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CLASP > Radiology: Trauma > Flashcards

Radiology: Trauma Flashcards

1
Q

what are the main 4 things you will pick up on a chest XR

A
  • pneumothorax
  • pneumonia
  • effusion
  • pneumoperitoneum
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2
Q

what will you see on a pneumothorax

A
  • dark area at edges
  • look for lobe collapse (lobe markings)
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3
Q

tension pneumothorax tx?

A
  • cannula in to treat it
  • then CT chest
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4
Q

what will you see with a pneumonia?

A
  • light and white
  • hazy type appearance
  • infective?
  • cancer red flags? could be cancer. repeat chest XR in 6 weeks to see if something underlying it
  • sometimes sits against heart border and destroys it
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5
Q

pleural effusion chest XR

A
  • find usually at bottom of the lung
  • dense whiteness
  • unilateral pleural effusion think cancer
  • if bilateral? congestive HF
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6
Q

what do you see in pneumoperitoneum?

A
  • gas under diaphragm
  • particularly on right hand side
  • double line
  • CT and call gen surgeon

(diaphragm is top line, gas in between and liver being pushed up on RS)

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7
Q

first line Ix for suspected bowel perforation

A
  • chest XR (and abdomen)
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8
Q

what are the 2 most likely things to see on abdominal XR in A+E?

A
  • obstruction
  • pneumoperitoneum
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9
Q

small bowel vs large bowel perforation

A
  • small bowel is more central and more looped as there is more to it than large bowel
  • lots of gas in small but none in large
  • next Ix CT
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10
Q

what is a pneumoperitoneum?

A

presence of free air in the peritoneal cavity

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11
Q

Name different types of fractures

A
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12
Q

on elbow you can visualise a normal fat pad anteriorly and posteriorly true or false?

A

false
- just anteriorly
- a visible posterior fat pad can indicate fluid or blood has caused it to rise

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13
Q

what is the anterior sail sign?

A
  • sign used to describe the shape anterior and posterior fat pads make
  • suggestive of a radial head fracture
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14
Q

in an elbow of a child what type of fracture would you suspect if both anterior and posterior fat pads are present on XR?

A
  • paediatric supracondylar fracture
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15
Q

if you see a spiral fracture in a child what additional queries would you have?

A
  • NAI
  • inform a senior consultant about concerns
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16
Q

how does a colles fracture present?

A
  • extra-articular fracture of distal radius as a result of a FOOSH
  • fracture of distal radial metaphyseal region with dorsal angulation
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17
Q

typical risk factor’s for colles fracture

A
  • osteoporotic patient e.g. elderly women
  • young person involved in high impact trauma i.e. contact sports, skiing, horse riding
18
Q

treatment for a colles fracture?

A
  • closed reduction and cast immobilisation
  • ORIF is considered when the fracture is unstable or unsatisfactory closed reduction is achieved i.e. >10 degrees dorsal angulation
19
Q

complication of colles fracture

A
  • malunion = dinner fork deformity
  • median nerve palsy and post-traumatic carpal tunnel syndrome
20
Q

what is a smith’s fracture

A
  • fracture of distal radius w associated volar (palmar) angulation of distal fracture fragments
  • considered reverse collest fracture
  • occurs after a FOOSH onto a flexed wrist or direct blow to back of wrist
21
Q

tx of a smith’s fracture

A
  • closed reduction and cast application
  • if fracture can be reduced but remains unstable, ORIF is required
22
Q

complications of a scaphoid fracture?

A
  • blood supply to scaphoid is retrograde so at risk of AVN
23
Q

different types of NOF fractures?

A
  • intracapsular
  • subtrochanteric
  • trochanteric
24
Q

why does AVN occur to femoral head after NOF fracture?

A

as the major blood supply to femoral head comes from femoral and profunda aa
- NOF can cut this blood supply risking AVN to femoral head

25
Q

where does intracapsular fracture occur?

A

neck of femur

26
Q

where does sub-trochanteric fracture occur

A
  • extracapsular fracture
  • just above femoral shaft and below trochanteric area
27
Q

note a GCS drop what is your first radiological investigation?

A
  • trauma CT
28
Q

what kind of CT scan would you get for a trauma type situation?

A
  • dual CT scan
  • contains an arterial and venous phase scan allows you to visualise blood etc
29
Q

white on a CT scan indicates?

A
  • blood
  • bone
30
Q

intracerebral haemorrhage

A
  • white
  • dark area around it indicating ischaemic damage or oedema
  • sometimes visualise a midline shift
31
Q

subdural haemorrhage

A
  • elderly patient fallen
32
Q

extradural haemorrhage

A
33
Q

skull change of shape indicates what?

A
  • fracture to the skull
34
Q

treatment for tension pneumothorax

A
  • insert 14G cannula into 2nd intercostal space mid-clavicular line and manage w chest drain
35
Q

treatment for spontaneous pneuomothorax?

A

primary pneumothorax:
- if <2cm and not SOB -> diacharge
- if >2cm or SOB -> 1st line needle aspiration, 2nd line is chest drain

secondary pneumothorax:
- if <1cm -> give oxygen and admit for 24 hours
- if 1-2cm -> 1st line needle aspiration, 2nd chest drain (admit for 24 hrs)
- if >2cm or SOB -> insert chest drain straight away

chest drains inserted into ‘safe triangle’ in mid-axillary line of 5th ICS

36
Q

what are borders of safe triangle for inserting a chest drain?

A
  • ant border of lat dorsi, lateral border of pec major and level of nipple
37
Q

what is an angiogram?

A
  • XR of blood or lymph vessels
  • liquid contrast agent is injected into bloodstream to make blood vessels visible on a scan
38
Q

splenic artery is a branch of what vessel?

A

coeliac artery

39
Q

why is coiling preferable to surgery in stable patients?

A
  • less risk
40
Q

what is endovascular coiling?

A
  • procedure performed to block blood flow into an aneurysm

CLASP (5 decks)

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