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108 Cards in this Set
- Front
- Back
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WHat are the indications for x ray abdomen?
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- vomit, abdominal pain- most common
- hematuria, pain when crapping, mass, fluid filled abdomen |
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Where should you shoot radiographs of the abdomen?
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-VD and right lateral
- diaphragm to the pelvic inlet - femurs perp. to the spine - hind legs pulled forward for urethral calculi |
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What are some technical factors you should take into consideration with the abdomen?
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-image should be dark enough to penetrate the liver
- abdomen has low inherent contrast -USE LOW KVP AND HIGH MAS- grid to decrease scatter |
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List the structures you can normally here?
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-liver spleen kidneys stomach duodenum small intestine cecum colon bladder prostate retroperitoneal fat
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What is the mass effect?
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-abdominal masses can often cause displacement of the other abdominal organs- this can help identify the origin of a mass
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What is the normal size of the liver on the lateral/ vd view
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lateral- caudoventral margin extends slightly caudal to costal arch; long axis of the stomach should be parallel to the ribs or perpendicular to the spine
VD- long asix of the stomach is perpendicular to the spine - caudal margins of the liver are difficult to visualize on this view |
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What would you expect to see with hepatomegaly?
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- CD/ventral margins extend caudal to costal arch
-liver edges are rounded -pylorus is dispaced cd/dorsal and to the left leading to a change in the long axis of the stomach |
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List the causes of hepatomegaly?
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- cushings
-fatty infiltration- DM, hepatic lipidosis - passive congestion: RHF -neoplasia- LSA - Inflammation cholestasis |
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WHat would be your DDX for lumpy margins?
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- malignant neoplasia
-nodular hyperplasia |
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Focal enlargement?
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- neoplasia
- nodular hyperplasia |
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IF the abdominal mass is really big was are your two DDX?
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- splenic mass
-liver cyst |
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DDX for generalized hepatomegaly?
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- Congenstion
- Cushing- steroids hepatopathy - Diabetes - Neoplasia - LSA Mast cell - Acute hepatitis - Hepatic Lipidosis - FIP |
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DDX for focal hepatomegaly?
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-neoplasia (hepatocellular ca, lymphoma, LSA)
- regenerative nodule -granuloma -abscess - cyst - hematoma |
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What are your DDX for microhepatica?
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- stomach shifted cranially- esp pylorus
- may be functionally normal -portosystemic shunt -hepatic fibrosis/cirrhosis |
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DDX for changes in liver opacity?
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-increased:
mineralization, biliary choleliths, parenchymal: parasitic cysts, granulomatious ds, neoplasia - decreased: gas |
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What are some examples of gas causes decrease liver opacity?
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- abscess
-portal gas- gdv - free peritonel air -biliary gas- ascending infection - pancreatitis, clostridium infection |
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Where do you see the spleen on vd?
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-caudolat to the stomach fundus
-craniolat to the left kidney |
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Where do you see it in cats?
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- laying along left sire on VD
- not seen normally on lateral |
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What causes spenomegaly?
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- drug induced- sedatives, anx, barbituates
- diffuse infliltrative process- LSA, HAS, Mast cell - vascular statis -splenic torsion -imflammatory- ehrlicia, toxo - chronic anemia |
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Characteristics of the Mature Young adult
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1. Age of financial independence
2. Tolerant of views of others 3. Self-acceptance, reflective, insightful 4. Assume responsibility for selves 5. Realistic, make decisions, take responsibility for decisions 6. Maturity - at max function and integrity, fully developed |
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What causes of loss of intra-abdominal detail?
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- AKA- loss of serosal surface detail
- lack of fat: young emaciation -peritoneal fluid - pacreatitis, peritonitis -carcinomatosis |
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Why would you do an esophagram?
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- regurgitation, dysphagia, anorexia, weight loss, recurrent secondary pneumonia
- to ID location, size and shape of the esophagus |
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What are some techniques to doing an esophagram?
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- lateral recumb.
- give contrast: barium paste gives mucosal detail; barium liquid gives luminal/ motility evaluation; organic iodine for suspected perforation- careful of pul edema - make exposure when patient swallows |
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WHat do you expect to see on a normal esophagram?
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- peristalsis
- dogs long. folds (skeletal) -cats- long. folds- cranial 2/3 skeletal and oblique folds caudel 1/3 smooth= herringbone patter |
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What would be abnormal to see?
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-pooling of contrast/ dilation, filling defects
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What would you see with hypomotility?
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adherence of the contrast to the mucosal. constriction/ narrowed lumen
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What is megaesphagus? how do you dx?
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- focal or diffuse esophageal dilation with hypomotility
-congentical/ acquired - numerous causes- aspiration pneumonia - do esophogram |
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Where are the common sites to get esophageal FB?
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-thoracic inlet
-heart base -LES |
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What do you see on x ray?
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- focal distention of the esophagus- pneumomediastinum, pleural effusion, mediastinal fluid, strictures
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What is a vascular ring anomaly?
