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17 Acute Care > Radiology > Flashcards

Radiology Flashcards

1
Q

preferred imaging studies

A

ct without contrast: trauma, stroke, acute headache, coma

mr without contrast: chronic headache, dementia

mr without contrast: seizure, infection, cancer

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2
Q

facial fractures are commonly caused by ___

A

blunt or penetrating trauma (vehicle accidents, assaults, falls)

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3
Q

types of fractures

A
  • linear (temporal, parietal)
  • depressed (due to direct blow to head)
  • diastatic (widening suture lines in childhood)
  • basilar
  • ping pong (infants)
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4
Q

most common form of traumatic intraaxial injury

A

cerebral contusion

- at inferior and polar surfaces of frontal and temporal lobes

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5
Q

epidural vs subdural hematoma

A

read

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6
Q

radiographic features of hematomas

A 
acute = hyperdense
subacute = hypo/isodense
chronic = hypodense
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7
Q

features of subarachnoid hemorrhage

A
  • ct: hyperdense material in subarachnoid space
  • angiography: to see aneurysms (cta, mra, dsa)
  • tears of subarachnoid vessels
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8
Q

intracerebral hematomas occur in ___

A

within brain tissue and due to severe head injury

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9
Q

causes of stroke

A

infarction: in situ thrombosis (atherosclerosis or embolism)
hemorrhage: hypertension

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10
Q

gold standard imaging for hemorrhage

A

ct

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11
Q

early signs of stroke

A
  • hypoattenuating brain tissue
  • obscuration of lentiform nucleus
  • dense mca sign
  • insular ribbon sign
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12
Q

benefits of mri for stroke

A
  • can contrast hemorrhagic and ischemic

- diffusion weighted imaging: most sensitive sequence for stroke imaging

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13
Q

screening assessment for head injuries

A

read (noncontrast ct)

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14
Q

imaging of choice for cervical spine injuries

A

plain films

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15
Q

lines that should be parallel and aligned

A
  • ant vertebral bodies
  • post vertebral bodies
  • spinolaminar lines
  • spinous process
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16
Q

most common fracture mechanism in cervical injuries

A

hyperflexion

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17
Q

fracture from cervical hyperextension

A

hangman’s fracture

  • best on lateral view
  • fractures through pars intercularis
  • anterior dislocation of the c2 vertebral body
  • prevertebral soft tissue swelling
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18
Q

fracture from axial compression

A

jefferson’s fracture

- axial blow to vertex of head (from diving headfirst)

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19
Q

radiographic features of spinal cord compression

A
  • plain film and ct: not for assessment and cause

- mri: gold standard!! to see spinal canal and contents

20
Q

imaging of choice for thorax

A

cxr

  • rib fractrues
  • pulmonary contusions/ lacerations
  • abnormal collections of air
  • abnormal collections of fluid
21
Q

most common blunt chest injury

A

rib fractures

  • 4-9 most common = pneumothorax and contusion
  • 1 only = facial fractures
  • 1 2 3 = serious trauma, ruptured bronchus
  • 10-12 = lacerated liver/spleen
22
Q

what is flail chest

A

> /=3 contiguous broken ribs in 2 or more places, moves paradoxically with respiration

23
Q

most common pulmonary finding in blunt chest injury

A

pulmonary contusion

24
Q

pulmonary laceration can result in the formation of a ___

A

traumatic lung cyst or traumatic lung hematoma

25
Q

pneumothorax secondary to high intrathoracic pressures from ventilation resulting in rupture of pleural bleb

A

tension pneumothorax

- midline structures are pulled to contralateral side

26
Q

signs of pneumomediastinum

A
  • spinnaker sail sign: elevation of thymic lobes due to pneumomediastinum
  • continuous diaphragm sign: entire diaphragm is visualized from one side to the other
27
Q

air appears around heart but does not extend above great vessels

A

pneumopericardium

28
Q

streaky air over lateral chest wall or neck

A

subcutaneous emphysema

  • localized: penetrating injury
  • diffuse: pulmonary interstitial emphysema
29
Q

abnormal collections of fluid from lungs

A
  • hemothorax

- chylothorax (lymph)

30
Q

abdominal radiology tests

A
  • erect cxr
  • abdominal x-ray (first line)
  • us abdomen
  • ct abdomen
31
Q

imaging for pneumoperitoneum

A

plain radiograph or ct

32
Q

bowel related signs of pneumoperitoneum

A
  • double wall sign or rigler’s sign

- telltale triangle sign

33
Q

peritoneal ligament related signs of pneumoperitoneum

A
  • football sign
  • falciform ligament sign (silver’s sign)
  • lateral umbilical ligament sign (inverted v)
  • urachus sign
34
Q

right upper quadrant signs of pneumoperitoneum

A
  • lucent liver sign
  • hepatic edge sign
  • ligamentum teres sign
  • morison’s pouch sign
  • cupola sign
35
Q

most common disorder of the urinary tract

A

renal/ureteric calculi, mostly calcium oxalate

36
Q

imaging modality for acute cholecystitis

A

uts

37
Q

findings in acute cholecystitis

A
  • cholelithiasis
  • gb wall thickening >3-5 mm
  • pericholecystic fluid
  • positive murphy sign
  • gb distention
38
Q

most common cause and imaging for peptic ulcer disease

A

h pylori infection and nsaid use, uses endoscopy or upper gi series

39
Q

imaging for appendicitis

A

uts or ct scan

40
Q

signs of diverticulitis

A
  • diverticulosis
  • pericolonic fat inflammation and inc vascularitis in mesocolon
  • symmetrical mural thickening
  • phlegmon formation
  • free fluid
41
Q

diagnostics for mechanical obstruction

A
  • xray, ct, uts, or mri
  • normal bowels: small bowel <3 cm, large bowl <6 cm, cecum <9 cm
  • 80% small bowel obs
42
Q

abnormal aaa findings

A
  • > 3cm abdominal aorta
  • thrombus within aneurysm
  • calcification
43
Q

types of fractures

A

read

44
Q

describing fractures by direction of fracture line

A
  • transverse
  • oblique
  • spiral
  • longitudinal
45
Q

describing fractures by relationship of fragments

A
  • displacement
  • angulation (a/p, m/l)
  • shortening
  • rotation
  • impaction, depression, compression
46
Q

describing fractures by number of fragments

A 
2 = simple
>2 = comminuted

uncommon: fatigue, insufficiency, secondary to pre-existing abnormality

17 Acute Care (7 decks)

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