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Jill's Quizzes > Radiography > Flashcards

Radiography Flashcards

1
Q

What are the indications for radiographing fractures?

A

Plan surgey, post op, monitor healing and complications

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2
Q

List 5 pseudofractures

A

Physes, nutrient foramina, fascial planes, mach lines, skull sutures, grid cracks

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3
Q

What are mach lines?

A

Where bones overlap and it is radiolucent

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4
Q

What are the directions of fracture lines?

A

Transverse, oblique, spiral

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5
Q

What do you need to include in your description of a fracture? (7 things)

A

Anatomical location (bone and part of bone), soft tissue, extend of cortical damage, direction of the fracture line, number and type of fragments, displacement and age of fracture

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6
Q

What is a comminuted fracture?

A

Several fragments where fracture lines communicate

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7
Q

What is a segmental fracture?

A

Bone has three or more fragments that DO NOT communicate

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8
Q

What is a compression fracture?

A

Shortening of the bones, typically the vertebra

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9
Q

What is an avulsion fracture?

A

Where the fragment is distracted by the pull of muscle, tendon or ligament ie tibial tuberosity, malleolus, greater trochanter

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10
Q

What is the difference between a slab and a chip?

A

A slab involves two articular surfaces fracture and a chip only involves one

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11
Q

How do you describe displacement of bones?

A

Describe the distal fragment in relation to the proximal fragment

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12
Q

What are examples of some non traumatic fractures?

A

Nutritional, metabolic, neoplastic, stress

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13
Q

What does complete and premature closure of physis lead to?

A

Shortening of the bone

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14
Q

What does assymetrical closure lead to?

A

Angular limb deformity

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15
Q

What does premature closure of the distal ulnar physis lead to?

A

Cranio-medial bowing of the radius, humero-ulnar joint space is widened and thickening of the cortices

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16
Q

What does premature closure of the distal radius physis lead to? (4 things)

A

Increased radio-humeral joint space, radious shorter that ulnar, subluxation of proximal ulna, increased radio-carpal joint space

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17
Q

Describe direct fracture healing

A

no cartilage stage, no visible callus. Rigid fixation with excellent anatomical alignment

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18
Q

Describe indirect/secondary fracture healing

A

Most common,some movement possible, boney bridging causes callus

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19
Q

When can primary bone healing occur?

A

Only when there is 100% stability

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20
Q

Describe the timeline of radiology fracture healing primary intention

A

Weeks 1-2 no change, Weeks 2-6 slightly wider gap and loss of crispness of edges,Week 7-12 fracture line disappears, Week 16 fracture line invisible

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21
Q

Describe the timeline of secondary intention bone healing

A

Week 1 widening of fracture gap and loss of crispness of edges, Week 2 immature callus with specks of mineralization, the callus does not cross the fracture line, Week 3 immature callus is more solid and dense, Week 4 ? 8 callus ossifies and become mature, fracture line disappears, Week 9 ? years remodeling

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22
Q

Describe Rhinohorn Callus

A

Periosteal stripping particularly at adductor muscle. Seen especially in younger animals if treatment is not initiated

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23
Q

What are some complications of fracture healing?

A

Clinical union, delayed union and non-union

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24
Q

What is a clinical union?

A

Mature bridging callus

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25
Q

What is a delayed union?

A

No bridging callus is seen within 4 weeks for young and 6 weeks for adult

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26
Q

Describe hypertrophic second intention healing

A

It is a viable non-union. Usually caused by rotational instability. There is lots of callus formation but no bridge

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27
Q

What is minimal callus second intention healing?

A

Some callus formation, but does not cross the gap.

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28
Q

Describe no callus second intention healing?

A

No or very limited callus formation, callus does not bridge the fracture gap

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29
Q

Describe dystrophic non-union

A

Non-viable non-union. Intermediate fragment aligned with one side but not the other. Vascularistaion takes place from one side

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30
Q

Describe necrotic non-union

A

Involves normally comminuted where avascularised portions in the middle obstruct healing

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31
Q

Describe defect non-union

A

Significant loss of bone between the fragments. Non-viable non-union

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32
Q

Describe atrophic non-union

A

Non-viable non-union the sequally to one of the about seen more commonly in tow breeds

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33
Q

What is malunion?

A

Fracture fragments heal in non anatomical bone alignment

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34
Q

What is your post op checkup ABCDS?

A

A: alignment, B:Bone, C:cartilage, D:device, S: soft tissue

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35
Q

What can contribute to implant failure?

A

Movement, loosening, breakage, bending

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36
Q

What can cause radiolucencies around an implant?

A

Movement, infection, heat necrosis

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37
Q

What is osteomyelitis?

A

A combination of osteitis, myelitis and periositis

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38
Q

What are the periosteal reactions to infection or neoplasm?

A

Solid, lamellated, thick brush, thin brush, sunburst, anomorphous bone

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39
Q

Describe subperiosteal scalloping

A

Eaten from the outside

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40
Q

Describe endosteal scalloping

A

Eaten from the inside

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41
Q

What are the three medullary reactions (in order of aggressiveness)?

A

Geographic, motheaten lyses and permeative lysis

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42
Q

What are the two routes of osteomyelitis?

A

Haemotogenous and exogenous

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43
Q

What does the haemotogenous rate of spread depend on?

A

Organism virulence, treatment and host defense/resistance

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44
Q

What lysis may you see at day ten of spread?

A

Permeative

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45
Q

What is a sequestrum and when does it normally form?

