Abdomen Flashcards
What bilaterally paired flat muscles are the innermost of the anterolateral abdominal wall muscles
Transversus abdominis
What doppler signal would be expected in the portal vein of a patient with portal hypertenstion
Hepatofugal flow
Which of the following is one of the three parts of an abdominal wall hernia
a) content
b) paraherniated cords
c) location
d) substance
a) content
What is the primary difference in the sonographic appearance between retroperitoneal fibrosis and para-aortic lymphadenopathy
a) renal fascia is less echogenic and smaller
b) renal fascia is more echogenic and larger
c) para-aortic adenopathy is less echogenic and smaller
d) para-aortic adenopathy is less echogenic and larger
a) renal fascia is less echogenic and smaller
What is the most common cause of acute posttransplant renal failure
a) infarct
b) vascular occlusion
c) renal vein thrombosis
d) renal tubule damage
d) renal tubule damage
What meaning is conveyed when an examination is described in terms of sensitivity
a) there is an indication the disease is likely
b) it documents whatever disease or pathology is present
c) quality images are provided with homogeneous intensity
d) patients will not experience discomfort during the exma
b) it documents whatever disease or pathology is present
The SMV empties into which vein
Portal
Which of the following is a sonographic characteristic of a phyllodes tumor
a) irregular border with thorough transmission
b) cystic spaces within a large, discrete, solid lesion
c) Even internal echoes with microcalcification
d) primarily cystic with multiple septations
b) cystic spaces within a large, discrete, solid lesion
If the sonographic exam demonstrates a large solid mass with mixed echo pattern on a 3 year old with a palpable mass in the LUQ, enlarged liver, weight loss, vomiting, hypertension abdominal pain, anemia, and elevated urinary catecholamines, what is the most likely diagnosis
a) adenoma
b) neuroblastoma
c) hypernephroma
d) pheochromocytoma
b) neuroblastoma
Where is the body and antrum of the stomach located relative to the gallbladder and porta hepatis
a) Medial
b) anterior
c) superior
d) posterior
a) medial
What protects the kidney from trauma and holds it in place in the abdominal cavity
a) hilum
b) adipose capsule
c) renal fascia
d) renal capsule
b) adipose capsule
What patient position increases the sensitivity of the FAST exam, especially in the detection of free fluid in the hepatorenal and perisplenic spaces
Trendelenburg
What sex hormone is secreted by the adrenal gland cortex
Androgen
The functional or true right and left intrahepatic lobar divisions are between what structures
a) gallbladder fossa and porta hepatis
b) left sagittal fossa and porta hepatis
c) porta hepatis and IVC
d) IVC and gallbladder fossa
d) IVC and gallbladder fossa
What term best describes the pancreatic hormone insulin
Endocrine
What is the most common etiology of Graves disease
Autoimmune disorder
What is the measurement range for the normal bladder wall thickness that accounts for the variability caused by bladder distention
3-6 mm
What occurs in the umbilicus area
a) the area is the genesis for the inguinal canal
b) the linea alba widens and courses laterally
c) the layers of the anterolateral abdominal wall fuse
d) lymphatic vessels outnumber blood vessels
c) The layers of the anterolateral abdominal wall fuse
What potential space separates the pancreas from the stomach
Lesser sac (omental bursa)
Although in most cases the sonographic appearance of the testes remains unchanged after vasectomy, what changes can occur in approx 40% of postvasectomy patients
a) hyperemia to one of both testis
b) infarction of one or both testis
c) atrophy of the scrotal sac
d) enlargement of the epididymis
d) enlargement of the epididymis
What is the most common primary liver malignancy in an adult
Hepatoma
What retroperitoneal compartment contains the pancreas, the ascending colon, and the descending colon
Anterior pararenal space
What is the echogenicity on a long plane of large muscle fibers
Homogenous
What is the primary function of the urinary system
Maintain homeostasis by controlling the composition and volume of blood
What pathology is most likely demonstrated on a 64 year old man with a slightly elevated prostate-specific antigen level and the endorectal sonogram documenting an 8.9 mm hypoechoic mass in the right peripheral zone
a) prostatitis
b) fibrosis
c) malignancy
