US of Abdo and Pelvis Flashcards
how is an image created in US
sound waves interact with tissue, reflected sound is converted into an electrical signal and displayed on the screen
what 2 types of B mode imaging is there
grey scale imaging
Black and white
what 3 types of doppler imaging is there and what do each show
colour doppler - shows presence and direction of flow
spectral doppler - shows direction and velocity of flow
power doppler - shows presence of low velocity flow
give the clinical indications for an abdo US - 10 points
epigastric pain (upper abdo) RUQ pain RUQ mass abnormal liver function tests pyrexia of unknown origin LUQ pain/mass renal failure renal mass haematuria transplants
what is looked at in an US exam
liver (left and right lobes) pancreas gallbladder and biliary tree (common duct) both kidneys spleen aorta assess for fluids in abdomen may have to extend to pelvis depending on clinical history
what is considered when assessing pathology on an US image
size - include measurements shape texture outline blood flow - using doppler
common pathologies of the liver - 3 points w explanation
Benign Liver Lesions - cysts (simple and complex), abscess, haematoma, haemangioma
Malignant Liver Lesions - hepatocellular carcinoma, mets
Diffuse Liver Conditions - fatty infiltration, cirrhosis
how could patients present with liver pathologies
RUQ pain
palpable mass
abnormal LFTs
common pathologies of the pancreas - 3 points
Pancreatitis - chronic, acute
Benign Disease - cysts, fatty sparing
Malignant Disease - pancreatic carcinoma, mets
Trauma
how could patients present with pancreas pathologies
epigastric pain
common pathologies of the gallbladder and the biliary tree - 5 points
Cholelithiasis (gallstones) - most common, more than 10% of UK pop has them, easily identifiable, may be mobile
Inflammatory Gallbladder Disease - acute and chronic cholecystitis - thickened wall and gallstone
Polyps - benign growth on gallbladder wall
Gallbladder Carcinoma
Obstructive Disease of the Biliary Tree
how could patients present with gallbladder and biliary tree pathologies
RUQ pain
common pathologies of the kidneys - 5 points
Renal Cysts and Cystic Disease - cysts, adult dominent polycystic disease (ADPD)
Benign Lesions - angiomyolipoma (asymptomatic, adenoma
Malignant Lesions - renal cell carcinoma (poss palpable mass, pain, non specific appearances), lymphoma
Renal Calculi - stones (acoustic shadow on image)
Renal Inflammation - pyrexia, pain, abnormal urine tests
how could patients present with kidney pathologies
pain
palpable mass
haematuria
abnormal urine tests
common pathologies of the spleen - 3 points w explanation
Splenomegaly - non specific sign often associated with other conditions such as infection, hypertension and malignant disease - normal = < 12cm
Benign Lesions - cysts, haemangioma, abscess
Malignant Lesions - lymphoma (affects lymphocytes and lymph system), mets, leukaemia (increase in malignant white blood cells)
clinical indications for US of female pelvis - 10 points
pain, pelvic mass, ovarian torsion, ruptured ovarian cyst, Pelvic inflammatory disease (PID), rule out pelvic mass (ovarian or uterine), abnormal vaginal bleeding, irregular menstruation (Amenorrhea - no bleeding, Oligomenorrhea - infrequent/light bleeding, bleeding between period, menorrahagia - heavy bleeding with period, post-menopausal bleeding), infertility/sub-fertility, intrauterine contraceptive device (ICD)
Trans-abdominal (TA)
full bladder required
limitations in visualisation
Trans-vaginal (TV)
better resolution
3D TV can show coronal plane as well as LS and TS
sometimes contraindicated
intimate exam
common pathologies of the uterus - myometrium - 3 points
Fibroids - benign tumour, presents with pain, palpable mass, heaving bleeding, sub-fertility or asymptomatic
Adenomyosis - endometrial tissue deposited in the myometrium, similar signs and symptoms to fibroids
Malignant Tumours - sarcoma, pain & bleeding but may be asymptomatic
common pathologies of the uterus - cervix - 1 point
Cervical Carcinoma - abnormal bleeding, discomfort, asymptomatic in early stages
common pathologies of the uterine cavity and endometrium - 3 points
Sub-mucosal Fibroids and Polyps - benign tumours, present with abnormal/heavy bleeding
Endometrial Hyperplasia - benign proliferation of endometrial tissue, PMB
Endometrial Carcinoma - malignant proliferation of endometrial tissue, PMB
common pathologies of the fallopian tubes
Salpingitis - inflammation and infection of the fallopian tubes, PID, pain, discharge, pyrexia or asymptomatic
Blocked Tubes - Hysterocontrastsalpingography (Hycosy), asymptomatic
common pathologies of the ovaries
Cysts - many types, may present with pain, rupture, bleeding, torsion
Benign - clear fluid (anechoic), haemorrhagic, endometriotic, benign cystadenoma, teratoma (dermoid)
Malignant
Trans-rectal
mainly used to assess the prostate
better resolution
sometimes contraindicated
intimate examination