A

A dead bone fragment that is dead and usually surrounded by a lucent zone. It is often more dense than normal bone.

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46
Q

When an osteomyelitis reaches >40 days what are some likely outcomes?

A

May cross joints, affect adjacent bones, form an involucrum and may form a cloaca

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47
Q

What in an involucrum?

A

Bone sleeve around a sequestrum form by a periosteal reaction, can be focal or extensive, thin or thick.

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48
Q

What is a cloaca?

A

Defect in the involucrum and it allows the pus to drain. The sinuses are often to the skin surface

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49
Q

How do you class periosteal reactions?

A

Active (indistinct margins) and active (distinct margins)

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50
Q

Describe focal osteomylitis?

A

Localised, sclerotic border, mild periosteal reaction, small sequestra.

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51
Q

What are the four main sites for osteosarcome?

A

Towards the knee and fleeing the elbow. Distal femur and proximal tibia & proximal humerus and distal radius

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52
Q

What are the three types of osteosarcoma?

A

Osteolytic, osteoblastic and mixed

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53
Q

List 5 radiological features of osteosarcomas

A

ST swellin, sunburst reaction, amorphous bone, endosteal scalloping, cortical spikes, motheaten to permeable lysis

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54
Q

What are the periosteal reactions of osteosarcomas?

A

Sunburst and amorphous bone

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55
Q

What is Codman?s triangle?

A

A solid periosteal reaction seen on the edge of an aggressive lesion

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56
Q

What can occur secondarily to osteosarcomas?

A

Pathological fractures and pulmonary metastases

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57
Q

What are some characteristics of osteomyelitis?

A

Osteomyelitis can occur in any breed at any type with poly or monostotic lesions, can cross joints, affect the metaphyseal and diaphyseal, aggressive extensive periosteal reaction, well defined transition zone, slow rate of change

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58
Q

What are some characteristics of osteosarcoma?

A

Osteosarcoma usually affects large breed dogs at 2-7 years old, monostotic lesion unless metastasis present, doesn?t cross joint, only metaphyseal region affected, irregular speculated sunburst reaction with an indistinct and long zone of transition, endosteal scalloping and quick changes on radiographs

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59
Q

What is a similarity of osteosarcoma and osteomyelitis?

A

Both can be monostotic lesions with motheaten to permeative lysis

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60
Q

Describe the cartilage change in chondrosarcoma

A

Lytic lesion, ballooning cortex, minimal periosteal reaction, mineralized cartilage. Ribs, pelvis, costochondral junction, nasal cavity.

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61
Q

Where are fibrosarcomas most common?

A

Normally in older dogs and often near joints (which they can cross). They metastasis via lymph nodes

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62
Q

Describe the bone reaction in fibrosarcoma

A

Lytic, no periosteal reaction, minimal ST swelling, bone or soft tissue origin

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63
Q

Describe osteomas

A

Younger dogs, flat bones, benign

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64
Q

Describe osteochondroma

A

Benign, immature animals , extra-osseous cartilage islands, ribs/radius/ulna/vertebrae, usually from metaphyses

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65
Q

List three metastatic bone neoplasia (metastasize to bone)

A

Mammary carcinoma, prostatic carcinoma, haemangiosarcoma

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66
Q

When do we commonly see retained endochondral cartilage cores?

A

In young, giant breed dogs that have excess Ca and fast growth. Metaphyseal cartilage spike

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67
Q

Describe endochondral cartilage cores?

A

Bilaterally symmetrical distal ulna, radiolucent cartilage core, sclerotic rim, may cause distal ulna delayed growth

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68
Q

What is the treatment for endochondral cartilage cores?

A

Slow down growth and ulna ostectomy

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69
Q

What causes nutritional secondary hyperparathyroidism?

A

Low calcium or high phosphate diets ? compensatory increase in PTH

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70
Q

Describe the radiographic appearance of nutritional secondary hyperparathyroidism

A

Osteopaenia, thin cortices, spinal curvature deformities with NORMAL PHYSES, Pelvic narrowing, compression fractures, bowing/malformation of bones

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71
Q

How do you treat nutritional secondary hyperparathyroidism?

A

Change to appropriate diet

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72
Q

What causes renal secondary hyperparathyroidism?

A

Renal dysplasia ? chronic renal failure & phosphate retention

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73
Q

What is the radiographic appearance of renal secondary hyperparathyroidism?

A

Skull damage most dramatic, los of lamina dura, ?floating teeth?, moth eaten appearance of mandible + gastric mucosal mineralisation

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74
Q

What do the physes look like in Rickets? (lack of Vit D or calcium)

A

ABNORMAL - widened

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75
Q

What breed commonly gets panosteitis? What is the most common site?

A

GSD in the long bones (pain on palpation). Humerus is most common site.

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76
Q

What does panosteitis look like radiography wise throughout the stages?

A

Early: smudging of trabiculae, beginning at nutrient foramen, patchy increased opacities in medulla, Middle: Roughened endosteum, coarse trabiculaion, mild periosteal reaction, Late: Resolution of medullary opacities, lucent/hollow medullary cavity for many years, thickened endostium, coarse trabiculae, scars

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77
Q

When is Metaphyseal osteopathy common?

A

Young, rapidly growing large breed dogs

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78
Q

Describe hypertrophic/Metaphyseal osteopathy

A

Painful condition, swelling over metaphyses of long bone, depression, variable pyrexia, cause unknown

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79
Q

Describe the timeline of hypertrophic osteodystrophy

A

Early: Irregular radiolucent line at metaphyses, 1-2 weeks: linear mineralized opacities separated from bone by a radiolucent line ?Metaphyseal paracortical cuffing?, 3-4 weeks: collar fuses with cortex, remodels, very opaque metaphyeal region, usually bilaterally symmetrical

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80
Q

What might be DDX?s for hypertrophic osteodystrophy?

