DRG3009 Image Critique > Chest & Abdo > Flashcards

Chest & Abdo Flashcards

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1
Q

ABBDO stands for?

A

air, bowel, bones, density, organs

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2
Q

what are the indications for AXR

A
  • Bowel gas pattern evaluation
  • Localise lines/tubes/FBs/free gas
  • Monitor renal calculi
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3
Q

what are the contraindications for AXR

A
  • Urgent imaging for critically unwell patient
  • CT is better option
  • Pregnant
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4
Q

what are the 4 quadrants of AXR

A

RUQ > LUQ > RLQ > LLQ

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5
Q

what are the 9 regions of AXR

A
  • right hypochondrium
  • epigastric
  • left hypochondrium
  • right lumbar
  • umbilical
  • left lumbar
  • right iliac
  • hypogastric
  • left iliac
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6
Q

hypogastric is AKA ?

A

suprapubic

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7
Q

what are the normal air locations in the abdomen

A

within lumen of bowel, lung bases, gastric bubble

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8
Q

what is pneumoperitoneum

A

presence of air within peritoneal cavity outside bowel lumen

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9
Q

what are the causes of pneumoperitoneum

A

ruptured hollow viscus, recent surgery

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10
Q

if the cause of pneumoperitoneum is unknown, what should be done

A

use CT

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11
Q

what are the 4 signs indicative of pneumoperitoneum

A
  • rigler’s sign
  • football sign
  • lucent liver sign
  • falciform ligament sign
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12
Q

what is rigler’s sign

A

double wall sign where air is present outside bowel lumen and outlines both inside and outside of bowel wall

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13
Q

what is football sign

A

Center of abdomen to appear darker

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14
Q

what is liver lucent sign

A

free gas collects anterior to liver and makes it more darker than usual but is subjective

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15
Q

what is falciform ligament sign

A

free air adjacent to falciform ligament mainly in neonatal perforations

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16
Q

what is subcutaneous emphysema

A

gas in soft tissue outlining walls of abdomen/lower chest/groin due to infection / gas tracking along tube/puncture/wound/recent surgery

