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Abdomin And Superficial Structures > Abdominal Wall > Flashcards

Abdominal Wall Flashcards

1
Q

What are the indications for an abdomen wall US?

A
  • Palpable mass (wall vs abdomen)
  • Surgical wound assessment
  • Trauma
  • Findings on other imaging modalities
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2
Q

Describe the scanning technique

A
  • High frequency linear transducer

- Minimal pressure used

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3
Q

Is pt prep required for scanning the abdominal wall?

A

No

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4
Q

What are the 3 abdominal wall layers?

A
  1. Epidermis
  2. Subcutaneous tissue
  3. Muscle
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5
Q

How thick is the epidermis?

A

1-4mm

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6
Q

What is the echogenicity of the epidermis?

A

Highly reflective layer, appears echogenic

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7
Q

What tissue is the subcutaneous layer made of?

A

Fat

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8
Q

How thick is the subcutaneous layer?

A

Variable

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9
Q

What is the echogenicity of the subcutaneous layer?

A

Variable- typically less echogenic than muscle

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10
Q

What factors influence echogenicity of fat?

A

Water content determines echogenisty of fat:
greater the water content- greater the echogenisty because there are multiple interfaces- all these interfaces are hyperechoic

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11
Q

Describe the rectus abdominis

A

Paired, midline anterior to abdominal wall

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12
Q

Where is the origin of the rectus abdominis?

A

PS and pubic crest and inserts into the xiphoid process and costal cartilage

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13
Q

What separates the rectus abdominis midline?

A

Linea alba

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14
Q

What encloses the RA muscle?

A

Rectus sheath

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15
Q

What forms the RA muscle?

A

Aponeuroses of the internal, external and transverse abdominus

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16
Q

What is the aponeuroses?

A

Flat sheets of strong, fibrous connective tissue that serve as tendons to attach muscle to fixed points

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17
Q

How many tendinous insertions attach the rectus shealth

A

3

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18
Q

What pathology can be seen by the 3 tendinous insertion points of the rectus sheath?

A

Localized hematomas

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19
Q

What is the linea alba?

A

Fibrous band that extends from the xiphoid to the PS

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20
Q

What forms the linea alba?

A

Aponeuroses of the 3 lateral abdominal muscles

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21
Q

Where is the linea alba the widest?

A

Above umbilicus

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22
Q

What common artifact does the linea alba cause?

A

Refractive duplication artifact

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23
Q

What is the sonographic appearance of the linea alba?

A

Echogenic

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24
Q

What is the arcuate line?

A

Point b/w umbilicus and symphysis where the posterior portion of the rectus sheath passes in front the rectus muscle

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25
Q

Where does the external oblique originate?

A

Outer surface of the lower 8 ribs

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26
Q

Where does the external oblique muscle insert into?

A

Xiphoid, linea alba, pubic bone and anterior iliac crest

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27
Q

What is the most outer layer of the abdominal muscle?

A

External oblique

28
Q

Where does the internal oblique muscle originate?

A

Lumbar fascia, anterior iliac crest and inguinal ligament

29
Q

Where does the internal oblique muscle insert?

A

Into the lower 3 ribs, xiphoid, linea alba and SP

30
Q

How does the internal oblique run in comparison to the external oblique?

A

Runs 90 deg to the external oblique

31
Q

Where does the transversus abdominis originate?

A

Lower 6 ribs, lumbar fascia, iliac crest and inguinal ligament

32
Q

Where does the transversus abdominis insert?

A

Xiphoid process, linea alba and PS

33
Q

What is the sonographic appearance of the muscle?

A

Hypoechoic to sonolucent
Striated appearance
Specular reflectors

34
Q

What are the 3 posterior wall muscles?

A
  1. Psoas Major
  2. Quadratus Lumborum
  3. Iliacus
35
Q

What is the shape of the psoas muscle?

A

Fan shaped

36
Q

Where does the psoas muscle originate?

A

Sides of the vertebral column

37
Q

Where does the psoas muscle insert?

A

Lesser trochanters of femurs

38
Q

How does the psoas muscle appear sonographically?

A

Hypoechoic and lateral to the spine

39
Q

Where is the QL positioned in comparison to the psoas muscle?

A

Posterolateral

40
Q

Where does the QL originate?

A

Iliac crest

41
Q

Where does the QL insert?

A

12th rib and upper 4th lumbar vertebrae

42
Q

Where is the QL positioned compared to the kidney?

A

Posterior

43
Q

Where does the Iliacus originate?

A

Iliac fossa, sacrum and SI jts

44
Q

Where does the iliacus insert?

A

Psoas major and lesser trochanters

45
Q

What is the inguinal canal?

A

Obliquely oriented tunnel

Slit like structure

46
Q

How does the inguinal canal run?

A

Inferior and medial

47
Q

What is the deep inguinal ring?

A

Opening at the superior end of the canal - defect in the transversalis fascia

48
Q

Where is the deep inguinal canal located?

A

Midway b/w anterior superior iliac spine and PS

49
Q

What is the superficial inguinal ring?

A

Opening at the inferior end of the canal

50
Q

Where does the superficial inguinal ring go through?

A

External oblique aponeurosis

51
Q

What structures does the inguinal canal contain?

A

Spermatic cord and round ligament of uterus

52
Q

What forms the anterior wall of the inguinal canal?

A

Aponeurosis of the external oblique muscle

53
Q

What forms the posterior wall of the inguinal canal?

A

Transversalis fascia

54
Q

What is the diaphragm made of?

A

Muscle and tendon

55
Q

Where does the diaphragm originate?

A

At the periphery of the thoracic cage with 3 groups of muscle fibres

56
Q

What are the 3 groups of muscle fibres of the thoracic cage?

A
  1. Lumbar spine (crura)- right (border and longer) and left
    Join in midline to form the arcuate line
  2. Lower sternum
  3. Lower 6 ribs
57
Q

Where do the 3 groups of muscle fibres converge radially and insert into?

A

Central tendon

58
Q

How does the crura appear sonographically?

A

Thin- hypoechoic band

Superior to CA- ant to aorta

At CA- lat to aorta

Posterior to IVC

59
Q

What are the 2 scanning approaches used in US to assess the pleural space?

A

Abdominal approach (subcostal) and intercostal

60
Q

What are the 2 windows used when scanning the inferior pleura spaces?

A

Liver and spleen

61
Q

What is the normal thickness of the diaphragm?

A

5mm or less

62
Q

What is a mirror image artifact an indication of when identified in the plerual space?

A

Evidence of absense of pleural fluid

63
Q

What is the distance of the pleural space from the rib interface when scanning intercostally?

A

Pleural space within 1cm from rib interface

64
Q

What is the difference between the sonographic appearances of the visceral pleura
compared to the parietal pleura?

A

Visceral- bright linear interface, moves with respiration “gliding sign”
Parietal- weak echogenic line or obscured, hypogenic separation of visceral and parietal pleura

65
Q

What is the meaning of the gliding sign?

A

When the visceral layer moves with respiration

Abdomin And Superficial Structures (12 decks)

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