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- congenital malformation of great vessels- PRAA - young dogs
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What do you see on x ray?
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-esophageal dilation cranial to the heart
- ventral displacement of the trachea -pooling of contrast cranial to constriction - normal or hypo-motile caudel to the esophagus |
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What are the esophageal neoplasias?
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- Primary: ASA, LMS, SCC, OSA
- Metastatic: more common -Spirocerca lupi - may see stricture, obstruction, mass |
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Esophageal hernies?
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hiatal- most common
paraesophageal -gastroesophageal intrussusception - all appear as increase ST opacity- caudel mediastinum/esophagus - esophagram to confirm -GSD |
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What is an esophageal diverticula and who gets it?
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-normal at thoracic inlet, out-pouching of the esophagus, secondary to obstruction, stricture or vascular ring
- brachycephalic breeds- shar pei, bulldogs |
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What parts of the stomach do you see on left lateral?
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- air in pylorus, fluid in fundus,
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RIght lateral?
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-air in fundus, fluid in pylorus
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VD? DV?
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VD- gas in body and pyloric antrum
DV- has in fundus |
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What is the gastrogram?
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- double contrast study- 1-2ml/lb barium suspension followed by 5-10ml/lb of room air
- need all 4 views |
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What do you see with GDV?
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- emergency
- take both laterals- the stomach is dsitended with gas and fluid, pylorus displaced dorsally and to the left - compartmentalize, +/- splenomegaly, +/- hypovolemic changes - gastric distention without torsion in normal position |
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How do you diagnose gastric ulcers
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- gastrogram: ulcer crater appearance as barium filled plateau projecting away from the lumen, adjacent rugae may be thick, lesser curvature and pyloric region
- usually do survery films |
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What are 4 gastric neoplasias you see?
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- ACA
-LSA -MCT -LSA |
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What is phythium?
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- fungal DZ seen in southern US- looks like neoplasia in stomach
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WHat do FB not in the pylorus appear as?
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-filling defects
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What can be used to help see a FB?
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- room air- then again a few years later
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What do you see on xrays with a pyloric outflow obstruction?
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-distended and gas and fluid filled stomach
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What causes gastric emptying?
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- pyloric dz
-iatrogenic: drugs, stress, insufficient gastric distention with contrast |
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What is the normal SI diameter?
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- 3 times the width of the last rib
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How much do you increase the KVP for UGI?
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- 10%
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How many mls barium?
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5-8ml/lb of barium sulfate via orogastric tube
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What should you use if you suspect perforation
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- 5mls organic iodine
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How many radiographs do you take?
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-all 4 views initially
- then dogs every 30 minutes VD and right lateral until the stomach is empty and crap is on colon - cats every 15 minutes and VD right lateral |
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Whats normal for a UGI?
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-smooth coating of mucosa
- passage of the barium through the GI tract to colon - dogs 3-4 hours - cats 1-2 hours - duodenum- string of pearls in a cat - pseudo ulcers- dog duodenum |
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What do you see with mechanical ileus?
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- localized
- moderate to severe distention- greater than 3 rib widths - non uniform distention - stacking or hair in turns causes: FB, stricture, granuloma, neoplasia, enteroliths, trichobezoards, parasites, adhesions |
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What is too big?
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dog: greater than 3 rib widths
cat: greater than 12mm ferrets: greater then 5-7mm foals: greater then length of L1 |
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What do you see with functional ileus?
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- not as common
- generalized moderate uniform distention causes: peritonitis, enteritis, dysautonomia, stress, spinal trauma, post surgery |
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What does a linear FB look like on xrays?
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-centralization and clumping of bowel
-plication of bowel loops - Dogs- most in stomach, duodenum -Cats look under tongue |
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What are the intestinal neoplasias?
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- ACA
- LSA -MCT -LMS |
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DO you see on survery xray what do you see with UGI?
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- sometimes
- with UGI see an annular constriction "apple core", mural or mucosal masses projecting into lumen - thick bowel - US great to ID this |
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What is the normal LI diameter?
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- Less than 5 rib widths
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Whats the dose for barium enema?
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3-6mls/lb
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What is the most common intussusecption? who do oyu see it in? what is it seen as on UGI or BE? causes?
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-ileo-colic
- most common in young dogs/cats - seen as filling defect on UGI or BE -causes: idiopathic, parasitic, viral enteritis, surgery, intestinal mass |
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What do you see on xrays for megacolon?
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-distended colon with opaque impacted feces
-causes: idiopathic, neurologic, secondary to pelvic trauma, secondary to stricture |
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What do you see on xray with colitis? WHat do you need to diagnose?
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- survery films normal
- BE shows mucosal irregularities, with ulcer formation lasagna -biopsy |
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What is the most common LI neoplasia?
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- adenocarcinoma
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What are the causes of pneumoperitoneum?
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-penetrating external wound: trauma, iatrogenic ( abdominocentesis, laparotomy)
-rupture of internal viscous: GI tract most common, most air comes from colon or stomach rupture |
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What are the roentgen signs?
