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261 Cards in this Set
- Front
- Back
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What is an IVP used for? |
Demonstrate nephrons and check kidney function |
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Cystography |
Procedure using contrast to visualize urinary bladder |
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What can cystography be used to evaluate? |
Bladder cancer Vesicoureteral reflux Bladder polyps Hydronephrosis |
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Retrograde pyelography |
Contrast is injected into ureter - flows upward instead of down like normal flow of urine |
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Renal angiography |
Used to visualize blood vessels in kidneys |
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What 5 categories are renal anomalies classified by? |
Number Size Shape Fusion Position |
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Renal agenesis (aplasia) |
Absence of one kidney Compensatory hypertrophy of existing kidney |
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Renal hypoplasia |
Abnormally small kidneys with normal morphology and reduced nephron number |
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Renal hyperplasia |
Abnormally large kidneys with normal morphology and increased nephron number |
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Horseshoe kidney |
Lower poles of kidneys are fused together
Normal kidney function |
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Crossed fused renal ectopy |
Both kidneys are on same side and fused together |
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Ectopic kidney |
Kidney located in an abnormal position - out of place Usually in the pelvis |
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Kidney prolapse/nephroptosis |
Kidney drops in erect position "floating kidney" |
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Double ureter |
2 ureters drain a single kidney - one drains the upper part, one drains the lower part |
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Ureterocele |
Congenital cyst-like dilation of ureter at bladder opening Causes obstruction |
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Appearance of ureterocele |
Cobra head |
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Bladder diverticula What causes it? |
Bladder lining pokes out through weak part of bladder wall Can be congenital or caused by chronic cystitis |
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Polycystic kidney disease |
Congenital
Many tiny cysts in the kidney at birth that enlarge with age and cause damage |
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Bladder trabeculae |
Bladder muscle has thickened over time Bladder has shaggy borders due to roughing of lining caused by cystitis |
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Staghorn calculus |
Large stone that fills pelvis of kidney Appears as horns of a deer |
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What causes staghorn kidney? |
Long standing infection with certain bacteria |
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Hydronephrosis |
"Water in the kidney" Distension and dilation due to obstruction of urine flow (stones) Degenerative |
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Simple renal cyst |
Acquired, not congenital Closed pouch filled with air or liquid, usually in lower poles of kidney Usually asymptomatic |
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Renal carcinoma |
Malignant cancer cells in the lining of the tubules of the kidney |
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Signs and symptoms of renal carcinoma |
Flank pain Hematuria Palpable mass |
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Wilm's tumor/nephroblastoma |
Malignant tumor of kidney that usually occurs in children - before age 5 No symptoms, firm palpable mass |
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Risk factors for bladder cancer |
Male Smoking |
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Pyelonephritis |
Bacterial infection of renal pelvis and calyces due to obstruction of urine |
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Most common renal disease |
Pyelonephritis |
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Cystitis |
Inflammation of urinary bladder |
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Circle of Willis What two arteries form it? |
Formed by basilar artery and internal carotid artery
Oxygenated blood supply for brain |
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Range of spinal cord |
Foramen magnum to L1 |
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Blood brain barrier |
Filtering mechanism of capillaries Blocks certain substances from entering brain tissue |
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When blood brain barrier breaks down due to disease/health conditions, what effect does this have on contrast media? |
Contrast is enhanced |
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Pineal gland calcification |
Fluoride accumulates in pineal gland causing it to harden Sleep cycle is disturbed |
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Where is choroid plexus located? |
Superior part of inferior horn of lateral ventricles |
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Choroid plexus filters blood to produce |
Cerebrospinal fluid |
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Falx cerebri calcification |
Small infolding of dura over floor of posterior cranial fossa Partially separates two cerebellar hemispheres |
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fMRI |
Functional MRI - can map brain activity and assess CNS |
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MRA |
Magnetic resonance angiography Demonstrates vascular anatomy w/o contrast |
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Spina bifida occulta |
Incomplete closure of vertebral arch in lumbosacral area |
