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Radiography 1 > Abdomen > Flashcards

Abdomen Flashcards

(98 cards)

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1
Q

palpate the abdomen

A
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2
Q

label the abdomen diagram

A
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3
Q

what are the functions of the GI system

A

ingestion, digestion, secretion, absorption, excretion (defecation)

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4
Q

fill out the digestion table

A
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5
Q

what are the stripy areas in an abdominal xray

A

rugae

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6
Q

what are the stripy bits in the large intestine

A

haustra

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7
Q

what does gas look like in xrays

A

not completely black, but a dark grey

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8
Q

where is gas usually found

A

stomach, rectum, sigmoid colon, large intestine
sometimes the small intestine
shouldn’t be anywhere else

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9
Q

what is a normal level of air fluid in the colon

A

2-3 loops

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10
Q

true/false, the large intestine is peripheral

A

true

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11
Q

is it normal to see air/fluid in the large intestine

A

no

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12
Q

what are abnormal findings in abdominal radiographs

A

extra luminal air (outside lumen): forms a crescent beneath diaphragm
calcification: chronic pancreatitis, endpoint of inflammation
organ size: liver, dilated bowel loops, distended bowl loops

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13
Q

is it important to also take chest radiographs

A

yes because the issue can start in the chest and present as abdominal pain/discomfort

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14
Q

what is the function of the oesophagus

A

peristalsis - transport of bolus by relaxation to swallow it and contraction to propel it

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15
Q

what is the purpose of the lower oesphageal sphincter

A

to stop regurgitation from the stomach (tensioned at rest)

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16
Q

common physiological pathologies of the oesophagus

A

dysphasia
excessive gastroesophaegeal reflux

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17
Q

what causes dysphasia

A

neurologic disorders
structural lesions
psychiatric disorders
resection
radiation fibrosis
medications

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18
Q

what does dysphasia lead to

A

deyhdration, malnutrition, pneumonia

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19
Q

how are oesophageal disorders diagnosed

A

contrast radiography, endoscopy, fluroscopy

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20
Q

is the oesophagus under voluntary or involuntary control

A

voluntary in the upper third (cervical), and then involuntary

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21
Q

what are common mechanical pathologies of the oesophagus

A

GORD

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22
Q

what is GORD

A

gastro-oesophageal reflux disease

gastric acid & pepsin begin to move into oesophagus and can cause necrosis of oesophageal mucosa and oesophageal stricture (e.g. scar tissue, narrowing, blockage)

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23
Q

what is the clinical presentation of GORD

A

acid reflux
ear infections
hoarse voice = issues with vocal chords
can lead to adenocarcinoma

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24
Q

what is GORD sometimes mistaken for

A

myocardial infarction (chest pain)