d) benign prostatic hypertrophy
c) malignancy
What is the most common benign breast tumor
Fibroadenoma
What pathology describes the enlargement of lymph nodes caused by inflammation, primary neoplasia, or metastasis
Lymphadenopathy (Adenopathy)
Which doppler finding indicates a thrombosis following a transjuglar intrahepatic portosystemic shunt
a) accelerated flow
b) reversed flow
c) absent flow
d) a velocity of > 50 cm/sec
c) absent flow
Bilaterally which structure is positioned adjacent to the trachea
Thyroid gland
When viewing an image obtained in the coronal plane where is the patients head relative to the displayed image
Left side
What anatomy is included in the spermatic cord
a) ejaculatory duct
b) ductus deferens
c) epidiymis
d) testicular artery and vein
d) testicular artery and vein
What periotoneal space is located posterior to the bladder and anterior to the uterus
Uterovesicle space
Neoplasm of which origin comprise the largest group of pancreatic tumors
Exocrine
What characteristic disginguishes a benign fibroadeonma in comparison to malignant appearing asses
a) smooth and well defined contour
b) lobulated irregular margins
c) receding nipple and skin changes
d) weak nonuniform internal echoes
a) smooth and well defined contour
What anatomic structure is located lateral and to the patients right of the common bile duct
Hepatic artery
In addition to a falling hematocrit, what is another clinical indication of a hematoma
a) lymphoma
b) leukocytosis
c) ecchymosis
d) elevated enzymes
c) ecchymosis
What is the likely explanation for a septated cystic mass in the head of the pancreas in a 43 year old, chronic alcoholic who presents with a normal serum lipase, elevated serum amylase, and an enlarging mass in the epigastrium
a) necrosis
b) pancreatic pseudocyst
c) hepatoma
d) acute pancreatitis
b) pancreatic pseudocyst
What is one of the most common causes of endogenous calculi
Aging
Which space or void is considered an anatomically true peritoneal space
a) space of retzius
b) morrisons pouch
c) perinephric space
d) lesser sac
d) lesser sac
The term sonolucent is a misnomer when it is used to describe which echogenicity
Anechoic
In what region does inflammation usually start with ulcerative colitis that is an inflammation disease confied to the colonic mucosa and submucosa
a) sigmoid
b) rectal
c) ascending colon
d) left colonic flexure
b) rectal
What plane is perpendicular to both the sagittal and transverse planes
Coronal
Leukopenia may result from what condition
anaphylactic shock
What is the most common site of retroperitoneal infections
Anterior pararenal space
What is the most common type of splanchnic artery aneurysm
Splenic
In the spleen, what structure is made of up lymph tissues arranged around splenic arteriole
White pulp
What type of pressure describes the normal venous system
low
What hormone regulates electrolyte concentration
Aldosterone
What is the most common cause for an abnormal cystic appearing dilated breast duct
Obstruction
What carcinoma affects more men and elderly with about equal frequency in the middle and lower third of the esophagus
a) lymphosarcoma
b) carcinosarcoma
c) adenoid cystic carcinoma
d) squamous cell carcinoma
d) squamous cell carcinoma
What is the primary action of the peroneus longus and brevis tendons regarding foot movement
Eversion
What projects from the splenic capsule and divides the spleen into several compartments
Trabeculae
What is the best diagnosis if the songraphic features include an irregular, solid, uneven, neovascular, hypoechoic mass with internal echoes within the walls of a normal sized thyroid gland
a) multinodular activity
b) goiter
c) thyroid carcinoma
d) thyroid adenoma
c) thryoid carcinoma
What diease begins as fibro fatty plaque on the intima of large arteries
Atherosclerosis
What is a choledochal cyst
Dilated extrahepatic duct
Approx what percentage of the livers blood is supplied by the hepatic artery
25%
What is the most common source of metastases to the breast from a primary cancer
Contralateral breast
In a longitudinal section, what portion of the pancreas is located anterior to the SMA ans posterior to the left lobe of the liver
a) body
b) tail
c) head
d) uncinate process
a) body
Which scanning plane should the sonographer initially select to best visualize the lower liver segment
Right posterior oblique
In cases of gastritis, thinning of the mucosa is considered a precursor of what pathology
Gastric carcinoma