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Meningocele |
Meninges protrude through spina bifida defect Spinal cord remains intact |
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Myelocele |
Spinal cord protrudes through defect in meninges |
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Myelomeningocele |
Spinal cord and meninges protrude through spina bifida defect |
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Hydrocephalus |
Excessive accumulation of CSF in ventricles Brain can atrophy |
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Non-communicating hydrocephalus |
Blockage of CSF flow from ventricles to subarachnoid space |
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Communicating hydrocephalus |
Impaired reabsorption of CSF - reabsorbed in arachnoid layer |
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3rd type of hydrocephalus (not communicating or non-communicating) |
Over production of cerebrospinal fluid Least common cause |
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Treatment for hydrocephalus |
Shunt to drain excess CSF to peritoneal cavity or heart |
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Arnold-Chiari malformation |
Malformation of cerebellum - cerebellum tonsils herniate through foramen magnum and put pressure on brain stem and spinal cord |
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Meningitis |
Inflammation of pia & arachnoid meninges due to bacteria Spreads through blood, lymph, trauma, from adjacent structures |
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How is bacterial meningitis transmitted |
Droplet |
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Symptoms of meningitis |
Fever, headache, stiff neck, vomiting, LOC , hydrocephalus |
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Encephalitis |
Infection of brain tissue - usually viral |
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Best method to diagnose encephalitis |
MRI |
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Primary encephalitis |
Caused by directly by virus - mosquitoes, herpes simplex virus |
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Secondary encephalitis |
Occurs after a viral infection (chickenpox, measles, flu) |
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Brain abscess |
Encapsulated collection of pus from cranial infection, head wound, sinus infection, or blood stream |
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Subdural empyema |
Brain abscess/pus between dura mater and arachnoid mater |
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Herniated nucleus pulposus |
Weakened/torn annulus fibrous ruptures allowing nucleus pulposus to protrude and compress spinal nerves |
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Cervical spondylosis |
Osteoarthritis in C-spine Osteophytes form and put pressure on spinal nerves/cord |
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What modality demonstrates compression of the spinal cord due to cervical spondylosis |
MRI |
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Multiple sclerosis |
Degeneration of myelin sheath resulting in impaired nerve conduction Tremors, bad vision, bladder problems, muscle weakening |
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Risk factors for MS |
Age 20-40, female, white |
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MRI shows what aspect of MS? |
Plaques on brain |
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3rd leading cause of death in US |
Cerebrovascular accident |
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CVA |
Cerebrovascular accident - any interruption of blood flow to the brain |
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Ischemic stroke |
Decreased blood flow due to a thrombus or embolus (clot) |
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What percentage of strokes are ischemic? |
87% |
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Hemorrhagic stroke |
Hemorrhage due to ruptured vessel, sudden onset |
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Infarct |
Tissue necrosis caused by decreased blood flow |
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Thrombolytic drugs may be given ___ hours after onset, but work best within ____ minutes |
3 hours 45 minutes |
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How does ischemic stroke appear on MRI? |
High intensity signal |
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MRI or CT is more sensitive to ischemic stroke? |
MRI - however the scan takes longer |
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Decreased density/dark areas on CT indicate |
Infarction, edema, abscess, cyst, old blood |
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Increased density/bright areas on CT indicate |
Fresh blood, calcifications |
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Computed Tomography Perfusion |
Demonstrates location of brain ischemia - shows areas where blood isn't reaching |
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TIA - transient ischemic attack |
Mini-stroke Temporary interruption of circulation to brain without infarction Warning sign of pending major stroke |
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Hemiparesis |
Weakness on one side |
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Hemiparesthesia |
Numbness on one side |
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Monocular blindness |
Total or partial loss of vision in one eye |
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How to assess for signs of stroke - ask patient to: |
(FAST) Smile (F - face) Raise both arms (A - arms) Speak a sentence (S - speak) *Time is Tissue (T) |
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Stroke - B.E. F.A.S.T. |
B - loss of Balance E - trouble seeing (Eyes) F&A - numbness/weakness in Face/Arm S - trouble Speaking T - Time is of the essence |
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ABI |
Atherothrombic brain infarction - thrombosis in large cerebral artery |
