Plain and Contrast X-ray Studies Flashcards Preview

OS 206: Abdomen and Pelvis > Plain and Contrast X-ray Studies > Flashcards

Flashcards in Plain and Contrast X-ray Studies Deck (83)
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1

5 densities normally present on x-rays

1) Gas - black
2) Fat - dark gray
3) Soft tissue/fluid - light gray
4) Bone/calcifications - white
5) Metal - intense white

2

T or F: It is only necessary to obtain an x-ray from either the upright or supine position for adequate examination

F (Both should always be done)

3

Difference between abdominal and kidney, ureter, bladder (KUB) plate

Captured structures

4

Structures captured on abdominal plate

Hemidiaphragm up to part of pelvis

5

Structures captured on KUB plate

Whole pelvic cavity

6

Summation effect

May be present with large organs as they approach the appearance of bone

7

Main consideration in preparing for an abdominal x-ray

Bowel preparation to minimize feces and gas

8

T or F: Patients should be discouraged from talking or screaming prior to an abdominal x-ray to minimize accumulation of gas in abdominal cavity

T

9

Prepartion wherein there is no food nor liquid intake for 4 to 6 hours prior to an abdominal x-ray

Nothing per orem (NPO)

10

Function of NPO preparation

Needed in contrast studies because dehydration will result in easier absorption of contrast media

11

What to examine in abdominal x-rays

1) Gas pattern
2) Presence or absence of extraluminal air
3) Soft tissue masses
4) Calcifications
5) Foreign bodies

12

Usual presence of extraluminal air when an x-ray is taken in the upright position

Below the hemidiaphragm

13

Possible causes of the presence of extraluminal air

Diseases, trauma, surgery

14

Normal gas pattern of stomach

Always with gas, producing a gastric bubble

15

Normal gas pattern of small bowel

2 to 3 loops of non-distended bowel

16

Normal gas pattern of large bowel

Gas almost always present in rectum and sigmoid colon

17

Primary structures outlined in the abdomen

Solid organs (liver, kidney, spleen), hollow organs (GI tract), and bones

18

Possible descriptions of abdominal structures

1) Visible or not visible
2) Too large or too small
3) Distorted or displaced
4) Abnormally calcified
5) Containing abnormal gas or fluid

19

Air on both sides of the intestine/stomach (luminal and peritoneal side)

Rigler's sign / double wall sign

20

Common contrast materials used in abdominal x-rays

1) Sodium bicarbonate
2) Barium sulfate/sulfide

21

T or F: Barium sulfate can be combined with Sprite for use in double-contrast studies

T (This combination provides both liquid and gas contrast)

22

Function of barium sulfate

Coats GI tract to see patterns and areas of obstruction, to establish integrity and deficiencies of the GI tract, and to locate areas of ulcers, craters, and polyps

23

Quantities of barium sulfate used in contrast studies

Initial 1 L of barium is ingested with an additional 250 cc introduced midway

24

Characteristics of large bowel in an x-ray

Peripheral; haustral markings don't extend from wall to wall

25

Characteristics of small bowel in an x-ray

Central; valvulae extend across the lumen; maximum diameter of 2 inches

26

Indication of large bowel obstruction (LBO)

Haustrations are almost gone

27

Indications of small bowel obstruction (SBO)

Stretched small bowel and may have dilated tube-like structures due to the obstruction

28

T or F: For gas-containing GI tract, ultrasound is the best modality

F (X-ray is the best modality for the gas-containing GI tract)

29

T or F: On normal film, any structure in the abdomen outlined by gas is part of the GI tract

T

30

T or F: On a supine AP radiograph, fluid lies posteriorly in the gut while gas in the bowel will float anteriorly on it

T

31

T or F: Fluid levels appear on supine AP films

F (Fluid levels do not appear on supine AP films)

32

Indications of a normal esophagogram

Smooth esophageal wall with clear border, no wrinkling nor obstruction, and which is collapsed if not swallowing anything

33

3 indentations/constrictions of the esophagus

1) Cervical constriction
2) Thoracic/broncho-aortic constriction
3) Diaphragmatic constriction

34

Location and cause of cervical constriction

At pharyngoesophogeal junction, caused by cricopharyngeus muscle

35

Cause of thoracic constriction

At arch of aorta (seen in AP view) and left main stem bronchus (seen in lateral view)

