like what?

A

usually small solid densities scattered throughout the liver
usually punctate
rarely cystic (due to hydatid disease) or a single solid density may be found
very rarely small “sand like” or “poppy seed” densities are found with some metastatic carcinoma

48
Q

the small hepatic calcifications are usually due to?

A

TB or histoplasmosis (granulomatous)

49
Q

hemangiomas of the liver may have?

A

dense phleboliths

50
Q

what is the most common coprolith?

A

appendicolith

51
Q

who can get appendicoliths?

A

child or adult

many demonstrate calcium, but not all

52
Q

what do appendicoliths look like?

A

homogenous, laminated or ringed calcifications within the appendix
small, up to 4 cm

53
Q

where are appendicoliths located?

A

RLQ superimposed over ilium and anterior to the spine of the pelvis

54
Q

what are appendicoliths usually due to?

A

calcification around a swallowed pit or seed

55
Q

are appendicoliths associated with appendicitis?

A

yes, in over 1/2 of patients

56
Q

what can appendicoliths bee seen with in appendicitis?

A

a lot of bowel gas

much higher rate of rupture with appendicoliths

57
Q

are appendicoliths usually symptomatic?

A

no

58
Q

describe what a cyst calcification looks like?

A

wall is a smooth calcific curvilinear rim of density

if there is internal calcification it is ill definied and less dense than the periphery

59
Q

cysts demonstrate 3 basic shapes, what are they?

A

round
ovoid
flattened

60
Q

what are the most common cyst sites?

A 
kidney (benign or malignant)
pancreas (rarely calcify)
spleen
liver
adrenal gland
61
Q

what are the 2 major types of cysts?

A

congenital

acquired

62
Q

congenital cyst

A

true cyst

epithelial lined, less common

63
Q

acquired cysts

A

(pseucocytes)

lined by fibrous tissue and more common

64
Q

what can cause acquired cysts?

A

trauma (blood)
infection (pus)
parasites
tumors

65
Q

when tumors calcify, what do they look like?

A

sand-like

poppy-seed densities

66
Q

what are the most often mentioned calcifications?

A

ovarian serous adenocarcinomas

its metastases are the most often mentioned and are called psammomatous bodies or psammoma

67
Q

neuroblastoma

A

same pattern as an ovarian serous adenocarcinoma

but in a young child and found aroun dhte area of the adrenal gland and kidney

Chest and Abdomen (4 decks)

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