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Lacunar infarction |
Thrombosis in small vessel Hole develops after infarct |
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Hemorrhagic CVA |
Bleeding in brain from ruptured/weakened vessel or aneurysm |
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Subarachnoid hemorrhage |
Hemorrhage between arachnoid and pia mater - usually due to ruptured berry aneurysm in Circle of Willis |
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What can subarachnoid hemorrhage cause? |
Blood in ventricles Hydrocephalus |
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Intracerebral hemorrhage |
Hemorrhage within brain tissue due to trauma or rupture of vessel |
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Modality of choice to diagnose neoplastic brain diseases |
MRI |
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Primary neoplastic brain disease are more common in |
Children |
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Metastatic brain tumors are more common in |
Adults |
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Most common primary CNS tumor |
Astrocytoma |
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Astrocytoma |
Tumor in cerebrum - frontal lobe |
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Most common type of primary brain tumor |
Glioma |
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Glioma |
Arises from glial cells Glial cells don't conduct nerve impulses, they support and protect neurons |
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Glioblastoma multiforme |
Highly malignant glioma Grade IV |
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Medullablastoma |
Highly malignant tumor in cerebellum |
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What modality is best to demonstrate posterior fossa, brainstem, and cerebellum? |
MRI |
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MRI does not image __________ |
Dense, petrous bone |
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Meningioma |
Benign tumor of arachnoid layer Doesn't invade brain tissue but can compress brain or spinal cord |
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Who is at most risk for meningioma? |
Women age 40-60 |
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What modality is best to diagnose meningioma |
CT |
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Pituitary adenoma |
Tumor of pituitary gland - usually benign |
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How can pituitary adenoma be seen on skull x-ray? |
Enlarged, distorted sella turcica on lateral skull |
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What surgeries can be used to treat pituitary adenoma? |
Transsphenoidal surgery - through sphenoid sinus Endoscopic pituitary surgery - through natural nasal pathway, no incisions |
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Acoustic neuroma |
Benign tumor of vestibular nerve connecting the inner ear to the brain |
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S&S of acoustic neuroma |
Hearing loss, ringing in hears, facial paralysis |
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Best modality to diagnose acoustic neuroma |
MRI |
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What does halo sign of blood represent? |
Tear in dura mater |
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Sonography is useful to demontrate what in infants |
Neonatal brains before closure of fontanels - Cerebral hemorrhage, hydrocephalus |
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Congenital diseases of CNS |
Spina bifida Hydrocephalus |
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Inflammatory/infectious diseases of CNS |
Meningitis Encephalitis Brain abscess |
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Degenerative diseases of CNS |
Herniated nucleus pulposus Cervical spondylosis Multiple sclerosis |
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Vascular diseases of CNS |
CVA (stroke) Ischemic stroke Hemorrhagic stroke |
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Neoplastic diseases of CNS |
Glioma Medullablastoma Meningioma Pituitary adenoma Acoustic neuroma |
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Where are red blood cells formed? |
By myeloid tissue from bone marrow |
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Life span of red blood cells |
120 days |
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Life span of leukocytes |
Two weeks |
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Acquired immunodeficiency syndrome (AIDS) |
Virus attacks immune system and leaves body vulnerable to life-threatening illnesses and cancer No cure |
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Imaging modality of choice to diagnose AIDS |
CT/MRI |
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Kaposi's sarcoma |
Neoplastic disease in AIDS patients Tumors form in connective tissues |
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What virus causes Kaposi's sarcoma? |
Human herpes virus 8 (HHV8) |
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Sickle cell disease |
Inherited RBC disorder Abnormal hemoglobin - causes anemia and infection |
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Multiple myeloma |
Cancer formed by malignant plasma cells Large amounts of protein cause reduced kidney function |
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Why is IV contrast contraindicated for pts with multiple myeloma? |
Reduced kidney function |
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S&S of multiple myeloma |
Bone pain Pathologic fractures Anemia Fatigue Recurring bacterial infections Renal failure |
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What modality is most sensitive to multiple myeloma |
MRI |
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Leukemia |
Disease of WBC's - overproduction of WBCs Anemia, bleeding, infection |
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S&S of leukemia |
