ABDOMEN II FINAL REVIEW Flashcards
liver is suspended from diaphragm and anterior wall by what ligament
Falciform ligament
pg. 208
fatty infiltration may be observed in all patients ( we pick the one that doesn’t fit )
Obesity Excessive alcohol intake Poorly controlled hyperlipidemia (cholesterol) Diabetes mellitus Excess corticosteriods Pregnancy Total parenteral hyperalimentation (nutrition) Severe Hepatitis Glycogen Storage Disease Cystic Fibrosis Pharmaceutical Chronic Illness pg. 235
What is Budd Chiari Syndrome?
Thrombosis of the hepatic veins or IVC
pg. 246
Echinococcal cysts have a higher incidence from where?
Sheep-herding areas
pg. 255
What is the most common benign tumor of liver?
Cavernous hemangioma
pg. 256
What is the benign liver tumor, can be found in patients with glycogen storage disease?
Liver Cell Adenoma
pg. 258
Patients with hepatocellular carcinoma likely to have had ___.
Cirrhosis
pg. 259
What is the most common form of neoplastic involvement in liver?
Metastatic Disease
pg. 259
RPV and GB found in what fissure?
Main Lobar Fissure
pg. 276
In severe hepatocellular destruction, AST and ALT levels are ___.
AST: significantly elevated
ALT: moderately elevated
pg. 215
Elevated alk phos is associated with ___.
Liver and biliary obstruction
pg. 33
Diminished vascular structures in the liver parenchyma most likely suggests ___.
Fatty infiltration
pg. 234
The falciform ligament extends from the umbilicus to the diaphragm. It contains the ___.
Ligamentum teres
pg. 208
Elevation of bilirubin leads to ___.
Jaundice
pg. 218
Patients with an abscess formation may have ___.
Fever Tenderness and swelling postop Chills Weakness Normal LFT's Leukocytosis Sepsis pg. 466
What tumor consists of large blood filled spaces?
Hemangioma
pg. 256
What cells does hepatocellular disease attack?
Liver cells (Hepatocytes) pg. 213
Glycogen storage disease type 1 is the most common, it is also known as ___.
von Gierke’s disease
pg. 239
What is the benign liver tumor located near the free edge of the liver?
Liver cell adenoma
pg. 258
What common malignancies affect the pediatric population?
Neuroblastoma Nephroblastoma (Wilm's Tumor) Hepatoblastoma Hepatocellular Carcinoma Leukemia Lymphoma pg. 697-698
In cases of choledocholithiasis, stones tend to lodge in ___.
the Ampulla of Vater
CBD?
pg. 295
The right and left hepatic ducts emerge and unite to form ___.
Common hepatic duct
pg. 268
What is the size of the common hepatic duct?
4 mm
pg. 268
In a 60 year old adult, how big should the common duct be?
6 mm
pg. 268
What is a phyrigian cap of the GB?
Folding of the fundus
pg. 273
What is the function of the GB?
Reservoir for bile and concentration of bile
pg. 273
What is a fold in the neck of the GB called?
Hartmann’s pouch
pg. 273
What is a positive Murphy’s sign?
Acute RUQ pain when palpating area
pg. 281
What are classic symptoms of GB disease?
RUQ pain after eating greasy food Nausea/vomiting Pain in right shoulder Jaundice pg. 278-279
What is inflammation of the GB?
Cholecystitis
pg. 281
What are the small polypoid masses that arise from the GB wall?
Cholesterolosis
pg. 288
What is the sonographic criteria for cholelithiasis?
Increased size Wall thickness Presence of internal reflections w/in lumen Posterior acoustic shadowing pg. 284
What is a porcelain GB?
Calcium incrustation of the gallbladder wall
Appears hyperechoic with posterior shadowing
pg. 288
What is sludge?
Thickened bile
Low level internal echoes
Nonshadowing
pg. 279
Where are the valves of Heister located?
In the neck of the GB
pg. 273
What are ALL of the effects of a fatty meal?
Causes the GB to contract because it pushes bile into the duodenum
pg. 273
What cavity does the pancreas lie in?
Retroperitoneal cavity
pg. 302
Also note that it is in the epigastrium and a portion lies in the left hypochondrium….behind the lesser sac.
What duct is in the pancreatic head?
Duct of Santorini
pg. 308
What structure is on the anterolateral border of the pancreatic head?
Gastroduodenal Artery
pg. 309
What is the primary pancreatic duct?
Duct of Wirsung
pg. 308
What is hemorrhagic pancreatitis?
Acute pancreatitis with rupture of vessels
Usually occur in alcoholics
Homogenous mass that can be septated and later becomes cystic
pg. 323-324
What veins course sagittal and posterior to the neck of the pancreas?
Superior Mesenteric Vein
Main Portal Vein
pg. 309
What is adenocarcinoma of the pancreas?
Most common primary neoplasm of pancreas
Symptoms: Jaundice, weight loss, nausea, palpable GB
Sonographic: Loss of parenchymal pattern, hypoechoic, irregular borders, biliary duct dilation
pg. 329-330
What is the duct of santorini?
Accessory duct located in the head of the pancreas
pg. 308
What is the normal size of the pancreatic duct?
Less than 2 mm
pg. 308
When a patient has acute pancreatitis, what lab value will be elevated 2 times the normal limit?
Amylase
pg. 311
What are the microscopic cells of the pancreas called?
Acini cells
Islets of Langerhans
pg. 310
The splenic vein courses ___ in reference to the pancreas?
posterior
pg. 309
What is the most common cause for acute pancreatitis?
Biliary tract disease
pg. 317
What is an annular pancreas?
Rare anomaly in which the head of the pancreas surrounds the second portion of the duodenum
pg. 309
What is cystic fibrosis?
Heredity disease that causes excessive production of thick mucus by the endocrine glands
Pancreas is replaced with fatty tissue and sometimes calcifications
pg. 327
In cases of acute pancreatitis, what does it look like sonographically?
Enlarged Hypoechoic Indistinct, but smooth borders IVC may be compressed Peripancreatic fluid collections pg. 319
What is the most common obstructive congenital obstruction in utero and in infants?
UPJ
pg. 713
Where are parapelvic cysts located?
Renal sinus or pelvis
pg. 380
What is the most common solid renal mass found in childhood?
Nephroblastoma (Wilm’s tumor)
pg. 387
What is fusion of the lower poles of the kidneys?
Horseshoe kidney
pg. 371
What is the most echogenic portion of the kidney?
Renal sinus
pg. 359
What is a cystlike enlargement of the lower end of the ureter?
Ureterocele
pg. 373