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25
what causes GORD
weakening/malfunction of oesophageal sphincter and stomach begins to prolapse through diaphragmatic oesophageal hiatus
26
how can you diagnose GORD
CT (particularly for neoplasia concerns), barium study
27
what is an oesophageal stricture
narrowing or tightening of the oesophagus that causes swallowing difficulty
28
what is causes oesophageal stricture
intrinsic diseases that narrow the lumen through inflammation, fibrosis or neoplasia extrinsic diseases that cause lymph node enlargement diseases that disrupt peristalsis & lower sphincter function
29
how is oesophageal stricture diagnosed
barium studies
30
what causes oesophageal obstruction
progression of stricture, injury, tumour growth, food & foreign bodies
31
what is achalasia
failure of LES to relax resulting in impaired peristalsis & dysphagia
32
does the stomach contain rugae
yes
33
what are common stomach pathologies
ulcer, carcinoma
34
what causes ulcers
failure of stomach wall to protect against pepsin risk factors are helicobacter pylori, NSAIDs by long term use because they decrease secretion mucus secretion which protects the lining
35
how is gastric ulcer (heliocbacter pylori) diagnosed
breath test for increased CO2
36
what is the purpose of the small intestine
- digestion by enzymes from pancreas - absorption of digested nutrients & fluids - neutralisation of gastric acid - solubilisation of lipids by bile salts
37
what percentage of nutrient absorption occurs in the small intestine
90%
38
what causes small intestinal obstruction
- postoperative adhesions (most common) - hernia - crohn disease - tumour
39
what is a small intestinal obstruction
proximal dilation due to accumulation of air secretions
40
what does a small intestinal obstruction look like in an xray
air in small intestine no air in large intestine e.g. a blockage pilcae are further apart
41
where are SI obstructions often located
intraluminal = bowel lumen (foreign bodies & gallstones) intramural = bowel wall due to crohn's, neoplasia, stricture, anastamoses extraluminal = adhesions, surgery, volvulus
42
what is a volvulus & what does it lead to
twisting of the mesentery in which blood vessels are located leads to ischaemia high fatality rate
43
how do you identify blockages in the SI
xray, CT for exact location
44
what is the string of pearls sign
small bubbles of gas in small intestine
45
what is intussusception
segment of intestine telescopes into ajoining section causing obstruction
46
what are the consequences of intussusception
necrosis, due to blood vessels, so requires urgent treatment
47
how is intussusception diagnosed
contrast enema
48
what is crohn's disease & where does it occur
any part, mainly illium, but occurs in patches looks like abcesses and ulcers
49
what is the difference between CD & ulcerative colitis
CD is an idiopathic chronic inflammatory disease that can affect any part of the GIT from mouth to anus it occurs in patches UC causes inflammation & ulcers in the superficial lining of the large intestine (mucosa)
50
how is CD investigated
contrast studies (can't be done with perforated bowel) CT - helps differentiate CD & UC
51
what is the function of the large intestine
absorb water from indigestible material (fibre), expulsion of waste products, vitamin production from bacteria
52
what are pathologies of the LI
diverticulosis obstruction/dilation tumour inflammation
53
what is diverticulosis
small pouches commonly found in the colon that form from defects in the smooth muscle walls of intestine common in > 70 yrs and diet related mostly asymptomatic
54
what is a large intestine obstruction & is it an emergency
yes it's an emergency
55
what causes LBO (large intestinal obstruction)
- neoplasia e.g. ovary, colon, pancreas, lymphoma - volvulus - post operative adhesions - strictures - hernia
56
what is an ileus
low gut motility, don't need to do much, dissolves in 2-3 days
57
what is a sign of volvulus in an xray
distended inverted U-shaped colonic loop e.g. a large black pouch
58
what should be distinguished from LBO
LBO
59
what causes ileus
abdominal surgery
60
what is bowel cancer
malignant polyps in the bowel benign polyps are common
61
how is bowel cancer screened
- occult blood (e.g. blood in stool), not always positive for bowel cancer but indicates need for colonoscopy - colonoscopy
62
what is AP supine
patient is supine & lying on back
63
what is the function of the liver
filtration of blood draining digestive tract, metabolism of protein, carbs, lipids, chemicals, production of plasma proteins, bile salts, excretion of cholesterol & bilirubin
64
how is the liver supplied with blood
hepatic artery & hepatic portal vein
65
what does the portal vein do
carry blood from GIT & spleen to liver has multiple anastomoses with systemic venous system
66
what is bilirubin
broken down haemoglobin, conjugated in the liver
67
why is faeces brown
bilirubin
68
is bilirubin water soluble
no
69
what are the pathologies of bilirubin
too much = jaundice, too much rb breakdown, or not being conjugated properly too little =
70
what are liver pathologies
metastatic tumor primary tumour cirrhosis trauma vascular obstruction
71
what is a primary tumour
tumour developed in the organ itself
72
what are liver primary tumours caused by
repeated replacement of cells due to hep C, alcohol use, NAFLD
73
what is a hepatic carcinoma
primary tumour in the liver
74
how are hepatic carcinomas diagnosed
ultrasound
75
how do metastases occur in the liver
since it is a primary filtration site, it also filters tumour cells
76
what is cirrhosis & what does it look like on a CT
scarring as a result of chronic damage can also be caused by blockage of hepatic arteries on a CT: lobulated margins, varices
77
what is a common cause of death from abdominal trauma
liver rupture, because there is a massive blood supply to the liver
78
what causes vascular obstruction in the liver e.g. of the portal vein
cirrhosis, hepatic malignancy
79
what is collateral circulation
diversion of blood due to blockage
80
what does collateral circulation cause
oesophageal varices they're not designed for that amount of blood so there is a high risk of haemorrhage
81
how is vascular obstruction diagnosed
ultrasound
82
what is the gallbladder
storage, concentration & release of bile salts
83
describe the connection of the liver to the gallbladder and descending part of the duodenum
from the liver there are the right & left hepatic ducts they form and become the common hepatic duct from the gallbladder there is the cystic duct it forms with the common hepatic duct to become the bile duct the bile duct and main pancreatic duct connect into the duodenum
84
what are gallbladder pathologies
gallstones, inflammation
85
what are gallstones, are they symptomatic
no asymptomatic formed form abnormal bile composition, mainly caused by cholesterol or pigment western countries mainly get cholesterol (diet related) pigment is mainly due to chronic biliary infection from calcium bilirubinate
86
what is cholelithiasis
gallstones
87
why can't you see cholesterol gallstones in an xray
cholesterol is not radio-opaque
88
what is cholecystitis & the 2 types
acute inflammation of gallbladder wall, usually following obstruction of the cystic duct by stone 1. gas from emphysematous cholecystitis (bacterial) 2. clacification from carcinoma
89
how is cholecystitis investigated
ultrasound
90
what are the main factors that determine whether gallstones form
cholesterol secreted by liver cells, relative to bile salts gallbladder stasis obesity diet rapid weight loss pregnancy drugs
91
what is the function of the pancreas
exocrine function and production & secretion of proteases, lipases & amylase endocrine is insulin & glucagon
92
on what anatomical side is the tali of the pancreas
left (right on image) tail ends at spleen
93
how is the pancreas evaluated
size, swelling indicates inflammation shrinkage, indicates chronic infl. due to scar tissue formation masses at the head (common bile duct) and tail (spleen)
94
what are pancreas pathologies
inflammation & tumours
95
what is prognosis for acute pancreatitis & causes
glands heal with no real effect or change caused by alcohol, gallstones, drugs
96
what is prognosis for chronic pancreatitis & causes
recurs intermittently causing functional & morphological damage visible signs of clacification on radiographs
97
how is pancreatitis diagnosed
ultrasound, CT in severe cases
98
how is pancreatic cancer found
very hard to detect, found by CT, very common but lowest 5 year survival rate can only really see it when it's a large size

Radiography 1 (13 decks)

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