From inner layer to outer layer, what are the 3 layers of supportive tissues surrounding each kidney
Fibrous renal capsule, perirenal fat, renal fascia
Locating the IVC, SMA, and gastroduodenal artery helps identify what portion of the pancreas
Head
Which urinary bladder anomaly is sometimes described as a cyst within a cyst
a) ectopic ureter
b) ectopic ureterocele
c) bladder exstrophy
d) bladder diverticula
b) ectopic ureterocele
spinal sonography is useful in the normal infant until approx how many months of age
5-6
What is the sonographic appearnance of the spinal canal
Anechoic
In what regions is the spine larger
cervical and lumbar
Inadequate or improper fusion of the neural tube describes
Spinal dysraphism
What open dysraphism presents as a flat plate of neural tissue flush with the skin surface
Myelocele
On a sonogram of a patient with a tethered cord, the conus medullaris will terminate at or below the level of which vertebral body
L3
What closed spinal dysraphism are collections of fat and connective tissue that appear at least partially encapuslated and have definite connection with the spinal cord
Spinal lipoma
When viewing an image obtained in the coronal plane, where is the patients head relative to the displayed image
Left side
What term can also be used to describe the preliminary report
a) diagnosis
b) interpretive report
c) technical impression
d) pathology classification
c) technical report
What plane is perpendicular to both the sagittal and transverse planes
Coronal
What meaning if conveyed when an examination is described in terms of sensitivity
a) there is an indication the disease is likely
b) it documents whatever disease or pathology is present
c) quality images are provided with homogeneous intensity
d) patients will not experience discomfort during the exam
b) it documents whatever disease or pathology is present
What encloses the bilateral spinae muscles
Posterior and middle layers of the thoracolumbar fascia
Suppurative inflammation describes what condition
Purulent exudate with necrosis
What is the sonographic appearance of the normal visceral perironeum
Nondistinct or same as the surrounding viscera
What space or void is considered anatomically true peritoneal space
Lesser sac
When speaking of abdominal parietal spaces, normally it refers to what type of space
Potential
What is the most common type of splanchnic artery aneursym
Splenic
What is a common finding associated with vascular stenosis
Poststenotic dilation
Which vessel lies posterior to the bile duct and anterior to the portal vein
Hepatic artery
What vessel does an increase in blood flow occur after eating
SMA
In normal arterial flow, where is the most turbulent arterial flow pattern demonstrated
Splenic artery
What separates the intrahepatic right lobe from the left lobe
Main lobar fissure
What straddles the midline, is superior to the head of the pancreas, and is anterior to the IVC
Caudate lobe
The functional or true right and left intrahepatic lobar divisions are between what structures
IVC and gallbladder fossa
What vessel supplies the liver with oxygen rich blood
Hepatic artery
What structure can present as a thick lucent band somtimes identified anterior to the spine, IVC or aorta
Crus of diaphragm
Approx what percentage of the livers blood is supplied by the hepatic artery
25%
The liver has the capacity to enlarge and store how much blood
200-400 mL
A marked increase of AST variance, greater than 1,000 ML is clincially indicative of what pathology
Acute severe fulminating hepatitis
What are the clinical implications for a 52 year old man with a liver sonography examination suggesting long standing liver disease and the presence of alpha fetoprotein
a) hepatitis
b) primary carcinoma
c) vitamin k deficiency
d) serum globulin deficiency
b) primary carcinoma
If a malignant neoplasm appears as an anechoic mass, what is the likely explanation for this echo characteristic
Dilated hepatic ducts
What is the most common primary liver malignancy in an adult
Hepatoma
What vessels are used to delineate the right and left lobes; the right posterior and right anterior segments; and the left medial and left lateral segments
Hepatic veins
what is the likely cause for echoes originating from within the gallbladder with acoustic shadows
Cholelithiasis
If a patient is in the supine position what is the course of the main portal vein
Transverse
What vessel supplies the gallbladder with blood
Cystic artery
