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OS 206: Abdomen and Pelvis > Plain and Contrast X-ray Studies > Flashcards

Plain and Contrast X-ray Studies Flashcards

1
Q

5 densities normally present on x-rays

A

1) Gas - black
2) Fat - dark gray
3) Soft tissue/fluid - light gray
4) Bone/calcifications - white
5) Metal - intense white

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2
Q

T or F: It is only necessary to obtain an x-ray from either the upright or supine position for adequate examination

A

F (Both should always be done)

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3
Q

Difference between abdominal and kidney, ureter, bladder (KUB) plate

A

Captured structures

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4
Q

Structures captured on abdominal plate

A

Hemidiaphragm up to part of pelvis

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5
Q

Structures captured on KUB plate

A

Whole pelvic cavity

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6
Q

Summation effect

A

May be present with large organs as they approach the appearance of bone

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7
Q

Main consideration in preparing for an abdominal x-ray

A

Bowel preparation to minimize feces and gas

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8
Q

T or F: Patients should be discouraged from talking or screaming prior to an abdominal x-ray to minimize accumulation of gas in abdominal cavity

A

T

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9
Q

Prepartion wherein there is no food nor liquid intake for 4 to 6 hours prior to an abdominal x-ray

A

Nothing per orem (NPO)

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10
Q

Function of NPO preparation

A

Needed in contrast studies because dehydration will result in easier absorption of contrast media

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11
Q

What to examine in abdominal x-rays

A

1) Gas pattern
2) Presence or absence of extraluminal air
3) Soft tissue masses
4) Calcifications
5) Foreign bodies

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12
Q

Usual presence of extraluminal air when an x-ray is taken in the upright position

A

Below the hemidiaphragm

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13
Q

Possible causes of the presence of extraluminal air

A

Diseases, trauma, surgery

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14
Q

Normal gas pattern of stomach

A

Always with gas, producing a gastric bubble

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15
Q

Normal gas pattern of small bowel

A

2 to 3 loops of non-distended bowel

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16
Q

Normal gas pattern of large bowel

A

Gas almost always present in rectum and sigmoid colon

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17
Q

Primary structures outlined in the abdomen

A

Solid organs (liver, kidney, spleen), hollow organs (GI tract), and bones

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18
Q

Possible descriptions of abdominal structures

A

1) Visible or not visible
2) Too large or too small
3) Distorted or displaced
4) Abnormally calcified
5) Containing abnormal gas or fluid

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19
Q

Air on both sides of the intestine/stomach (luminal and peritoneal side)

A

Rigler’s sign / double wall sign

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20
Q

Common contrast materials used in abdominal x-rays

A

1) Sodium bicarbonate

2) Barium sulfate/sulfide

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21
Q

T or F: Barium sulfate can be combined with Sprite for use in double-contrast studies

A

T (This combination provides both liquid and gas contrast)

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22
Q

Function of barium sulfate

A

Coats GI tract to see patterns and areas of obstruction, to establish integrity and deficiencies of the GI tract, and to locate areas of ulcers, craters, and polyps

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23
Q

Quantities of barium sulfate used in contrast studies

A

Initial 1 L of barium is ingested with an additional 250 cc introduced midway

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24
Q

Characteristics of large bowel in an x-ray

A

Peripheral; haustral markings don’t extend from wall to wall

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25
Q

Characteristics of small bowel in an x-ray

A

Central; valvulae extend across the lumen; maximum diameter of 2 inches

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26
Q

Indication of large bowel obstruction (LBO)

A

Haustrations are almost gone

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27
Q

Indications of small bowel obstruction (SBO)

A

Stretched small bowel and may have dilated tube-like structures due to the obstruction

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28
Q

T or F: For gas-containing GI tract, ultrasound is the best modality

A

F (X-ray is the best modality for the gas-containing GI tract)

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29
Q

T or F: On normal film, any structure in the abdomen outlined by gas is part of the GI tract

A

T

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30
Q

T or F: On a supine AP radiograph, fluid lies posteriorly in the gut while gas in the bowel will float anteriorly on it

A

T

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31
Q

T or F: Fluid levels appear on supine AP films

A

F (Fluid levels do not appear on supine AP films)

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32
Q

Indications of a normal esophagogram

A

Smooth esophageal wall with clear border, no wrinkling nor obstruction, and which is collapsed if not swallowing anything

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33
Q

3 indentations/constrictions of the esophagus

A

1) Cervical constriction
2) Thoracic/broncho-aortic constriction
3) Diaphragmatic constriction

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34
Q

Location and cause of cervical constriction

A

At pharyngoesophogeal junction, caused by cricopharyngeus muscle

35
Q

Cause of thoracic constriction

A

At arch of aorta (seen in AP view) and left main stem bronchus (seen in lateral view)