A

Haemotogenous osteomyelitis and SH(Salter Harris) type 1 fractures

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81
Q

What is Maries disease

A

Bone disease

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82
Q

Describe Maries disease

A

Bilatterally symmetrical, extensinve, usually skips joints. If you remove mass the limb changes resolve.

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83
Q

What periosteal reaction can hypertrophic dystrophy have?

A

Thick to thin periosteal reaction extending from distal limbs proximally

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84
Q

What are the clinical signs of craniomandibular osteopathy?

A

Mandibular swelling, salivation, difficulty eating

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85
Q

What are the boney changes in craniomandibular osteopathy?

A

Bony proliferation of the mandible, tympanic bulla, petrous temporal bone

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86
Q

What should you examine when you are looking at a joint radiograph?

A

Anatomical relationship, ST swelling, joint space, subchondral bone, peri-articular new bone, calcification

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87
Q

What are the radiological signs of soft tissue swelling?

A

Displacement or distortion of adjacent structure, increase in soft tissue opacity, enlarged joint space

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88
Q

What may be cause of soft tissue swelling?

A

Synovial effusion, synovial thickening and soft tissue masses

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89
Q

What can increase joint space?

A

Stress, skeletal immaturity, synovial effusion, joint laxity, join incongruity, thickened cartilage

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90
Q

What can decrease joint space?

A

Incorrect centering, cartilage attrition (weakening) and muscle contracture

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91
Q

What can cause decreased opacity of subchondral bone?

A

Septic arthritis, osseous cyst and OC

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92
Q

What can increase opacity of subchondral bone?

A

Cartilage attrition, inflammation, stress/trauma induced remodelling

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93
Q

What are osteophytes?

A

Outgrowth of bone at the margin of the articular surface of a synovial joint. Body is trying to increase articular surface

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94
Q

What are enthesophytes?

A

Focal proliferation of new bone to form a bony spur at an enthesis (ligament/tendon insertion)

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95
Q

What can be cause of enthesophytes?

A

Trauma/inflammation, ossified fibrocartilage and may be intra-articular

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96
Q

What are some examples of intra-articular calcification?

A

Joint mice, menisci, synovium

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97
Q

What are some examples of juxta-articular calcification?

A

Calcinosis circumscripta or myositis ossificans

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98
Q

What muscles are prone to calcifying tendinopathies?

A

Infraspinatus, supraspinatus, Iliopsoas, psoas minor, gluteal muscles

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99
Q

Describe malignant synovioma?

A

More seen in dogs. Soft tissue swelling that invades joints. Cortical erosion, destruction and lysis. Multiple lucent cyst like changes. Minimal or no periosteal reaction.

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100
Q

What are the radiographic signs of degenerative joint disease?

A

Narrowing of joint space, subluxations, articular soft tissue swelling, subchondral sclerosis, osteophyte, enthesophyte, joint mice

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101
Q

Describe the timeline of infectious/inflammatory arthritis

A

Early: swelling/fusion of joints, increased joint space, mild periosteal reaction, Advanced: decreased joint space, subchondral erosions, Chronic: osteomyelitis resulting in epiphyseal destruction, periosteal reactions, sub/luxations, eventually possible ankylosis

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102
Q

What is rheumatoid arthritis?

A

Immune mediated disease where there is erosion at synovial attachments and subluxation that develop into angular deformities. Commonly affect s the distal joints, symmetrical and ligamentous weakness

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103
Q

What are the radiographic signs of rheumatoid arthritis?

A

Subchondral radiolucencies, erosion at synovialattachments and angular deformities

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104
Q

Describe congenital luxation

A

IN younger patients, flattened humeral head, shallow glenoid and medial luxation

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105
Q

What is omarthrosis?

A

Arthrosis of the shoulder joint. There may be osteophytes and joint mice

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106
Q

What is osteochondrosis?

A

Failure of endochondral ossification, there is disruption of cartilage mineralization and ossification. Seen in young fast growing breeds. Over nutrition especially Ca+

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107
Q

What does OC lead to?

A

OCD

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108
Q

Describe the anomalies of OC

A

Saucer shaped defect that can form a joint ouse. IN the caudal third of the humeral head.

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109
Q

Describe calcific tendonitis of the shoulder joint

A

Mineralisation of the supraspinatus muscle tendon insertion. Seen in Rottweiler?s especially but may be asymptomatic.

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110
Q

What is elbow dysplasia?

A

Abnormal development of the elbow joint, an all encompassing term

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111
Q

What are the 4 major developmental abnormalities in the elbow?

A

Osteocondrosis, ununited anconeal process, incongruency and fragmented medial coronoid process

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112
Q

What does elbow dysplasia result in?

A

Irriversible elbow arthrosis which leads to pain and lameness

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113
Q

Describe the pathogenesis of ununited anconeal process

A

Larger breeds have a separate centre of anconeal ossification which should fuse at 20 weeks. There is relative overgrowth of the radius ? pressure on anconeus

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114
Q

Describe the radiographic findings for UAP?

A

Often bilaterally symmetrical, flexed ML, lucent vertical line between the anconeus and proximal ulna, arthrosis (usually severe) and incongruity

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115
Q

What can be a confuser when diagnosing UAP?

