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DMST 254 ABD 1 > Adrenal, spleen, lymphatics and more socrative > Flashcards

Adrenal, spleen, lymphatics and more socrative Flashcards

1
Q

Which of the following terms refers to a decrease in white blood cells?

  1. Leukocytosis
  2. Leukopenia
  3. Leukomalacia
  4. Leukorrhea
A

Leukopenia

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2
Q

Which of the following are the characteristic folds demonstrated in the large bowel

  1. Haustra
  2. Valvulae conniventes
  3. Teniae coli
  4. Rugae
A

Haustra

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3
Q

Which of the following is produced by the adrenal medulla?

  1. Aldosterone
  2. Glucocorticoids
  3. Estrogen
  4. Catecholamines
A

Catecholamines

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4
Q

In a normal adult, which of the following would most be echogenic?

  1. Liver
  2. Spleen
  3. Renal sinus
  4. Muscle
A

Renal sinus

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5
Q

Which of the following substances is secreted by the stomach mucosa?

  1. CCK
  2. Gastrin
  3. Secretin
  4. Amylase
A

Gastrin

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6
Q

Which of the following can be mistaken for pathology when performing an ultrasound of the spleen?

  1. Left lobe of the liver
  2. Tail of the pancreas
  3. Fluid in the stomach
  4. All of the above
  5. None of the above
A

All of the above

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7
Q

Which of the following abdominal wall muscles are located most anteriorly?

  1. Rectus abdominis
  2. External Oblique
  3. Internal Oblique
  4. Transversus Abdominis
A

Rectus abdominis

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8
Q

The left crus of the diaphragm is longer and broader than the right? T/F

A

False

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9
Q

The term gliding sign refers to the movement of the parietal pleura during respiration. T/F

A

False

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10
Q

Cortisone is produced in which area of the adrenal gland?

A

Zona Fasciculata

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11
Q

Which of the following describes the sonographic appearance of a neonatal adrenal gland?

  1. Hypoechoic core, anechoic rim
  2. Hypoechoic core, Hyperechoic rim
  3. Hyperechoic core, Hypoechoic rim
  4. Anechoic core, hyperechoic rim
A

Hyperechoic core, Hypoechoic rim

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12
Q

What term would be used to describe a spleen that is 16 cm in length?

A

Moderate splenomegaly

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13
Q

Which of the following statements regarding the white pulp of the spleen is true?

  1. Produces antibodies
  2. Composed of splenic sinuses
  3. Lined with phagocytic cells
  4. Represents the venous component
A

Produces antibodies

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14
Q

What is the name of the extracellular fluid that circulates around the cells of the body?

A

Interstitial fluid

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15
Q

Which of the following statements regarding lymph nodes is false?

  1. Part of the RE system
  2. Surrounded by a capsule
  3. Cluster along lymph vessels
  4. Often a site of primary disease
A

Often a site of primary disease

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16
Q

Enlarged para-aortic lymph nodes may mimic an aneurysm T/F?

A

True

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17
Q

The esophagus pierces the diaphragm at what level?

A

T10

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18
Q

Which of the following statements regarding the cecum is false?

  1. Located superior to the ileocecal valve
  2. Pouch-like area of the origin of the ascending colon
  3. Located in the RLQ of the abdomen
  4. Appendix extends from the inferior margin
A

Located superior to the ileocecal valve

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19
Q

What term best describes the echogenicity of the submucosal layer of the GI tract?

A

Hyperechoic

(the layers that start with a m, is hypoechoic)

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20
Q

The GI tract has endocrine function, T/F?

A

True

The stomach excretes gastrin

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21
Q

Sonographic assessment of a non-distended bowel segment demonstrates a single wall thickness of 6 mm. This measurement is consistent around the entire circumference. What do these findings indicate?

A

Thickened bowel wall; likely inflammatory

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22
Q

The linea alba can cause which of the following imaging artifacts?

  1. Mirror image
  2. Refractive duplication
  3. Reverberation
  4. Posterior enhancement
A

Refractive duplicaiton artifacts

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23
Q

Which of the following muscles runs horizontally in the body?

  1. Rectus abdominus
  2. External oblique
  3. Internal Oblique
  4. Transversus abdominus
A

Transversalis abdominus

its in the name “transverse”

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24
Q

Which of the following describes the path taken by the inguinal canal in the body?