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- enhanced visual/serosal margin detail
-visualization of abgdominal structures not normally seen -intrabdominal gas opacities not conforming to or visualized within GI tract- look like small gas bubbles |
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What causes improved serosal surface detail?
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- surgery
-penetrating wound -bowel perforations - negative contrast cystogram with iatrogentic rupture -idiopthatic |
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What do you see with free peritoneal air?
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- large to moderate volume
-caudel surgace of diaphragm |
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How do you diagnose a pneumoperitoneum?
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- positional xray- horozontal beam
- do elevated dorsal recumbency: see gas in area of liver diaphragm and falciform fat -do lateral recumbency: gas in right cranial quardrant away from fundus of stomach- air seen against liver |
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Why do you do a vaginocystourethrogram?
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- need GA
- pelvic/ vag mass, dysuria, hematuria, incontinence, urethral stricture/ tumor |
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What would your DDZ be for uterine enlargement?
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- tubular structure that extends caudal to the pelvic canal
1- gravid or post-partum uterus 2- pyometria, mucometra |
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What do you see on xray with uteromegaly?
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- cranial and dorsal displacement of SI and colon
- body between colon and bladder - coiled tubular structure - may be easier to see on VD along flanks - medial displacement of SI from L& R - characteristic of uteromegaly |
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When do fetuses mineralization?
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-43-45d
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What could cause dystocia?
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- stenosis of pelvic canal from old fx
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How could you tell if a fetus was dead on xray?
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-hyperflexed or hyperextended
- collapsed skull bones - intrafetal or intrauterine gas |
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Name 4 causes for prostate enlargement?
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1- cysts
2- infection 3- bph 4- cancer |
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In a neutered dog what is mineralization caused by? intact?
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- adenocarcinoma in neutered
- prostaitis in intact |
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What do you see on xrays if the prostate is big?
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-dorsal displacement +/- compression of the colon
- cranial displacement of the bladder- look for triangle between the bladder and prostate to be sure it is the prostate you are seeing -assess shape and opacity |
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What do you see radiographically with prostatic neoplasia?
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- sub-lumbar lymphnode enlargement
- new periosteal bone formation last 2-3 L veterbrae and sacrum - +/- mineralization - do prostatic wash |
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Where does the medial illiac LN live? What do you see with enlargement?
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- ventral to L6-L7
-ventral displacement of colon - increased ST opacity in iliax region |
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What does the mesentetic LN drain? what do you see with enlargement?
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- drains abd. viscera
- see central abdominal mass in area of root of mesentary displacing abdominal viscera peripherally and ventrally |
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What are the 3 associations with LN enlargement?
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- LSA
- Neoplastic or inflammatory disease of pelvic canal ( prostate, urinary bladder, uterus) - granulomatous DZ |
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Where does adenocarcinoma met to?
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lumbar spine
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What are 2 causes of art/ big liver?
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1- fat pad
2- feline asthma |
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Young animals can have large what?
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liver and heart and its normal
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left lateral the lvier lobe hangs where?
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-down
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Whats a bates body?
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-necrotic fat
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Where is the head of the spleen located?
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- left side bc of gastroplenic ligament
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Cat and ferret where is the spleen?
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-stays on left side
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If you have a splenic mass what do you do next?
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xray chest- no mets US liver--> hematoma doesnt met to liver so it could be hemangioma not HSA
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Should you x ray kitten/ puppy?
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- no because you cant see much
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Where do you see mineralizations with renal cats?
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- stomach
-adrenals -walls of arteries |
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What can look like mineralization?
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-pepto
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On x ray what findings are there of megaesphagous?
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- ventrally displaced trachea
-tracheal stripe |
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What is the difference between the dog and cat esophagus?
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-cat has white streaks then oblique slants - herring bone pattern
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What may cause the intestines to go into a pile
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-falciform fat
-retroperitinem fat |
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how do you tell the difference between obstructive ileus and paralytic on x ray?
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obstructive- localized dilation- couple huge segments, stacking and hair pins
paralytic- generalized dilation all distended but only moderate |
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If the width of the intestine is bigger than 3 rib widths- then its...
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obstructive
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What does dysauntonomia mean?
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- air everywhere just not intestine
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Who do you see intussusception in?
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- young dogs just wormed
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Why might cats get megacolon?
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pelvic fx?
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Free air in abdomen caused by what?
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bowel rupture
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Hepatoplenomegaly Number one DDX
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LSA
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The uterine body may be dorsal to the bladder in ovese animals ( usually invisible) you can do a spoon test to detect mild uteromegaly... what do you see with the spoon test?
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colon then uterus then bladder stacked
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Met. Dz does what to films?
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decrease detail
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How many days to fetal mineralization?
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42-45 days
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When examining the retroperitoneal space what might circular mineral opacities ventral to L4 and L5 be?
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- circumflex iliac arteries
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Why might there be loss of detail in retroperitoneal space?
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- young animal no fat
-emaciated - free fluid in space -mass in space |