A

Superimposition of the medial humeral epicondyle physis in view that are not fully flexed in dogs

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116
Q

Describe the pathogenesis of fragmented medial coronoid process

A

Asynchronous radial and ulnal growth with relative ulnar overgrowth. Abnormal load put on MCP ? incongruity and often is bilateral

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117
Q

What do you see radiographically with FMCP?

A

Blunted MCP and osteophytes on MCP with sclerosis and kissing lesion on distal humerus

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118
Q

What do you see radiographically with osteochondrosis?

A

Often bilaterally symmetrical, CRL-CdMO best view, saucer flattening in subchondral bone, arthrosis, subchondral sclerosis, rarely cartilage flap seen

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119
Q

Describe incongruency

A

Increased humero-ulnar joint spaces. Bigger gap between the lateral coronoid processes and the adjacent proximal radius

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120
Q

Describe elbow dysplasia grading

A

0-3 based on presence and size of osteophytes

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121
Q

What type of hip luxation is most common?

A

Craniodorsally ? traumatic

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122
Q

What are common fractures of the pelvis area?

A

Avulsion fractures of the femoral head and acetabular rim fractures

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123
Q

What do you look for to identify a sacro-iliac subluxation?

A

For step at the sacroiliac junction ? Rammus cranialis ossis pubis is most common fracture

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124
Q

What is Legg-Calve-Perthes Disease (LCP)?

A

Avascular femoral head necrosis associated with decrease or lack of blood supply to the femoral capital epiphysis. Young small toy breeds are most commonly affected.

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125
Q

What do you see throughout the stages of Legg-Calve-Perthes Disease (LCP)?

A

Early: widened joint spae and subtle radiolucency of the femoral head. , Late: collapse of subchondarl bone, flattening of femur head, widening of femur neck, coxa vara

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126
Q

Describe the pathophysiology behind Canine Hip Dysplasia

A

Polygenic traits, moderately hereditable, fast growing breeds, normally not seen radiologically before 4-6 months of age

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127
Q

What are the environemental and genetic influences on canine hip dysplasia?

A

Rapid growth, high calcium, low protein diet, excessive exercise when young

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128
Q

How much should the femoral head be in the acetabulum?

A

50%

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129
Q

What are the radiological changes of subluxation of the hips?

A

Femoral head coverage, medial deviation, lateral deviation and Norberg Angle

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130
Q

What are the radiological changes of DJ?

A

Tramlines (osteophyte formation on the cranial margin of the femoral head), Morgan?s lines (enthesophyte formation on the caudal margin of the femoral head), Remodelling (osteophytes), and Lipping & bilabiation (articular osteophytes)

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131
Q

What is genu valgum?

A

Bowed legs

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132
Q

What is genu varum?

A

Knock- kneed

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133
Q

What is coxa valga?

A

Deformity of the hip joint where the neck of the femur angle changes to create a straighter bone

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134
Q

What is coxa vara?

A

Decrease in the angle of incidence

135
Q

What is coxa plana?

A

Flattening of the femoral head

136
Q

Describe the radiological view of congenital patella luxation

A

Medial bowed distal femur, sigmoid shaped stifle, angulation of the femorotibial joint space, medial displacement of the tibial tuberosity

137
Q

What is stifle osteochondrosis?

A

Subchondral defect on the distal aspect of the lateral femoral condyle

138
Q

Describe acute cruciate rupture

A

Effusion and soft tissue obliteration of the infrapatella fatpad

139
Q

Describe chronic cruciate rupture

A

Arthrosis: base and apex of patella,proximal aspect of trochlea ridge, fabellae, medial aspect of lateral femoral condyle

140
Q

What are the luxations of the tarsus

A

Medial trochlea ridge of talus, less commonly lateral ridge

141
Q

What are the OCD of the tarsus

A

Medial trochlea ridge of the talus, DJD, small joint mouse, joint effusion, Rottweiler predisposed

142
Q

How do you get optimal quality for spinal radiographs?

A

General anaesthesia, collimate, grid, centre in area of interest andhigh detail film-screen combination

143
Q

Why do you use foam pads to position the animal for spinal radiographs?

A

To ensure spine is straight otherwise you may get artifactual narrowing/stenosis

144
Q

How many of each vertebrae are NORMALLY in dogs/cats?

A

7 C, 13T, 7L, 3S

145
Q

When do the end plates of the vertebrae close in a dog?

A

11-12 months

146
Q

List 4 congenital spine conditions

A

Spina bifida, transitional vertebrae, block vertebrae, hemi vertebrae

147
Q

What are transitional vertebrae?

A

Sacralistion, lumbarisation or thoracolisation of vertebra

148
Q

What is block vertebrae

A

Congenital fusion of two adjacent vertebrae

149
Q

What do you need to differentiate block vertebrae from?

A

Disospondolosis

150
Q

On what radiographic view do you see butterfly vertebrae?

A

VD. Failure of central part of body to form. Brachycephalic and screw tail breeds.

151
Q

What are hemi vertebrae?

A

Wedge shaped vertebral body. Incomplete ossification.

152
Q

What can hemi vertebrae lead to?

A

Scoliosis and lordosis and is a weak spot in the spine predisposed to trauma

153
Q

Describe the pathogenesis of atlanto-axial instability

A

IN small/toy breeds. There is dens fracture, dens agenesis and ligament agenesis

154
Q

What is spondylosis?

