Download NURS 5355 Midterm Exam: CT Scan Interpretation for Neurological and Pulmonary Conditions and more Exams Nursing in PDF only on Docsity!
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Does conventional x-ray assess for intracranial abnormalities? - ANSWER No. Conventional x-ray does not have a significant role in assessing for intracranial abnormalities
What does contrast do? - ANSWER Emphasizes certain structures by blocking x-rays. Appears white on imaging.
What are indications for a CT Brain? - ANSWER Acute stroke/CVA or acute and severe headache with suspicion of ICH or head trauma. Order non-contrasted CT Brain.
What can appear white on a non-contrasted CT Brain? - ANSWER Bone, blood, or metallic foreign body.
When would you NOT give contrast? - ANSWER Contrast allergy or renal failure. DO NOT give contrast if creatinine is greater than 1.5 mg/dL (can cause acute tubular necrosis)
What is the brain window? - ANSWER Brain window is used to assess densities that are close to the average density of brain soft tissue. "Windowing"-the process for which CT imaging is manipulated on a gray scale based on certain numbers to change or enhance the appearance of the image to highlight specific features. Brain window has limited info on bone structures.
What is the bone window? - ANSWER Bone window looks at bone density. *Allows you to look at both windows (brain and bone) when reviewing a CT
brain. The windows allow the clinician to optimize specific anatomic details.
What are the three plane views for CT brain? - ANSWER Axial, Coronal and Sagittal
What is the most common view to assess the brain? - ANSWER Axial view
What is white matter in the brain? - ANSWER White matter: centrally located, dark, high content of myelinated axons.
What is gray matter in the brain? - ANSWER Gray matter: Externally located, lighter in color and has fewer axons but higher number of cell bodies.
Hypodense tissue on CT brain: - ANSWER Appears darker. Can be a result of infarcted tissue, air and/or edema.
Isodense tissue on CT brain: - ANSWER Normal brain tissue.
Hyperdense tissue on CT brain: - ANSWER Appears lighter on imaging. Can result from calcium, contrast administration, metal (such as aneurysm clips) or blood.
Will an initial CT brain show ischemic changes after an ischemic CVA? - ANSWER No, It may not demonstrate ischemic changes. The areas of low attenuation and hypodensity may not be present until 12-24 hours after the acute event.
What does a CT brain look like in someone who has had a hemorrhagic CVA?
- ANSWER Areas of increased attenuation and hyperdensity (white circle). The hyperdensity will be easily visible on a non-contrasted CT due to the hemoglobin component within blood. Over time, the blood becomes denser
brain? - ANSWER Metastasis is more evident with contrast. Metastasis presents as "ring enhancement"
What are the two types of cerebral edema? - ANSWER Vasogenic: extracellular edema due to increased permeability of brain capillaries (BBB breakdown). It is mainly in the white matter and occurs due to malignancy or infection
Cytotoxic: intracellular edema due to an osmotic imbalance between the cell and the extracellular fluid. It is mainly in the gray matter.
*Most importantly, cannot differentiate between the gray and white matter which is highly indicative of cerebral edema.
What does atrophy of the brain look like on CT brain? - ANSWER Atrophy is the loss of gray and white matter. Atrophy leads to proportionate enlargement of the ventricles and sulci.
What is standard for CT chest? - ANSWER CT chest without contrast is standard. Only order with contrast if you want to assess vascular disease.
What are the indications for CT chest? - ANSWER COPD, interstitial lung disease, pulmonary nodules/masses, aneurysm dissection, pulmonary emboli, infections/cavitary lesions, differentiating pulmonary processes.
When would a CT chest with angiography be ordered? - ANSWER To assess blood vessels (arteries and veins) of interest
When would a CT chest with contrast be ordered? - ANSWER To assess capillaries in soft tissue
Increased attenuation on chest CT will appear: - ANSWER White/lighter. Denser substances will absorb more xray
Decreased attenuation on chest CT will appear: - ANSWER Dark. Less dense substances will absorb less xray
What is the lung window? - ANSWER The lung window is used to identify lung parenchyma abnormalities and identify normal vs abnormal bronchial anatomy.
What is the bone window (lung) - ANSWER The bone window is used to view bony structures (ribs)
What is the mediastinal window? - ANSWER The mediastinal window is used to visualize the mediastinal, hilar and pleural structures.
