RADIO QUIZ 2: ABDOMEN

M/C; this view is useful in assessing abdominal pathologies (bowel obstructions, calcifications, neoplastic changes)

* includes both halves of the diaphragm*

kidnets, ureters, bladder view; assessment of bowel and urogenital system; VERY SIMILAR TO AP supine

does not necessarily contain diaphragms

used to ID free intraperitoneal gas (pneumoperitoneum); can be performed when the patient is unable to be transferred to, or other imaging modalities are not available

air in the stomach, air in 2 or 3 loops of nondilated small bowel, air usually in rectosigmoid

depending on the amt of fat around visceral structures, their outlines may be partially visible

lies centrally, with the large bowel framing it

mucosal folds are known as valvulae conniventes & are visible across the full width of the bowel

-3cm wide

- wall features pouches or sacculations that protrude (known as haustra)

- inbetween haustra are plicae semilunares

- haustra typically thicker & do not appear to completely transverse the bowel

-*unreliable if dilated large bowel haustral pattern may traverse the bowel

- feces have mottled appearance & are most visible in colon due to trapped gas

-6 cm wide & sigmoid is 9 cm

psoas muscle, thoracic & lumbar spine, pelvis, sacrum, hip bones

diaphragms, stomach, liver, kidneys shadow, small & large bowel

"Step ladder appearance"

- may be seen on upright abd views of pt caused by arrangement of fluid filled & dilated small bowel loops in a step wise configuration

-everything past the obstruction appears white

overall bowel gas pattern is a pattern of disproportionate dilation of multiple loops 2/2 adhesions

inability to pass gas or stool

dilated cecum takes on mammalian embryo shape

sigmoid volvulus: twisted sigmoid colon

mucosal thickening of the haustra due to inflammation & edema causing them to appear like thumb prints projecting into the lumen

Ulcerative colitis; caused by the stenosing of the colon

Achalasia/stricture

radiolucent ring in the upper esophagus; occurs in the cervical esophagus near cricopharyngeus muscle; arise from the anterior wall & never from the posterior; Dx TOC: barium swallow

symptomatic, narrow esophageal B ring occuring in the distal esophagus & usu associated w/ a hiatal hernia; hx of food impactions; intermittent dysphagia

outpouching of pharyngeal muscle; cricopharyngeal muscle fails to relax during swallowing

"double wall sign"; pneumoperitoneum may cause both sides of bowel wall to be visible; get CXR if you suspect pneumoperitoneum for air under diaphragm on an erect