36
Q

Location of diaphragmatic constriction

A

At esophageal hiatus

37
Q

Structure to be checked for patients with recurring acid reflux

A

Cardiac/gastroesophageal sphincter

38
Q

Structures outlined by gas in the stomach in supine position

A

Body and antrum of stomach

39
Q

Location of pool of resting gastric fluid in supine position

A

Fundus of the stomach beneath the diaphragm

40
Q

Circular outline created by pool of resting gastric fluid in fundus of the stomach

A

Gastric pseudotumor

41
Q

T or F: C-loop of the duodenum goes around the spleen

A

F (The C-loop goes around the head of the pancreas)

42
Q

Location where the major pancreatic duct and common bile duct exits

A

Ampulla of Vater (2nd part of duodenum)

43
Q

Location where the minor pancreatic duct enters

A

Minor duodenal papilla (2nd part of duodenum)

44
Q

Importance of the ileocecal valve

A

Landmark of origin of certain diseases (such as TB) and common site of seed being lodged

45
Q

Calcified fecal matter that may predispose the patient to appendicitis

A

Appendecolith

46
Q

Most distensible part of the colon that receives fluid directly from the ileum

A

Caecum

47
Q

Highest fixed point of the colon on the right

A

Hepatic flexure

48
Q

Highest fixed point of the colon on the left

A

Splenic flexure

49
Q

T or F: Hepatic flexure is usually higher than the splenic flexure

A

F (Hepatic flexure is usually lower than splenic flexure)

50
Q

Location where contrast for imaging of the colon may be inserted

A

Rectum

51
Q

2 mobile areas of the colon

A

1) Transverse colon

2) Sigmoid colon

52
Q

Reason for the mobility of transverse and sigmoid colon

A

Longer mesenteric attachments compared to ascending and descending colon

53
Q

2 important retroperitoneal landmarks; 2 of the few straight lines of the body

A

Psoas muscle

54
Q

Vertical limits of the kidneys

A

Upper border of T12 on the left to the lower border of L3 on the right

55
Q

Characteristics of the kidneys

A

Bean-shaped soft tissue density high in the upper part of the abdomen

56
Q

T or F: The kidney is very mobile and moves down with inspiration in the upright position

A

T

57
Q

T or F: The left kidney is higher than the right kidney and is about 1.5 cm bigger

A

T

58
Q

T or F: Normal livers have a homogenous nature

A

T

59
Q

Hepatomegaly

A

Upper margin of the liver is above the subcostal margin

60
Q

Characteristics of the liver

A

Located in the RUQ, presenting as a large area of soft tissue density

61
Q

Characteristics of the spleen

A

Located in the LUQ, about the size of the patient’s heart or fist

62
Q

Enlargement of the spleen

A

Hepatosplenomegaly

63
Q

T or F: The bladder appears as a hollow organ on x-ray

A

F (Bladder appears solid because it is full of fluid)

64
Q

T or F: The uterus can be identified on plain films

A

F

65
Q

Best modality for solid organs (gallbladder, spleen, liver, pancreas)

A

Ultrasound

66
Q

Limitation of ultrasound

A

Abdomen must not be gassy for proper visualization

67
Q

T or F: Stones in the large intestine appear black on ultrasound

A

F (Stones in the large intestine appear white on ultrasound)

68
Q

T or F: Since the gallbladder is flattened after eating fatty foods, patients must fast before imaging to preserve the gallbladder’s bile content

A

T

69
Q

Components of double contrast studies

A

Liquid contrast (barium sulfate) and air

70
Q

T or F: Lymph adenopathies, usually found in the rectal area, can be seen in both AP and lateral views

A

F (Only in lateral view)

71
Q

Outpouchings of mucosa and muscularis mucosa at sites of blood vessel penetration

A

Diverticula

72
Q

Enlargement in the retropharyngeal space indicates the presence of what?

A

Retropharyngeal abscess

73
Q

Appearance of an esophageal carcinoma

A

Irregular/nodular and eccentric esophageal narrowing

74
Q

Concentric constriction of colorectal cancer in the rectum or sigmoid colon

A

Apple core deformity

75
Q

Use of x-rays when dealing with ingested foreign bodies

A

Shots taken every few hours to monitor the progress of foreign bodies

76
Q

Intussuception

A

Process by which a segment of intestine invaginates into the adjoining intestinal lumen, causing bowel obstruction

77
Q

Hirschprung’s disease

A

Loss of innervation of myenteric ganglia at distal colon (commonly at the rectosigmoid), resulting in inability to push out feces

78
Q

Gallstones

A

Accumulations of salt, fat, and cholesterol due to nutritional habits

79
Q

T or F: Smaller gallstones have a better prognosis than larger gallstones

A

F

80
Q

Blockage of the biliary tree by small gallstones

A

Choledocholithiases

81
Q

Progressive luminal narrowing due to ingestion of caustic substance

A

Caustic esophageal stricture

82
Q

Hampton’s line

A

Represents the thin rim of undermined gastric mucosa

83
Q

Smooth, sharply delineating soft tissue mass surrounding a benign ulcer

A

Ulcer mound

OS 206: Abdomen and Pelvis (5 decks)

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