Fatigue Anemia Fever Night sweats Weight loss Bruising Bone pain |
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Lymphoma |
Cancer of lymphocytes |
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What modality is good to demonstrate enlarged nodes that occur with lymphoma? |
CT |
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How many different forms of lymphoma exist? |
43 |
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Hodgkin's lymphoma |
Lymphoma that affects B lymphocytes - called Reed-Sternberg cells |
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Imaging of choice for Hodgkin's lymphoma (4) |
Chest x-ray PET CT MRI |
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S&S of Hodgkin's lymphoma |
Fever Night sweats Splenomegaly Enlarged lymph nodes |
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Primary modality for examination of female reproductive system |
Sonography |
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Uterus didelphys |
Duplication of uterus, cervix, and vagina |
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Hysterosalpingography |
Used to see shape of uterus and patency of fallopian tubes Contrast injected into cervical canal and observed with fluoro |
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Pelvic inflammatory disease |
Bacterial infection of female reproductive system, specifically fallopian tubes |
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Modality used to diagnose PID |
DMS |
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Mastitis |
Breast inflammation usually caused by infection Most common during first 6mos of breast feeding |
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Ovarian cystic masses |
Cysts within ovary, asymptomatic May cause aching, pressure, sharp pain Treatment not necessary |
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Endometriosis |
Endometrium (lining of uterus) grows outside the uterus Involves ovaries, fallopian tubes, and tissue lining pelvis |
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How does endometriosis appear |
Blood filled "chocolate" cysts |
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Modality to diagnose endometriosis |
DMS |
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Polycystic ovary |
Enlarged ovaries containing multiple small cysts |
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Cystadenocarcinoma |
Malignant tumor of ovary Makes of 60% of all ovarian cancers |
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2nd most commonly diagnosed genital carcinoma |
Cystadenocarcinoma |
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S&S of cystadenocarcinoma |
Urinary bladder or rectal pressure Back pain Bloating Can be asymptomatic |
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Carcinoma of the cervix |
Abnormal growth pattern of epithelial cells around neck of uterus |
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What can an annual PAP smear detect? |
Carcinoma of cervix |
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S&S of carcinoma of cervix |
Abnormal bleeding Impaired renal function |
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Leiomyomas (uterine fibroids) |
Benign overgrowth of uterine muscle tissue Often calcify |
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Cystic teratoma ovary |
Benign neoplastic mass from unfertilized ovum in ovary Often contains hair, teeth, thyroid tissue |
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Fibroadenoma |
Common benign breast tumor Solid, well-defined mass that doesn't invade surrounding tissues |
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Fibrocystic breasts |
Overgrowth of fibrous tissue or cystic hyperplasia |
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S&S of fibrocystic breasts |
Masses Tenderness before onset of menstrual period |
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What is used to differentiate solid masses within breasts? |
DMS |
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2nd leading type of cancer in women |
Breast carcinoma |
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5 classifications of breast carcinoma |
In situ carcinoma Ductal carcinoma in situ Lobular carcinoma in situ Invasive ductal or lobular carcinoma Inflammatory carcinoma |
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In situ carcinoma |
Cancer that has stayed in the place it began Involves epithelial cells |
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Ductal carcinoma in situ |
Presence of abnormal cells inside the milk duct of a breast Noninvasive, has not spread |
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Earliest form of breast cancer |
Ductal carcinoma in situ |
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Lobular carcinoma in situ |
Abnormal cell growth in lobules - milk-producing glands at end of breast ducts Increases risk of invasive cancer in the future |
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Invasive ductal or lobular carcinoma |
Starts in lobules or ducts and metastasizes to other parts of the body |
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Inflammatory carcinoma of the breast |
Cancer cells block the lymph vessels in the skin of the breast |
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Most aggressive type of breast cancer |
Inflammatory carcinoma |
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What appearance does inflammatory carcinoma have? |
Peau d'orange - orange peel |
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S&S of breast cancer |
Lumps Pulled in nipple Dimpling Discharge Redness/rash Skin changes |
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Risk factors for breast cancer |
Female Early menarche Late menopause First pregnancy after 30 Family history Breast cancer genes |
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Hydatidiform mole (Molar pregnancy) |
Overproduction of abnormal tissue that is supposed to develop into the placenta |