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17
Q

what are signs of inguinal / femoral hernia

A

bowel gas projected over soft tissues of groin

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18
Q

what does the small bowel consist of

A

Duodenum + jejunum + ileum

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19
Q

small bowels are normally ___ in diameter

A

<3mm

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20
Q

between erect and supine AXR, which is better to show air-fluid level

A

erect AXR

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21
Q

what does presence of air within peritoneal cavity outside bowel lumen suggest

A

pneumoperitoneum

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22
Q

when small bowel loop diameter is more than 3mm, what does it suggest

A

obstruction

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23
Q

what are causes of SBO

A

adhesions secondary to previous abdominal surgery

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24
Q

where is the location of small vs large bowels

A

small = central abdo
large = peripheral abdo

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25
what is the normal diameter of small vs large bowels
small = 3cm large = 6cm cecum = 9cm
26
what are the mucosal folds of small vs large bowels
small = thin valvulae conniventes crossing width of small bowel loop large = thick haustral folds which do not cross colon width
27
is fecal loading a reliable indicator of constipation
no
28
when the intestinal walls lose its normal haustral pattern and has thumbprints, what does it suggest
colitis
29
what causes large bowel volvulus
large bowels rotating on its mesenteric pedicle which affects the sigmoid colon
30
what is the volvulus shape which suggests sigmoid volvulus
coffee bean
31
where does cecum volvulus extend from
right lower quadrant towards left upper quadrant
32
what is colitis
Inflammed colon due to infection, inflammation, ischaemia, drug reaction, chemical exposure
33
what are the signs of colitis
thickened colon wall, smooth featureless colon, toxic megacolon
34
what bacteria causes toxic megacolon
C difficile infection
35
what kind of patients have lead pipe, featureless colons
patients with long histories of ulcerative colitis / crohns disease
36
what does luminal distension suggest
megacolon formation
37
what is the main sign to suggest colitis
featureless lead pipe
38
where is the stomach located
left upper quadrant
39
what can be used to show fluid levels in gastric bubble
erect AXR + decubitus
40
what foreign objects are commonly seen in the stomach
PEG, NGT, gastric band, gastric sleeve staples
41
what does enlarged liver suggest
hepatomegaly
42
what is riedel's lobe
developmental variant with tongue-like inferior projection of right liver lobe to below inferior margin of right costal cartilage
43
what are signs of splenomegaly
elongated splenic contour which extends inferiorly and may overlap with left kidney and bowel
44
what does calcified gallbladder suggest
porcelain gallbladder which is predisposed to malignancy
45
calcified phleboliths are mostly found in
pelvis
46
gallstones usually found in ___ but may hang in ___
right upper quadrant; right lower quadrant
47
pancreatic stones are secondary to __
previous pancreatitis
48
costochondral cartilage calcifications are more prevalent among ___
elderly
49
gas within hepatic biliary duct likely due to __
stent insertion into CBD
50
what can be used to estimate location of uterus
IUCD & fibroids
51
ABCDE of chest
airways, breathing, circulation, diaphragm, everything else
52
upper trachea is found at __
midline
53
lower trachea is found at __
slightly deviated to the right at aortic knuckle level
54
carina bifurcation occurs at __
mid thoracic spine level
55
left bronchi is more ____ than right
longer, narrower and oblique
56
what bronchus is more prone to FB and ETT malposition
right main bronchus
57
bronchi are more visible due to ___
asthma
58
bronchi are more dilated due to __
bronchiectasis
59
bronchi are more distorted due to __
lung fibrosis
60
left lung is ___ than right
smaller and longer
61
what fissures does right lobe have
oblique and horizontal fissure
62
what fissure does left lobe have
oblique fissure
63
what segments are in the right upper lobe
anterior, posterior, apical
64
what segments are in the right medial lobe
medial, lateral
65
what segments are in the right lower lobe
superior, posterobasal, lateral basal, anterobasal, medial basal
66
where is lingula found
left lung
67
what segments are in the left lower lobe
superior, posterior, lateral, anteromedial
68
what segments are in the left upper lobe
Superior & inferior lingular segments, anterior & apicoposterior
69
where is azygos lobe most commonly found in
medial right upper lung
70
why is azygos lobe not a true lobe
does not have its own bronchial and vascular supply
71
what is azygos lobe
deep folding of pleura into right upper lung
72
what is pulmonary sequestration
Developmental anomaly of lung tissue with no connection to bronchial tree / pulmonary vasculature
73
75% lie within normal lung and have no ___ with 25% have ____
separate pleural covering (intralobar); separate pleural covering (extralobar sequestration)
74
intralobar is most common in __
childhood with recurring lung infections
75
extralobar is most common in ___
newborn period as respiratory distress, infection, cyanosis
76
10% of extralobar sequestrations are located ___
below diaphragm
77
where is the heart
Heart lies left of midline and has well-defined contours
78
Hila is the central branch point for ___
bronchi, pulmonary arteries, pulmonary veins
79
what is the cardiac size criteria for cardiomegaly
AP: >60% PA: > 50%
80
___ mimics cardiomegaly appearance
pericardial effusion
81
if aortic knuckle contour is lost, where is the pathology
posterior mediastinum, left upper lobe
82
where does the SVC drain into
right atrium at cavoartial junction at level of 3rd costal cartilage
83
where is right paratracheal stripe
density of SVC adjacent to trachea and does not extend above right clavicle
84
how to tell if patient has dextrocardia
heart position is reversed and lies in the right side of mediastinum but take note that this could be due to incorrect heart marker was used. Check with previous images and radiology department to confirm it is not post-processing error.
85
what is the optimal position of ETT
tip of ETT within trachea between 3 to 7 cm above carina
86
what is the sub-optimal position of ETT
tip in trachea but too close to carina (<3 cm) and might enter right/left main bronchus = unilateral lung ventilation
87
what is a mal-positioned ETT
tip outside trachea and within right/left main bronchus
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