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IMAG234 - Advancing Radiographic Practice > US of Abdo and Pelvis > Flashcards

US of Abdo and Pelvis Flashcards

1
Q

how is an image created in US

A

sound waves interact with tissue, reflected sound is converted into an electrical signal and displayed on the screen

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2
Q

what 2 types of B mode imaging is there

A

grey scale imaging

Black and white

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3
Q

what 3 types of doppler imaging is there and what do each show

A

colour doppler - shows presence and direction of flow
spectral doppler - shows direction and velocity of flow
power doppler - shows presence of low velocity flow

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4
Q

give the clinical indications for an abdo US - 10 points

A 
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
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5
Q

what is looked at in an US exam

A 
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
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6
Q

what is considered when assessing pathology on an US image

A 
size - include measurements
shape
texture
outline
blood flow - using doppler
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7
Q

common pathologies of the liver - 3 points w explanation

A

Benign Liver Lesions - cysts (simple and complex), abscess, haematoma, haemangioma
Malignant Liver Lesions - hepatocellular carcinoma, mets
Diffuse Liver Conditions - fatty infiltration, cirrhosis

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8
Q

how could patients present with liver pathologies

A

RUQ pain
palpable mass
abnormal LFTs

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9
Q

common pathologies of the pancreas - 3 points

A

Pancreatitis - chronic, acute
Benign Disease - cysts, fatty sparing
Malignant Disease - pancreatic carcinoma, mets
Trauma

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10
Q

how could patients present with pancreas pathologies

A

epigastric pain

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11
Q

common pathologies of the gallbladder and the biliary tree - 5 points

A

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

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12
Q

how could patients present with gallbladder and biliary tree pathologies

A

RUQ pain

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13
Q

common pathologies of the kidneys - 5 points

A

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

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14
Q

how could patients present with kidney pathologies

A

pain
palpable mass
haematuria
abnormal urine tests

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15
Q

common pathologies of the spleen - 3 points w explanation

A

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)

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16
Q

clinical indications for US of female pelvis - 10 points

A

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)

17
Q

Trans-abdominal (TA)

A

full bladder required

limitations in visualisation

18
Q

Trans-vaginal (TV)

A

better resolution
3D TV can show coronal plane as well as LS and TS
sometimes contraindicated
intimate exam

19
Q

common pathologies of the uterus - myometrium - 3 points

A

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

20
Q

common pathologies of the uterus - cervix - 1 point

A

Cervical Carcinoma - abnormal bleeding, discomfort, asymptomatic in early stages

21
Q

common pathologies of the uterine cavity and endometrium - 3 points

A

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

22
Q

common pathologies of the fallopian tubes

A

Salpingitis - inflammation and infection of the fallopian tubes, PID, pain, discharge, pyrexia or asymptomatic
Blocked Tubes - Hysterocontrastsalpingography (Hycosy), asymptomatic

23
Q

common pathologies of the ovaries

A

Cysts - many types, may present with pain, rupture, bleeding, torsion
Benign - clear fluid (anechoic), haemorrhagic, endometriotic, benign cystadenoma, teratoma (dermoid)
Malignant

24
Q

Trans-rectal

A

mainly used to assess the prostate
better resolution
sometimes contraindicated
intimate examination

25
Q

what do prostate US examine

A

evaluates the distal vas deferens, nasal ampullae, seminal vesicles, the prostate gland, ejaculatory ducts

26
Q

what do scrotal US examine

A

evaluates the testicles, epididymii, proximal vas deferens

27
Q

clinical indications for a male pelvic US - 3 points

A

Bladder - urinary problems, poor flow, incomplete emptying of the bladder, urgency to micturate
Prostate Gland - Elevated Prostatae Specific Antigen (PSA), known prostate carcinoma
Testes - pain, swelling, mass, infertility

28
Q

Common pathologies of the prostate - 2 points

A

Prostatitis - calcifications

Benign prostatic hypertrophy/hyperplasia

29
Q

common pathologies of the testes - 8 points

A 
epipdydimial cyst
ectasia/obstruction
hydrocoele 
calcifications
testicular torsion
testicular abscess
benign masses
carcinoma
30
Q

what are the benefits to US - 7 points

A

relatively inexpensive
repeatable
portable - space, can be used during medical procedure, can be done on ward after procedure
good for wide range of pathologies
good for looking at soft tissue
well tolerated by patient - not usually painful
no ionising radiation

31
Q

what are the limitations of US - 5 points

A 
Diagnostic Limitations  =
non specificity 
some pathology not well demonstrated - tissue characteristics, resolution
patient characteristics - BMI, bowel gas
equipment characteristics
32
Q

patient preparation for an US Abdo - 3 points

A

starve for 6 hrs prior
plain fluid (nothing fatty) - ensures distended gallbladder
reduces bowel gas

33
Q

patient preparation for an US pelvis (TA) - 3 points

A

full bladder - 1-2 litres 1hr before exam so =
acoustic window
pushes bowel away
pushes uterus on a plane that aids visualisation

34
Q

patient care for Abdo/Pelvis US exam

A

generally well tolerated
Communication - high level of skill required, more one-to-one, aware of what is said and how it is said to patient
Abdomen = exposed, use of gel, explain procedure
Pelvis = lower abdo/pelvis exposed, use of gel, full bladder, explanation of procedure, TV and trans-rectal scans = intimate, chaperone advised

IMAG234 - Advancing Radiographic Practice (19 decks)

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