TEST 2 Flashcards
important obscured/invisible structures on CXR
-sternum
-esophagus
-spine
-pleura
-fissures
-aorta
common cause of tracheal deviation
-Atelectasis- mucus plug
-Pneumothorax-trachea deviates away
-Aortic Aneurysm
-Compressing Mass/Tumor
-more fluid on a side -> trachea deviates towards the higher pressure
-Note borders
-Irregular tends to be malignant
-Regular tends to be benign lesions
why do chest xray with abdominal pathology
-upright
-chest disease can mimic abdominal
-pleural effusions
viewing fluid
-upright
-lateral
-supine and prone is bad
-Bowel and other organ structures:
-gas pattern
-Bones
-Calcifications
alignment
-look at pelvic rami
-spine orientation
-diaphragms/xiphoid to pubic symphysis
small bowel
-<3cm
-central
-lines span the width of the bowel
-valvulae conniventes
-diff dx- younger, acute, surgery
large bowel
-haustra
-MC- colon tumor (MC left colon)
-volvulus, diverticulitis (uncommon), intussusception (from tumor), hernia
Local inflammation
-pancreatitis, cholecystitis, appendicitis, start of SBO
volvulus
-MC sigmoid
-can be cecum
generalized gas pattern
-surgery or electrolytes
-sepsis
-infection
-dead bowel
extraluminal air MC location
-intraperitoneal (pneumoperitoneum)
-retroperitoneal air
-air in bowel wall (pneumatosis intestinalis)
-air in biliary system (pneumobilia)
signs of free intraperitoneal air
-air beneath diaphragm
-visualization of both sides of bowel wall
-visualization of falciform ligament
cecal volvulus
-congenital -> young
-incomplete dorsal mesenteric fixation of cecum or ascending colon -assoc with abnormally elongated mesentery distal to this area of absent mesentery
-N/V/C
sigmoid volvulus
-chronic constipation
-high roughage diet
-surgery
-blood supply can be cut off -> generalized gas pattern
-pencil stool or none
-roundworm infestation
-megacolon (often due to chagas dz)
esophagram
-hiatus hernia
-epigastric pain
-globus hystericus- throat pain
-persistent vomiting
-fistula
-cant pass endoscope
achalasia
-dilated and stenosed
esophageal web
-plummer vinson syndrome
-chronic iron deficiency
-squamous cell carcinoma assoc
-barium swallow
-tx- dilation
esophageal tumor
-jagged
-dark spot on esophagus -> barium doesnt light it up
-grey shades change
barium enema indications
-Lower GI Bleeding
-Iron deficiency anemia
-Chronic diarrhea
-Screening
-Colon Cancer
-Assess inflammatory bowel disease
-Intussusception
polyp
-smooth
-symmetric
apple core lesion
-ridged
-colon tumor
-need a CT with contrast -> grows its own vasculature
3,6,9
-small bowel
-large
-cecum
pneumotosis intestinalis
-air escapes to intestinal wall
-infection
-necrotizing enteral colitis
-dilated bowel
biliary tree
-infection by gas forming organisms- emphysematous cholangitis
-incompetant sphincter of oddi
-recent surgery
-you should not see any change darkness
