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Year 4 Overview/Random tests > Radiology > Flashcards

Radiology Flashcards

1
Q

Where does a plain abdo film extend to?

A

Lung bases to pubic symphysis

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2
Q

System for plain abdo film reporting?

A

4 solid organs - liver, spleen, pancreas, kidneys (over psoas muscle)
4 hollow organs - stomach, small bowel, large bowel, bladder (gall and normal)
4 other things to check for - lung bases, bones, calculi, free gas and hernial orifices
NB aortic/splenic artery calcification normal

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3
Q

What are the only times you would see the spleen or the pancreas?

A

Spleen if enlarged

Pancreas if calcifies

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4
Q

Most common axis for the stomach to twist on in volvulus?

A

Organoaxial due to hiatus hernia

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5
Q

How to distinguish small bowel loops vs large bowel loops?

A

Small bowel: lines () go all the way across, lots of it, central.
Large bowel: bigger? lines only extend 2/3s of the way across, outside of centre - fixed at splenic flexure and hepatic flexure
‘Gas filled viscus’ if unsure which

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6
Q

What is thumb-printing?

A

Oedematous bowel wall - gas trapped in lumen hence shape around edge.

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7
Q

Causes of oedematous bowel wall?

A

Infection/inflammation/ischaemia/infiltration due to malignancy etc

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8
Q

What to consider if massive massive colon?

A

Pseudo-obstruction (?laxative abuse)

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9
Q

Common places for large bowel volvulus?

A

Caecal and sigmoid

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10
Q

Where might abnormal gas be?
NB beware no gas within bowel is not normal either.
Can do a lateral xray to check for free gas.

A

Intraperitoneal - NB meniscus if gas in stomach to help differentiate/ nb can see lung markings behind/look nder liver.
Retroperitoneal - Riglers sign?
Biliary tree - rare - emphysematous cholecystitis associated with diabetes. OR gas after a stone passed.
Urinary - iatrogenic.
Abscess

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11
Q

What does free gas look like in comparison to bowel contained gas?

A

Quadrilateral shapes.

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12
Q

Normal vs pathogenic calcification?

A

Normal - lymph nodes, fibroids, phleboliths

Pathological - renal/biliary/vascualr/bladder.

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13
Q

Systemic approach to CXR?

A

Details
View
Adequately inspired/exposed?
Heart - aorts - hilum - long zones - diaphragm - gas elsewhere - ribs/bones

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14
Q

Where does the 50% of the chest rule for the heart apply?

A

50 % of GREATEST trans thoracic diameter

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15
Q

What is peri bronchial cuffing?

A

Fluid tracking before florid pulmoary oedema

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16
Q

What helps distinguish pneumonia types?

A

Peripheral/zones vs per-hilar

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17
Q

Why does TB prefer apical ZONES of lungs?

A

Less oxygen

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18
Q

What common disease gives rise to chronically flat diaphragms?

A

Emphysema

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19
Q

What is the lingula?

A

RMV equivalent

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20
Q

What would you see on a CXR if pneuomothorax?

A

Flat diaphragm, vertical R bronchus, mediastinal shift - reveals vertebral bodies/widening.

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21
Q

What is the deep sulcus sign?

A

Costophrenic deepening, often only see flattened diaphragm

22
Q

Rib fractures on CXR?

A

Consistently underestimated.

23
Q

How to tell if fluid is in a vacuum or not?

A

Meniscus = vacuum

24
Q

How can you see the difficult LLL collapse common after cardiac surgery?

A

Look at medial end of hemidiaphragm. Can you follow hemidiaphragm to the aorta? If not could be LLL collapse mimicking heart border.

Also, left hilum lowers/vessels on the left move.

25
Q

What is the sail sign?

A

Big thymus in kids?

26
Q

What does hilar lymphadenopathy show?

A

Sarcoid or malignancy (should be concave not bulging)

27
Q

If an US is lower frequency what does that mean?

A

Higher penetration, lower resolution picture

28
Q

When do you use linear not curved US probes?

A

For carotid dopplers/nerve blocks etc

29
Q

What things in US are very reflective of sound?

A

Gas and stones
Fat
(All v white)

30
Q

How to tell the difference between gas and stones on US?

A

Gas: lines echoing behind (ringdown?)

31
Q

US landmark for pancreas?

A

SMA coming of aorta

32
Q

Early and late signs on US of biliary obstruction?

A

Early - dilated CBD (if no gall bladder 10-12mm acceptable)

Late - visible/dilated intrahepatic ducts

33
Q

Where do you look for free fluid in the abdomen?

A

Morrison’s pouch (potential space between R kidney and liver) NB also on left - spleen

34
Q

Signs of hydronephrosis on US?

A

If can see black collecting system around fatty medulla of kidney

35
Q

How to measure aorta for aneurysm?

A

AP: look up cut offs but 5/5.5cm for surgical fixing.

36
Q

Pelvic US - instructions to patient?

A

Full bladder: to move bowel out the way

37
Q

What used to be common first-line imaging in major trauma?

A

CXR, pelvis, lateral c-spine, plain abdominal film

38
Q

What are you looking for in major trauma in mediastinum?

A

Superior mediastinal contours for aortic injury, mediastinal widening - rupture.

39
Q

What is the deep sulcus sign?

A

Deep costophrenic angle

40
Q

Why do people die of tension pneumothoraces quickly?

A

Increase in thoracic pressure causes kinking of SVC/IVC -> VF > Death.

41
Q

What views for a C-spine xray?

A

CTLV -> inferior lateral -> AP -> obliques - to get cervical/thoracic junction.

42
Q

Where are most C-spine injuries?

A

50% are in the cervical-thoracic junction.

50% are in the base of C2 (?)

43
Q

Structure for assessing c-spine xray?

A

Anterior v line; odontoid peg in the vertebral body of C2; interlaminar/spinolaminar line; spinous processes line (aka curvature - NB not C1); Soft tissue anterior area in adults - common area to develop a haematoma.

44
Q

What is the mechanism for a C1 compression injury?

A

Occipital condyles press against C1 body, if the ligament is torn then this leads to the connection with C1 and C2 being lost.

45
Q

What is a Jefferson fracture?

A

Fracture through the anterior and posterior arches of C1; mostly due to axial loading - hyperextension injury. Stability is dependent on the integrity of transverse ligament. Lateral masses are displaced laterally as transverse ligament if torn.

46
Q

C2 fracture of odontoid peg - how many types?

A

Type I: stable - above ligament
Type II: below peg
Type III: through entire body

47
Q

C2 fracture of odontoid peg - what is seen on x-ray/how do they present?

A

Lack of alignment in anterior line/present late holding head - wobbly.

48
Q

What is a Hangman’s fracture?

A

Fracture of pars interarticularis/both pedicles.

C2/3 posterior relapse.
If unstable then the posterior ligament is ruptured -> anterior displacement due to chip of vertebral body.

49
Q

Stability rule for vertebral fractures?

A

If more than one out of three columns if affected

50
Q

What is the cause of locked facets?

A

Lateral blows/hyperflexion (like a tiled roof when flex, jams up)

51
Q

What are the signs/problems associated with 1 vs bilateral locked facets?

A

1: malrotation is biggest problem. Look for transverse processes on AP film.
Bilateral: translocation of vertebral body on lateral film. (movement of the v body forward)

52
Q

Pelvis - blunt trauma and haemorrhage - what can we do?

A

Embolisation.

Year 4 Overview/Random tests (11 decks)

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