A

Degeneration of the intervertabral discs with formation of osteophytes on the vertebral endplates. There is progressive new bone formation

155
Q

Describe the grades of spondylosis

A

Grade 1,2,3,4

156
Q

When does primary spondylosis become significant?

A

If it extends laterally or at the LS region and in boxers

157
Q

What may cause secondary spondylosis?

A

CVI, disc prolapsed, discospondylitis, trauma, disc fenestration

158
Q

What is ossifying pachymeningitis?

A

Ossification of the dura mater. It is not significant and is seen in older large breeds.

159
Q

What does ossifying pachymeningitis look like?

A

A mineralized line lying horizontally in the vertebral canal

160
Q

What is spondylarthrosis?

A

DJD of articular facets seen in older dogs

161
Q

What can cause disc herniation?

A

Trauma, degeneration, TL and C spines usually affected,

162
Q

What are the types of disc herniation?

A

Hansen Type 1 (fast extrusion) and Type 2 (slow protrusion)

163
Q

What are the radiological signs of disc herniation?

A

Narrowed intervertebral disc space, interorbital foramen shape and opacity, altered artilucation facet, mineralized opacities within the vertebral canal and C spine has later protrusion

164
Q

What is Wobbler?s Syndrome?

A

Cervical vertebral malformation malarticulation

165
Q

What are the signs of CVMM?

A

Hindlimb ataxia, avoids/detests neck manipulation

166
Q

What are the radiological changes in CVMM?

A

Vertebral canal stenosis, lateral compression, medially deviating pedicles or articular facet malformation

167
Q

What are the soft tissue changes in CVMM? (cervical vertebral malformation malarticulation)

A

Hypertrophy with ventral compression and dorsal compression, joint capsule, inter arcuate ligament

168
Q

What is discospondylitis?

A

Infection of the i/v discs and vertebral end plates via haemotogenous route. Usually the thoracic and lumbar vertebrae.

169
Q

What are the radiological signs of discospondylitis (in a timeline)?

A

Decrease of width in i/v disc space ? increase of i/v disc space and lysis of end plates with sclerosis of adjacent bodies ? bony reaction and the lytic area fills up with bone ? kyphosis

170
Q

Outline the treatment for discospondylitis

A

Isolate organism and do antibiogram. At least 6 weeks AB course

171
Q

What is spondylitis?

A

Inflammation of the vertebral body cause by bacterial, parasites, FB or metastatic neoplasia

172
Q

Where is the periosteal reaction usually with spondylitis?

A

Brushlike, lamellar or solid

173
Q

How much of the vertebral bone need to be destroyed before we can see it radiologically?

A

50%

174
Q

How do you know is neoplasia is extra-medullary or intra-medullary?

A

Swelling (intra) or shrinkage (extra) of cord near the radio-opaque area

175
Q

What does a multiple myeloma look like in the spine?

A

Holes in the vertebrae and usually in the pelvis as well

176
Q

What are some frontal sinus pathologies?

A

Neoplasia, infection

177
Q

What are some TMJ pathologies?

A

TMJ dysplasia, subluxation, lft

178
Q

What are some examples of tympanic bullae pathology?

A

Fluid accumulation, thickening of wall with/without irregular new bone

179
Q

Describe nasal neoplasia

A

Lysis of bone of nasal cavity, generalized/unilateral/bilateral , generalized loss of turbanant detail

180
Q

Describe the radiological appearance of chronic rhinitis?

A

Lucent foci, focal or multifocal lesions, localized ST opacity

181
Q

Name a lanryx/pharynx pathology in the cat

A

Nasopharyngeal pulp

182
Q

Describe the radiographic technique used for radiographing the thorax

A

You want ?long scale? (high Kv and low mAs)

183
Q

What are the best views for thoracic radiograph normally?

A

DV and RLR. With RLR you get a more accurate representation of the heart but less aeration of the right lung lobes. The heart naturally lies on the left hand side and falls towards the midline resulting in improved apex visibility

184
Q

Where does the cranial vena cava enter the crus?

A

The right diaphragmatic side

185
Q

Where does the left diaphragmatic crus lay on a RLR?

A

It lies behind the right but is pushed forward on a LLR

186
Q

The VD view of a thoracic radiograph improves visbility of which particular lung lobe?

A

Accessory

187
Q

What are the radiological thoracic differences between dogs and cats?

A

Cats heart lays down more and psoas muscle extends into thorax on lateral views and can be confused with pleural effusion

188
Q

What can cause artifactual interstitial lung patterns?

A

Decreased lung field, increased opacity, poor ventilation and superimposition of adipose tissue

189
Q

What can obesity make a false diagnosis of?

A

Cardiomegaly

190
Q

What do young animals have that older ones do not (thorax)?

A

Thymus

191
Q

What are some unique thoracic characteristic of bulldogs?

A

Redundant trachea and a widened cranial mediastinum

192
Q

What are some unique thoracic characteristics of dachshunds?

A

Heart appears larger

193
Q

What breed has excessive skin folds?

A

Sharpei

194
Q

List some extra-thorasic anomalies

A

Air pockets, fractured humerus, vertebral fracture and spondylosis, omarthrosis and spondylitis

195
Q

What are some intra-thoracic age related changes?

A

Pulmonary osteomata and end-on vessels ? age related changes

196
Q

Using the ?clock analogy? name the sections of the cardiac anatomy

A

11-1 : aortic arch, 1-2 : pulmonary artery, 2-3 : left auricle, 2-5 : left ventricle, 5-9 : right ventricle, 9-11: right atrium

197
Q

What creates the auricle?

