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Chest and Abdomen > Part 2 > Flashcards

Part 2 Flashcards

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1
Q

what are renal calculi also called?

A

nephroliths, nephrolithiasis, uroliths, urolithiasis, kidney stones

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2
Q

where are renal calculi located?

A

collecting (pelvico-calaceal) system

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3
Q

80-90% of renal calculi are?

A

opaque and probably could be seen on plain film

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4
Q

what do renal calculi look like?

A

small and homogeneously dense structures (no lucent centers)

round, oval, irregular in shape, often with a peak

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5
Q

where are renal calculi located on a lateral film?

A

they ill overlie the spine often over the arch or posteiror aspect of the vertebral bodies

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6
Q

when are renal calculi painful?

A

when they obstruct, can cause LBP

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7
Q

staghorn calculi

A

when calcium may fill calyces and renal pelvis

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8
Q

are ureteral calculi visible?

A

yes, usually

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9
Q

what do ureteral calculi look like? how big are they?

A

homogenous and oval or irregular in shape

1-3 mm, can be up to 5 mm

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10
Q

locations where ureteral stones tend to lodge.

A

L1-3 paraspinally at pelvicoureteral junction
brim of pelvis
within 1 inch of ischial spine superiorlyly at teh vesicoureteral junction (MC)

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11
Q

differences between ureteral calculi and phelboliths

A

phleboliths- below the ischial spines not move much on future films

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12
Q

what can obstruction because of renal calciuli cause?

A

significant pain, hydronephrosis

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13
Q

how soon do stones usually pass?

A

3-4 days

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14
Q

bladder calculi can be overlooked when?

A

they are small, they can be large

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15
Q

what do bladder calculi look like?

A

usuallyround, oval or stellate

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16
Q

what are the usual causes of bladder calculi?

A

urinary stasis (MC)
infection
elderly males

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17
Q

where are bladder calculi located on xray?

A

suprapubic region close to midline

could be found higher or laterally positioned if there is prostatic hypertrophy

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18
Q

nephrocalcinosis

A

appear as small clumps of stippled (punctate) calcifications in the kidney parenchyma
bilateral and widespread

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19
Q

are gallstones visible on xray?

A

not usually

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20
Q

what are more commonly seen in chiropractic offices?

A

gallbladder stones

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21
Q

what do gallstones look like on film

A

multiple stones with faceted (flat) surfaces and a peripheral rim of calcification
can be laminated if old
lucent internal branching cracks filled with nitrogen gas may be seen internally (mercedes benz sign

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22
Q

when do you see a mercedes benz signs?

A

when old stones dehydrate and shrink

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23
Q

where are gallstones located on film?

A

RUQ

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24
Q

when can a patient experience pain with gallstones?

A

small stones pass easily
recurrent cholecystitis
obstruction of a duct
perforation of gallbladder with fistula formation (to duodenu or colon

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25
what is the gas often found in the ducts from gallbladder stones called?
pneumobilia
26
what other disorder can occur from gallstones?
peritonitis | a large stone can cause bowel obstruction
27
what is the worst case senario concerning the gallbladder?
cancer
28
describe milk of calcium bile
bile that has a lot of calcium gallbladder looks white upright films demonstrate a horizontal fluid level
29
what is a petrified gallbladder due to?
unknown, maybe cholecysitis
30
describe what you would see on a film with petrified gallbladder?
thin linear calcification in the muscular wall or submucosal layer of the gallbladder pear, ovoid or round shaped usually cystic duct obstruction, but may not be seen
31
describe pancreastic calcifications seen on film
punctate densities in the pancreatic duct | usually located on both sides of the spine (cross midline)
32
what are pancreatic calcifications usually due to?
chronic inflammatory process | chronic alcoholics
33
where are adrenal gland calcifications located?
paraspinally at L1 level on AP film | lateral film: overly spine
34
pattern of adrenal gland calcifications
punctate and cystic- curvilinear or ringed
35
why might someone get adrenal gland calcifications?
neonatal hemorrhage (punctate) post traumatic hemorrhage (punctate or cystic) TB and histoplasmosis (punctate, TB cystic too)
36
31% of cortical malignancies contain?
calcium
37
what do lymph node calcifications look like?
small solid calcifications clumped in clusters irregular and mottled interior often multiple, could be singular
38
where are the lymph node calcifications usually located?
close to psoas muscle on AP | mesenteric nodes are anterior to spine on lateral
39
what are the MC calcific abdominal lymphatics?
mesenteric
40
where are para-aortic nodes located?
close to the spine at L2-4 (rare)
41
calcified lymphnodes are due to?
healed infections (TB)
42
what is the most common region of have lymph node calcifications?
hilar region of the chest
43
what are splenic calcifications usually due to?
TB, histoplasmosis, maybe brucellosis
44
what do splenic calcifications look like?
small, solid, scattered (punctate)
45
what else can appear like a splenic calcification?
phleboliths in hemangiomas
46
cystic calcifications of spleen are due to?
echinococcal infestation (hydatid disease) hemorrhage cyst congenital
47
hepatic calcifications look like what?
usually small solid densities scattered throughout the liver usually punctate rarely cystic (due to hydatid disease) or a single solid density may be found very rarely small "sand like" or "poppy seed" densities are found with some metastatic carcinoma
48
the small hepatic calcifications are usually due to?
TB or histoplasmosis (granulomatous)
49
hemangiomas of the liver may have?
dense phleboliths
50
what is the most common coprolith?
appendicolith
51
who can get appendicoliths?
child or adult | many demonstrate calcium, but not all
52
what do appendicoliths look like?
homogenous, laminated or ringed calcifications within the appendix small, up to 4 cm
53
where are appendicoliths located?
RLQ superimposed over ilium and anterior to the spine of the pelvis
54
what are appendicoliths usually due to?
calcification around a swallowed pit or seed
55
are appendicoliths associated with appendicitis?
yes, in over 1/2 of patients
56
what can appendicoliths bee seen with in appendicitis?
a lot of bowel gas | much higher rate of rupture with appendicoliths
57
are appendicoliths usually symptomatic?
no
58
describe what a cyst calcification looks like?
wall is a smooth calcific curvilinear rim of density | if there is internal calcification it is ill definied and less dense than the periphery
59
cysts demonstrate 3 basic shapes, what are they?
round ovoid flattened
60
what are the most common cyst sites?
``` kidney (benign or malignant) pancreas (rarely calcify) spleen liver adrenal gland ```
61
what are the 2 major types of cysts?
congenital | acquired
62
congenital cyst
true cyst | epithelial lined, less common
63
acquired cysts
(pseucocytes) | lined by fibrous tissue and more common
64
what can cause acquired cysts?
trauma (blood) infection (pus) parasites tumors
65
when tumors calcify, what do they look like?
sand-like | poppy-seed densities
66
what are the most often mentioned calcifications?
ovarian serous adenocarcinomas | its metastases are the most often mentioned and are called psammomatous bodies or psammoma
67
neuroblastoma
same pattern as an ovarian serous adenocarcinoma | but in a young child and found aroun dhte area of the adrenal gland and kidney

Chest and Abdomen (4 decks)

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