36

Location of diaphragmatic constriction

At esophageal hiatus

37

Structure to be checked for patients with recurring acid reflux

Cardiac/gastroesophageal sphincter

38

Structures outlined by gas in the stomach in supine position

Body and antrum of stomach

39

Location of pool of resting gastric fluid in supine position

Fundus of the stomach beneath the diaphragm

40

Circular outline created by pool of resting gastric fluid in fundus of the stomach

Gastric pseudotumor

41

T or F: C-loop of the duodenum goes around the spleen

F (The C-loop goes around the head of the pancreas)

42

Location where the major pancreatic duct and common bile duct exits

Ampulla of Vater (2nd part of duodenum)

43

Location where the minor pancreatic duct enters

Minor duodenal papilla (2nd part of duodenum)

44

Importance of the ileocecal valve

Landmark of origin of certain diseases (such as TB) and common site of seed being lodged

45

Calcified fecal matter that may predispose the patient to appendicitis

Appendecolith

46

Most distensible part of the colon that receives fluid directly from the ileum

Caecum

47

Highest fixed point of the colon on the right

Hepatic flexure

48

Highest fixed point of the colon on the left

Splenic flexure

49

T or F: Hepatic flexure is usually higher than the splenic flexure

F (Hepatic flexure is usually lower than splenic flexure)

50

Location where contrast for imaging of the colon may be inserted

Rectum

51

2 mobile areas of the colon

1) Transverse colon
2) Sigmoid colon

52

Reason for the mobility of transverse and sigmoid colon

Longer mesenteric attachments compared to ascending and descending colon

53

2 important retroperitoneal landmarks; 2 of the few straight lines of the body

Psoas muscle

54

Vertical limits of the kidneys

Upper border of T12 on the left to the lower border of L3 on the right

55

Characteristics of the kidneys

Bean-shaped soft tissue density high in the upper part of the abdomen

56

T or F: The kidney is very mobile and moves down with inspiration in the upright position

T

57

T or F: The left kidney is higher than the right kidney and is about 1.5 cm bigger

T

58

T or F: Normal livers have a homogenous nature

T

59

Hepatomegaly

Upper margin of the liver is above the subcostal margin

60

Characteristics of the liver

Located in the RUQ, presenting as a large area of soft tissue density

61

Characteristics of the spleen

Located in the LUQ, about the size of the patient's heart or fist

62

Enlargement of the spleen

Hepatosplenomegaly

63

T or F: The bladder appears as a hollow organ on x-ray

F (Bladder appears solid because it is full of fluid)

64

T or F: The uterus can be identified on plain films

F

65

Best modality for solid organs (gallbladder, spleen, liver, pancreas)

Ultrasound

66

Limitation of ultrasound

Abdomen must not be gassy for proper visualization

67

T or F: Stones in the large intestine appear black on ultrasound

F (Stones in the large intestine appear white on ultrasound)

68

T or F: Since the gallbladder is flattened after eating fatty foods, patients must fast before imaging to preserve the gallbladder's bile content

T

69

Components of double contrast studies

Liquid contrast (barium sulfate) and air

70

T or F: Lymph adenopathies, usually found in the rectal area, can be seen in both AP and lateral views

F (Only in lateral view)

71

Outpouchings of mucosa and muscularis mucosa at sites of blood vessel penetration

Diverticula

72

Enlargement in the retropharyngeal space indicates the presence of what?

Retropharyngeal abscess

73

Appearance of an esophageal carcinoma

Irregular/nodular and eccentric esophageal narrowing

74

Concentric constriction of colorectal cancer in the rectum or sigmoid colon

Apple core deformity

75

Use of x-rays when dealing with ingested foreign bodies

Shots taken every few hours to monitor the progress of foreign bodies

76

Intussuception

Process by which a segment of intestine invaginates into the adjoining intestinal lumen, causing bowel obstruction

77

Hirschprung's disease

Loss of innervation of myenteric ganglia at distal colon (commonly at the rectosigmoid), resulting in inability to push out feces

78

Gallstones

Accumulations of salt, fat, and cholesterol due to nutritional habits

79

T or F: Smaller gallstones have a better prognosis than larger gallstones

F

80

Blockage of the biliary tree by small gallstones

Choledocholithiases

81

Progressive luminal narrowing due to ingestion of caustic substance

Caustic esophageal stricture

82

Hampton's line

Represents the thin rim of undermined gastric mucosa

83

Smooth, sharply delineating soft tissue mass surrounding a benign ulcer

Ulcer mound