A

Mainstem bronchi divergence

198
Q

What are the main species difference of dog and cat of the heart?

A

In dog Lau is 2-3 whereas in the cat it is 1-2. The cardial apex points more to the left in the dog and more centrally in the cat

199
Q

What does a wide shallow chested dogs heart look like?

A

Shorter rounder heart with apparent more sterna contact

200
Q

What does a deep narrow chested dogs heart look like?

A

Ling oval heart with apex in vertical position

201
Q

What does an intermediate chest size look like?

A

Ovoid or egg shaped heart

202
Q

What is different about a young dogs cardiac silhouette compared to an older dog?

A

A young dogs heart is apparently bigger and they have a thymus

203
Q

What does an older cats cardiac silhouette look like?

A

The heart gets ?lazy? and lays down and has increased sterna contact

204
Q

How should you measure the cardiac silhouette?

A

Long axis of heart: ventral aspect of carina and to the cardiac apex. Short axis: line perpendicular and on the widest point of the heart. T4 ? T9 and T4 - T7. Normal is 8.5 ? 10.5

205
Q

How can you measure feline VHS?

A

The maximum width of the heart should not exceed cranial aspect of the 5th rib to caudal aspect of the 7th rib

206
Q

What do you need to remember if you think there is right heart enlargement?

A

A rotated VD/DV can mimic a inverted ?D? sign

207
Q

What can cause microcardia?

A

Acute myocardial failure, HAC, emaciation, hypovolaemia

208
Q

How can you assess pulmonary vessels?

A

The diameter of the artery or vein should be no greater than the width of the 9th rib where they cross it

209
Q

Is the oesophagus usually visible?

A

Not unless it is airfilled normally

210
Q

Where do FB most commonly lodge in the oesophagus?

A

Thoracic inlet, base of heart and oesophageal hiatus

211
Q

Describe the musculature of a cats oesophagus

A

The caudal third is smooth muscle and the cranial 2/3 is striated muscle

212
Q

What is the tracheo-oesophageal stripe sign?

A

A stripe that occurs when there is summation of the tracheal and oesophageal walls , air must be present in the trachea and oesophagus

213
Q

When can you see the tracheal wall best?

A

If there is air in the oesophagus or the rings are mineralised. The lateral view is best with head in neutral position

214
Q

Where does a normal trachea sit?

A

Diverges slightly from the thoracic spine

215
Q

What can ventroflexion of the neck do?

A

Cause focal dorsal displacement of the terminal trachea

216
Q

What breeds are predisposed to trachea dorsal displacement?

A

Brachycephalic breeds

217
Q

What masses may cause dorsal displacement of the trachea?

A

Cardiac or mediastinal masses, pleural effusion and foreign bodies

218
Q

What can cause ventral displacement of the trachea?

A

Obesity

219
Q

What structure prevents the trachea from displacing to the left?

A

The aorta

220
Q

What can cause right lateral displacement of the trachea

A

Can be artefactual or caused by oesophageal dilation, medistinal shift or a heart based tumor

221
Q

What dog breeds are predisposed to tracheal collapse?

A

Older, brachycephalic and toy breeds

222
Q

What can cause artifactual narrowing of the trachea?

A

Obese patients and the fat within the longus colli muscle

223
Q

What can you see with inspiration and expiration with tracheal collapse?

A

Narrowing and widening of the trachea

224
Q

What are the three reasons the mainstem bronchi may widen on the DV/VD?

A

Left atrial enlargement, tracheobronchial lymphadenopathy, caudo-dorsal mediastinal mass

225
Q

What is peri-bronchial cuffing?

A

Lumen diameter stays that samebut appears radiologically thicker

226
Q

Describe a diffuse interstitial pattern

A

When inflammation goes to interstitium resulting in fading of the adjacent vessels and an all over haziness

227
Q

Describe the alveolar pattern

A

All that is visible is the air filled bronchi

228
Q

What do you see upon full inspiration?

A

Caudodorsal lungs to 13th rib, cranial end at 1st rib.

229
Q

What is an unstructured pattern?

A

Artifactual

230
Q

What are the types of structured patterns?

A

(interstitial ) Bronchial (chronic allergic bronchitis/feline asthma), reticular (interstitial fibrosis/lymphoma), nodular (metastases/eosinophilic bronchopneumopathy) or mixed

231
Q

What are the four reasons for an artifactual diffuse unstructured interstitial pattern?

A

Obesity, expiratory, shortscale, underexposure

232
Q

What ?sign? is characteristic of alveolar pattern?

A

Lobar

233
Q

What mediastinal structures are normally visible?

A

Trachea and its bifurcation, heart, aorta, CVC, thymus in young and oesophagus

234
Q

What mediastinal structures are not normally visible?

A

Cranial VC, main pulmonary artery, nerves, thoracic duct, lymphnodes

235
Q

What is the normal width of a craniodorsal mediastinum in a dog/cat?

A

2 x thoracic ribs in dog and 1 x thoracic rib in cat

236
Q

What does the sterna lymph node drain?

A

Abdominal cavity (not the tissues)

237
Q

What can cause a mediastinal shift away from the affected side?

A

Pneumothorax, pleural effusion, DH, large lung/pleural mass, lobar emphysema

238
Q

What causes a mediastinal shift towards the affected side?

A

Atelectasis, lung lobe torsion, lobectomy, hypostasis, adhesions, pneumothorax

239
Q

What are the most common sites for mediastinal masses?

A

Cranioventral, hilar and peri-hilar masses and caudodorsal

240
Q

What other changes can accompany a mediastinal mass?