What does pneumonia look like on chest CT? - ANSWER Localized area of fluffy white. Air bronchograms may be visualized which are gas/fir filled bronchi that are surrounded by alveoli will with fluid, pus or some other material.
What does pneumothroax look like on chest CT? - ANSWER Pneumothorax is the collapsing of the lung due to separation of the visceral and parietal pleura. It will appear black or dark because air is less dense compared to toher structures within the lung.
What does bullae look like on chest CT? - ANSWER Large bullae can be seen with emphysema or COPD. It will appear as a bubble filled cavity in the lung. Lung wall will also appear thin.
What does a lung mass look like on chest CT? - ANSWER Large, localized, irregularly rounded shaped white shadow.
What does pulmonary nodules look like on chest CT? - ANSWER Multiple, small, scattered irregularly rounded shaped white shadows. Nodules are less than 3 cm and can be present as solid of sub-solid in appearance.
When should oral vs. IV contrast be used in CT abdomen & pelvis? - ANSWER
IV contrast for trauma, abdominal pain (like appendicitis), detection of aortic aneurysm or dissection of mass. Oral contrast should be used for non-traumatic abdominal pain, inflammatory disease, abdominal or pelvic abscess or bowel perforation.
What window is the abdomen primarily viewed in? - ANSWER The abdominal window.
What are the most common planes to view CT abdomen & pelvis? - ANSWER The axial and coronal planes
What does small bowel obstruction look like on CT abd & pelvis? - ANSWER Dilated small bowel loops that are filled with air and fluid. If concerned for a bowel obstruction, oral contrast is not necessarily needed. The fluid and air within the small bowel will provide visualization.
What does large bowel obstruction look like on CT abd & pelvis? - ANSWER Dilated loops of large bowel that are overshadowing the remaining abdominal structures.
What does free intraperitoneal air look like on CT abd & pelvis? - ANSWER Dark, linear. The air is not contained in any bowel and is most commonly caused by rupture of an air-containing loop of bowel or stomach. Free
What do cholelithiasis look like on CT abd & pelvis? - ANSWER White, round, located on the right by the liver.
What does nephrolithiasis look like on CT abd & pelvis? - ANSWER White, round, located in one or both kidneys.
What does hydronephrosis look like on CT abd & pelvis? - ANSWER Dark, hazy shadow on one or both kidneys. Hydronephrosis is the swelling of one or both kidneys due to build up of urine resulting from obstruction or structural defect that inhibits proper drainage of urine.
What does diverticulosis look like on CT abd & pelvis - ANSWER Small, round, outpouchings most commonly in the sigmoid region.
Potential complications- Diverticula become inflamed or bleed. CT wound show diverticula and adjacent colonic wall thickening, pericolonic inflammation, abscess formation and/or colonic perforation.
What does colitis look like on CT abd & pelvis? - ANSWER Diffuse thickening of the colon wall aka accordion sign
Other signs= irregular narrowing of the bowel lumen due to edema, known as thumb printing and infiltration of the surrounding fat.
What does pancreatitis look like on CT abd & pelvis? - ANSWER **Pancreatitis is a clinical diagnosis with CT A&P. Pancreatitis on CT show enlargement of all or part of the pancreas, peripancreatic stranding or fluid collections, low-attenuation lesions in the pancreas from necrosis and pseudocyst formation.
What does liver cirrhosis look like on CT abd & pelvis? - ANSWER A cirrhotic liver has a nodular appearance also described as "lobulated contour."
Other signs on CT= liver shrinkage with the right lobe characteristically becoming smaller, mottled, portal hypertension resulting in dilated vessels/varices, splenomegaly and ascites.
For a good image to be displayed with ultrasound, what must be adequate between the transducer and body surface? - ANSWER Contact. Good contact with a coupling gel eliminates air gaps.
When utilizing ultrasound, which plane would the upper portion of the image be closer to the transducer? - ANSWER Longitudinal
What does echogenicity refer to? - ANSWER Refers to the brightness or darkness of tissue on ultrasound.
What does echogenic or hyperchoic mean? - ANSWER Tissue that appears
What is the most common reason for ultrasound? - ANSWER To assess abdominal structures