What is the best explanation if the sonogram reveals a focal area of high echogenicity with acoustic shadowing
Cholelithiasis
Acute cholecystitis is most likely to occur secondary to what entity
Calculi impaction in the cystic duct
What anatomic structure is located lateral and to the patients right of the CBD
Hepatic artery
Locating the IVC, SMV, and gastroduodenal artery helps identify what portion of the pancreas
Head
What vessel courses to the patients right and is located posterior to the pancreas
splenic vein
The echogenicity of the pancreas is equal to or greater than that of which organ
Liver
Neoplasms of which origin comprise the largest group of pancreatic tumors
Exocrine
What is the name of the accessory pancreatic duct
Duct of Santorini
What enzyme digests carbohydrates
Amylase
What is the principle site of filtration within the spleen
Red pulp
What splenic function removes iron and other substances from erythrocytes
Pitting
What term describes the echogenicity of the normal spleen parenchyma when compared to the liver
Isoechoic
Leukopenia may result from what condition
Anaphylactic shock
What may be demonstrated in the spleen, liver, kidneys, and adrenal glands in patients with extrapulmonary pneumocystis carinii secondary to AIDS
Calcifications
What process contributes to an aquired aplasia and hypoplasia
Repeated infarction
What is the deepest, innermost, mucosal esophaeal surface that can be visualized on both endoscopic and transabdominal imaging
Mucosal surface
Thinning of the mucosa is considered a precursor of what pathology
Gastric carcinoma
What carcinoma affects more men and elderly with about equal frequency in the middle and lower third of the esophagus
Squamous cell carcinoma
What portion of the duodenum includes the duodenal bulb
First
What is the most common primary neoplastic lesion of the small bowel
Smooth muscle tumors
In what region does inflammation usually start with ulcerative colitis that is an inflammatory disease confined to the colonic mucosa and submucosa
Rectal
From inner layer to outter layer what are the 3 layers of supportive tissues surrounding each kidney
Fibrous renal capsule, perirenal fat, renal fascia
From lowest to highest echo amplitude, what is the correct order for the normal renal structures
Medulla, cortex, sinus
What blood vessel courses between the SMA and aorta
Left renal vein
What is the name for the one afferent arteriole that divides into a capillary network in the glomerular capsule
Glomerulus
What is the primary function of the urinary system
Maintain homeostasis by controlling the composition and volume of blood
what is the most significant clinical implication of an elevated serum creatine
50% plus nephron destruction
What tumor accounts for approx 80-90% of all renal malignancies in adults
Renal cell carcinoma
What condition is associated with urinary stasis
Nephrolithiasis
What is the most common composition of renal calculi
Calcium oxalate
Where is the prostate gland located
Between the bladder and the pelvic floor
What hormone regulates electrolyte concentration
Aldosterone
Which mass is adrenal in origin and secretes hormones
a) wilms tumor
b) adenoma
c) pheochromocytoma
d) neuroblastoma
c) pheochromocytoma
What is the most common congential breast anomaly
Polythelia
Compared to the normal testicular parenchyma, what is the predominant sonographic appearance of malignant testicular tumors
Hypoechoic
What is the globus major
Epididymal head
What is the primary action of the peroneus longus and brevis tendons regarding foot movement
Eversion
What is the echogenicity on a long axis plane of large muscle fibers
Homogenous
What attaches bone to bone
Ligaments
What term is used to describe common flexor osteotendinopathy
Golfers elbow
What condition results when the patient is unable to synthesize erythropoietin
anemia
What is the normal flow pattern for a pancreatic allograft
Monophasic venous flow
What is the most common cause of acute posttransplant renal failure
Renal tubule damage
What is a sign of cardiac tamponade
a) symmetrical ventricular contraction
b) loss of respiratory variation in the IVC
c) bowing of the interventricular spetum into the right ventricle
d) collapse of all chambers during systole
b) loss of respiratory variation in the IVC
What term is used to describe air located outside of the lung but within the pleural cavity
Pneumothorax
What is the relationship between the needles bore size and its gauge
Inverse