A

Displacement of thoracic structures, fluid in mediastinum, concurrent pleural effusion, other signs of thoracic disease

241
Q

What are fissure lines?

A

?fluid lines? that dissect between lung lobes

242
Q

What do reverse fissure lines indicate?

A

Mediastinal effusion

243
Q

What do you see with pleural effusion?

A

Fissure lines, apparent widening of mediastinum, retraction of lung lobe edges, soft tissue opacification of edges

244
Q

What do you see with pneumothorax?

A

Air within pleural space, retraction of lung lobe edges, elevation of heart from sternum

245
Q

What do you see with tension pneumothorax?

A

Severe lung lobe atelectasis, flattening of diaphragm, scalloping of intercostals spaces and mediastinal shift

246
Q

What do you see with diaphragmatic rupture?

A

Border effacement of thoracic structures, displacement of thoracic structures, loss of diaphragmatic line, displacement of abdominal structures

247
Q

How could you confirm small diaphragmatic ruptures?

A

Positive coeliography

248
Q

Where does the normal gastric axis lay?

A

Maximally parallel to the intercostals space and minimally perpendicular to the thoracolumbar spine

249
Q

What is the normal width of a small intestinal loop?

A
250
Q

What is the normal width of the colon?

A

1.5 width of L7

251
Q

What are some contrast studies that you can do?

A

Pneumogastrogram, positive contrast gastrogram, doublecontrast gastrogram, GIT flow through, pnuemocolon, barium enema, double contrast enema

252
Q

How do you adequately prepare a patient for a radiograph?

A

Starve, enema, survey rads, what to use, sedation

253
Q

How do you perform a pneumogastrogram?

A

Measure appropriate length of tube, pass tube, inflate with air, for location/mass/FB

254
Q

Describe the GIT through flow

A

Large volume (10ml barium/kg or 1ml iodine/kg), For size, shape, content and emptying. Do multiple serial views. You will do a RLR, DV and DV oblique. @ 30mins and 3 hrs in dog AND 15 mins and 1.5 hrs in a cat.

255
Q

What are pseudo-ulcers?

A

Normal variant of the duodenum

256
Q

Describe positive contrast colonography

A

Starve, enemas, survery rads, sedation or GA, barium iodine, You do it to distinguish LI from SI, fro structures, large masses, intussuseptions

257
Q

Why would you do a pneumocolon?

A

To distinguish LI from SI, strictures, masses and intasusseptions

258
Q

What is a redundant colon?

A

Normal variant seen in large dogs. Extra bends in the descending colon.

259
Q

What can cause the stomach to be non-visible?

A

Empty/collapsed, no fat, peritoneal effusion

260
Q

What can cause cranial gastric displacement?

A

Microhepatica and diaphragmatic hernia.

261
Q

What can cause caudal gastric displacement?

A

Hepatomegaly or hepatic mass

262
Q

What can cause right displacement of the stomach?

A

Spleen and L liver mass

263
Q

What can cause left displacement of the stomach?

A

Pancreas or R liver mass

264
Q

What can cause an enlarged stomach that is normal in shape?

A

Acute gastritis, over-indulgence, respiratory distress or outflow obstruction

265
Q

What can cause delayed gastric emptying?

A

Pyloric hypertrophy or pyloric neoplasia

266
Q

What can be cause of a large stomach that is abnormal in shape?

A

GDV

267
Q

Describe GVD and rads

A

Popeye arm, boxing glove, compartmentalization

268
Q

What can cause gastric perforation?

A

Ulcers, FB or necrosis after GDV

269
Q

What are the best tools for diagnosing gastric ulcers and neoplasia?

A

Ultrasound okay but endoscopy is best!!!

270
Q

What width do the intestine need to be to be suggestive of ileus?

A

> 2 x thoracic rib width

271
Q

What things can cause ileus?

A

Enteritis, partial obstruction, drugs, severe dehydration, electrolyte imbalances

272
Q

What is dilation of the SI a medical emergency?

A

When it is > 4 x thoracic rib width

273
Q

What are the radiographic signs of enteritis?

A

Long coils or gas filled loops, rapid transit time, barium segmented or string like

274
Q

What are the types of intestinal obstruction?

A

Complete/partial, mechanical/functional and proximal/distal

275
Q

Should you give contrast to a complete obstruction patient?

A

NO

276
Q

When can you see a gravel sign?

A

With partial obstruction

277
Q

What are tear drop gas bubbles in the intestines suggestive of?

A

Linear FB

278
Q

What is the difference between constipation and obstipation?

A

Obstruction due to mechanical or functional

279
Q

What radiographic sign is suggestive of colitis?

A

Spring coil in contrast

280
Q

What can cause a luminal filling defect?

A

Neoplasia, FB, faeces

281
Q

How big is a normal prostate?

A

No larger than 70% of the sacropubic length

282
Q

How big is a normal kidney in a cat?

A

2-3 x length of L2

283
Q

What are the DDx?s for small kidneys?

A

Chronic renal disease, atrophy or developmental dysplasia

284
Q

List 5 DDx?s for bilateral renomegaly

A

Renal failure (acute), nephritis, hydronephrosis, neoplasia, granuloma

285
Q

List 5 DDx?s for unilateral renomegaly

A

Neoplasia, abscess, haemotoma, granuloma, hydronephrosis

286
Q

What can cause mineralization of the kidneys?

A

Neoplasia, nephroliths, dystrophic mineralisation

287
Q

How do you prep for an excretory urogram?