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Benign prostate hyperplasia (BPH) |
Enlargement of prostate gland Palpable through rectum Common after age 50 |
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Adenocarcinoma of the prostate |
Cancer of prostate Bone metastasis in 75% |
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Osteoporosis |
Porous bones, decreased bone density Osteoclasts working too much |
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What kind of fractures occur with osteoporosis? |
Pathologic fractures Compression fractures of spine |
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Dowager's hump |
Kyphotic deformity due to osteoporosis in T-spine (compression of thoracic vertebrae) |
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Osteopenia |
Bone density lower than normal |
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What percent bone loss must happen before it can be visualized on x-ray? |
30% |
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Which is worse - osteoporosis or osteopenia |
Osteoporosis |
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Osteomalacia |
Bone softening, bone doesn't calcify due to lack of calcium and other vitamin, esp. vitamin D |
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Osteomalacia in children, before growth plate closes |
Rickets |
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Paget's disease (osteitis deformans) |
Chronic bone disorder, excessive abnormal bone remodeling |
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Where does Paget's disease usually occur? |
Spine, pelvis, skull, proximal long bones |
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Appearance of Paget's on x-ray |
Cotton wool |
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Acromegaly |
Thickening of bone because growth plate is closed Caused by excessive growth hormone from pituitary adenoma |
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Diabetes insipidus |
Damage to hypothalamus or pituitary gland causes disruptions in normal levels of vasopressin Causes kidneys to produce a lot of urine |
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Hypopituitarism |
Decreased level of absence of pituitary hormones Causes dwarfism in children and premature aging in adults |
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Cushing syndrome |
High levels of cortisol Round faces, difficulty healing after injury, female-male characteristics |
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Diabetes mellitus |
Metabolic diseases in which there are high blood sugar levels over a prolonged period |
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Type I DM |
Genetic, juvenile diabetes |
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Type II DM |
Insulin-resistant, adult onset Inadequate secretion of insulin |
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Hyperthyroidism |
Thyroid secretes excess hormones Enlarged thyroid gland, nervousness, hyperactivity |
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What scan can detect hyperthyroidism |
Radionuclide scan |
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Hypothyroidism |
Thyroid doesn't secrete enough hormone Decreased energy, weight gain, cold intolerance |
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Hyperparathyroidism |
Too much parathyroid hormone Increases calcium release from bone resulting in bone destruction |
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Hyperparathyroidism subtractive or additive |
Subtractive |
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Acromegaly subtractive or additive |
Additive |
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Nephrocalcinosis |
Deposits of calcium in renal parenchyma caused by disorder of calcium metabolism Not kidney stones |
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Most common cause of death in ages 1-44 |
Trauma |
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Level I Trauma center |
Provide total care for all injuries 24 hr coverage by surgeons |
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Level II Trauma center |
Most common Can handle majority of patients - more critical may be referred to trauma I |
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Trauma III center |
Located in remote areas Provide prompt assessment, resuscitation, stabilization More critical patients can be sent to higher level of trauma centers |
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Jefferson fracture |
Burst fracture of C1- both lateral masses offset Seen on open mouth AP C-spine projection |
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Fractures of the skull appear more ______ than normal vascular markings |
Translucent |
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Linear fracture of skull |
Straight, shaprly defined, non-branching lines |
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Depressed fracture of skull |
Appears as a curvilinear density Caused by high speed impact |
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What indicates a basilar skull fracture? |
Air-fluid levels in sphenoid sinus or clouding of mastoid air cells |
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What modality is better than x-ray to demonstrate basilar skull fractures? |
CT/MRI |
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Traumatic brain injury |
Head trauma where brain is traumatically shaken |
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Most often affected regions of traumatic brain injury |
Frontal Temporal Occipital |
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Coup |
Brain bruise on same side as trauma |
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Contrecoup |
Brain bruise on opposite side of trauma |
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Contusion |
Neuron damage, edema, and punctate (pin point punctures or depressions hemorrhaging) |
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How does a contusion appear on a CT? |