A

Functional tests, assess hydration status, empty GIT, survey radiographs

288
Q

What are the contraindication for an excretory urogram?

A

Anuria, dehydration, sensitivity to contrast agent

289
Q

How do you perform an excretory urogram?

A

DO a bolus injection iodine. Perform an immediate VD. Rads at 10 and 20 minutes

290
Q

What are the three phases of the urogram?

A

Angiogram, nephrogram (1min), pyelogram (10min)

291
Q

What could can poor/slow opacification of urogram?

A

Underdose, renal failure, reduced functional tissue

292
Q

What are some disorders of the pelvis?

A

Pelvic dilation, pelvic filling defects, pelvic distortion

293
Q

What can be cause of a dilated ureter?

A

Ectopic, ascending infection, obstruction (calculus/stricture)

294
Q

What do you see with a ruptured ureter?

A

Opacification of retroperitoneal space, leakage of contrast medium, hydroureter more proximally

295
Q

How do you diagnose ectopic ureter?

A

EU, ultrasound

296
Q

What do ectopic ureters lead to?

A

Urinary incontinence, commonly females, hydroureter on affected side

297
Q

What are the indications for bladder radiology?

A

Dysuria, haematuria, pyuria, stranguria or incontinence

298
Q

What may cause you to not see the bladder on radiograph?

A

Empty, displacement, rupture, bilateral ectopic ureters

299
Q

What can cause caudal displacement of the bladder?

A

Hernia, short urethral syndrome

300
Q

What are the indications for doing a bladder contrast study?

A

Location, integrity, wall thickness, mucosal detail and luminal filling defect

301
Q

How should you prepare for a bladder contrast study?

A

Empty GIT, survey radiographs, sedation, empty bladder, place catheter

302
Q

What are the indications for positive contrast cystogram?

A

Location, shape, rupture, large filling defect or mural masses

303
Q

How do you perform a positive contrast cystogram?

A

Diluted iodinated medium. 100-150mls.

304
Q

What are the indications for a pneumocystogram?

A

Location, shape, rupture, large filling defects or marked wall thickening

305
Q

How do you perform a pneumocystogram?

A

Lateral recumbency to avoid air emboli, cats: 10-15 dogs: 10-200ml. Descrease mAs.

306
Q

What are the indications for double contrast cystogram?

A

Good for everything. Excellent for mucosal detail and small filling defects

307
Q

What are some of the filling defects?

A

Gas bubbles, blood clots and calculi

308
Q

Describe the different stages of cystitis

A

Early: cranioventrally thickened wall, Chronic: diffuse thickening of wall, polypoid: focal wall thickening

309
Q

What can cause loss of integrity?

A

Tears/ruptures, cystitis, leakage of contrast medium and poor abdominal serosal detail

310
Q

What does bladder neoplasia look like on US?

A

Focal wall thickening most commonly in the bladder trigone. Most commonly TCC

311
Q

How do you perform a +ve contrast urethrogram on male?

A

Empty the colon and do survey radiographs. You want a full bladder, keep penis tip closed and inject 5-15ml of contrast

312
Q

How do you perform a +ve contrast urethrogram on a female?

A

Foley?s catheter, clamp it, inflate with iodinated contrast medium

313
Q

What can cause urinary incontinence?

A

Bladder hypoplasia, intrapelvic bladder, patent urachus, neoplasia, ectopic ureter, intersex, uretro-vaginal fistula

314
Q

What are some urethral conditions?

A

Calculi, strictures, urethritis, neoplasia, rupture

315
Q

Describe pneumocystography

A

Bladder is filled with room air, amount is patient specific

316
Q

Why would you perform cystography?

A

Bladder size and shape, wall thickness, calculi and verify normal position of bladder

317
Q

What are sound waves?

A

Bands of compression or rarefaction of the molecules of the conduction medium

318
Q

What does the transducer do?

A

Converts electrical energy into sound energy

319
Q

What happens when sound is propagated through a medium?

A

It undergoes attenuation and loses strength

320
Q

If you have smaller wave lengths, what happened to your resolution?

A

Increases

321
Q

What is the acoustic interface?

A

When tissues of different densities areadjascent to each other they form a barrier.

322
Q

What colour is fluid on ultrasound?

A

It is anechoic (black)

323
Q

What is acoustic enhancement?

A

A relatively more energetic beam

324
Q

What happens when soundwaves hit bone?

A

You get an anechoic acoustic shadow

325
Q

What is the reverberation artifact?

A

Where air completely reflects soundwaves at the interface

326
Q

What is lateral resolution?

A

Two objects next to each other ? perpendicular to the sound beam

327
Q

What is axial resolution?

A

When two objects are behind each other or parallel to the sound beam

328
Q

What does lateral resolution depend on?

A

Beam width, focal zone, transducer type

329
Q

Describe electronic transducers

A

Different types but we like linear best. Different image, different field and different types are good for different things

330
Q

What is overall gain?

A

Artificially enhances the whole image

331
Q

What does the time gain control do?

A

Near and far field gain

332
Q

What are some useful artifacts?

A

Acoustic enhancement or shadowing, refractive and reflective shadows

333
Q

What are some confusing artifacts of ultrasound?

A

Reverberation (comet-tail and ring-down), mirror image and slice thickness

334
Q

Describe mirror image artifacts?

A

Two properties must be present for this to occur ? highly reflective and curved surface ie. Gallbladder, liver, lung thing. The sound wave is reflected further into the body at a highly reflective curved surface

Jill's Quizzes (4 decks)

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