Small, ill-defined increased density (bright) areas |
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Concussion |
No structural damage, just electrical activity disrupted Temporary LOC |
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How long to recover from a concussion? |
24 hours |
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S&S of concussion |
Headache Vertigo Vomiting |
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Recovery from a concussion can result in |
Hematoma |
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Hematoma |
Collection of blood |
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4 types of hematoma |
Epidural Subdural Subarachnoid Intracerebral |
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Epidural hematoma |
Results from torn artery, blood pools between skull and dura mater Affects brain and ventricles |
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Which type of hematoma has the highest mortality rate? |
Epidural |
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What shape does an epidural hematoma appear as? |
Convex/lens shaped |
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Subdural hematoma |
Bleeding between dura and arachnoid layers, due to tear in veins Can occur with or without trauma Onset anywhere between 24hrs to 10 days Affects brain and ventricles |
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How do subdural hematomas happen in elderly patients with brain atrophy? |
Sudden head movements can tear veins when the brain is atrophied |
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How does a subdural hematoma appear? |
Crescent-shaped |
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Subarachnoid hematoma Where is it most frequently located? |
Blood between arachnoid and pia layers
Most frequently at vertex of head |
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Intracerebral hematoma What causes it? |
Bleeding in cerebrum Occurs due to stroke or ruptured hemangioma, not trauma |
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Common sites for intracerebral hematoma |
Frontal Temporal Occipital |
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Delayed union |
Fracture that doesn't heal within the usual time |
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Malunion |
Fracture that heals in a faulty position Occurs if fracture is not properly reduced or immobilized |
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Nonunion |
Fracture in which healing does not occur and fragments do not join Often due to lack of vascularization |
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Open/compound fracture |
Broken bone has penetrated the skin |
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Closed fracture |
Broken bone does not penetrate through the skin |
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Comminuted |
Fragments of major fracture, shattered |
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Luxation |
Dislocation of joint |
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Subluxation |
Partial dislocation of joint |
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Which way do shoulders dislocate? |
Anteriorly |
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Legg-Calve-Perthes Disease |
Avascular necrosis affecting femoral head |
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Fat pad sign |
Visibility of fat pad on posterior elbow indicates injury |
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Greenstick |
Pediatric fracture Cortex broken on one side |
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Torus |
Pediatric fracture Cortex folds back onto itself |
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Bennett fx |
Fracture of base of first metacarpal |
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Boxer's fx |
Fracture of neck of fifth metacarpal Happens when fist hits solid object |
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Avulsion |
Piece/chip of bone is pulled away |
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Occult fx |
Hard to detect, clinical signs manifest w/o radiographic evidence |
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Pott's fx |
Fracture of both malleoli (tib & fib) with dislocation |
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Colles' fx |
Posterior displacement Hyperextension |
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Smith's fx |
Wrist fracture, anterior displacement Hyperflexion |
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Blowout fx |
Orbital floor breaks due to direct blow |
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Tripod fx |
Free floating zygoma - fracture at all 3 sutures |
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Myositis ossificans |
Formation of bone tissue inside muscle tissue after a traumatic injury |
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Fat embolism |
Fat from bone marrow enters the blood stream |
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Bone healing process |
Clot Osteoblasts gather Provisional callus Provisional callus becomes bony callus Bone reunited |
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Bone healing process - bone becomes reunited within |
4 to 6 weeks |
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Atelectasis |
Incomplete expansion of the lung as a result of partial or total collapse |
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Compression atelectasis |
Blood, pleural effusions, or any other space-occupying lesions cause lung collapse |
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Absorption atelectasis |
Air is completely absorbed from alveolie beyond an obstructed bronchus |
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Tension pneumothorax |
Air enters pleural space but cannot exit- complete collapse of lung resulting in deviation of trachea, shift of mediastinum, depression of hemi-diaphragm |
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Pneumoperitoneum |
Free air in peritoneal cavity |