  1. Inferior and medial
  2. Inferior and lateral
  3. Anterior and medial
  4. Anterior and lateral
A

Inferior and Medial

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25
Q

Increased water content increases the echogenicity of fat on ultrasound. T/F?

A

True

Fat and water don’t mix, they layer/ interfaces, Interfaces increase echogenicity

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26
Q

Which of the following imaging artifacts is evidence of the absence of fluid in the pleural space?

  1. Mirror image
  2. Refractive duplication
  3. Posterior shadowing
  4. Posterior enhancement
A

Mirror image

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27
Q

Left anterolateral abdominal wall. Identify the wall layer indicated by the number “1”?

A

Left external oblique muscle

  1. Internal Oblique muscle
  2. External Oblique muscle
  3. Transversalis abdominus
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28
Q

Midline abdominal wall. What is the name of the structure indicated by the arrow?

A

Linea Alba

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29
Q

The adrenal is a double endocrine gland composed of what two parts?

A
  1. Cortex (90% of the gland, essential for life)
  2. Medulla (10% of the gland)
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30
Q

The adrenal glands sit how in relation to the kidneys?

A
  1. Anterior
  2. Medial
  3. Superior
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31
Q

The adrenals are retroperitoneal and are located in which space?

A

Perirenal space

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32
Q

The adrenals are often described as having what type of configuration?

A

V,Y, or Z configuration

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33
Q

Which adrenal is usually slightly larger?

A

The left adrenal is usually slightly larger than the right

34
Q

Unlike an adult, in the newborn the adrenal glands are proportionally _________ compared to the kidneys?

35
Q

The adrenal cortex secretes what hormones which are what to life?

A

The adrenal cortex secretes steroid hormones which are essential to life

36
Q

From outer to inner, name the three zones of the adrenal cortex and the hormones they produce?

A
  1. Zona glomerulosa: Mineralocorticoids
  2. Zona Fasciculata: Glucocorticoids (cortisone)
  3. Zona Reticularis: Sex hormones (androgens and estrogens)
37
Q

The adrenal medulla is the _________ portion of the gland and is responsible for the _____________ response?

A
  1. Central portion
  2. Fight or flight
38
Q

The medulla secretes what catecholamines?

A
  1. Epinephrine
  2. Norepinephrine
39
Q

Describe the sonographic appearance of the adrenal gland in an adult

40
Q

Describe the sonographic appearance of the adrenal gland in an neonate

41
Q

What is the scanning technique to approach the right adrenal?

A
  1. Intercostal approach
  2. Supine or LLD/LPO
  3. Use liver as a window
42
Q

What is the scanning technique meant to approach the left adrenal?

A
  1. Intercostal approach
  2. RLD or RAO
  3. Use spleen and left kidney as a window
43
Q

The spleen is the largest unit of the ____________________ system. This system refers to all cells and tissue that exhibit ______________?

A
  1. Reticuloendothelial (RE)
  2. Phagocytosis
44
Q

During fetal development, the spleen plays a role in what?

A

Hematopoiesis: the formation of blood

45
Q

The spleen is an intraperitoneal organ located in the ________ region

A

Left hypochondrium

46
Q

The long axis of the spleen runs along the long axis of the ______ rib?

47
Q

The size of the spleen can be quite variable but it typically measures less then ___ cm in length?

48
Q

What is red pulp?

A
  1. consists of venous sinuses and splenic cords
  2. The venous sinuses are lined with phagocytic cells which destroy pathogens in the blood
49
Q

What is the white pulp?

A

Tiny islands of tissues in the spleen which contains lymphocytes and produces antibodies

50
Q

What are the RE functions of the spleen?

A
  1. Produce lymphocytes and antibodies
  2. Storage of iron and metabolites
51
Q

What are other organ specific functions of the spleen that are not RE focused?

A
  1. Filter blood (destruction/ removal of old RBCs)
  2. Blood reservior
  3. Erythropoiesis (fetus)
52
Q

Describe the sonographic appearance of the spleen

A
  1. Homogenous echotexture
  2. Always more echogenic than the kidney
  3. Isoechoic or slightly more echogenic than the live
  4. Crescent shaped
53
Q

Name 3 normal anatomical structures that can be mistaken for pathology when scanning the spleen

A
  1. Left lobe of the liver (pseudoperisplenic lesion)
  2. Tail of the pancreas (mistaken for a mass in the hilar region)
  3. The stomach (when fluid is present in the stomach it can be mistaken for a cystic mass in the hilar area)
54
Q

Name the variant

55
Q

The lymphatics are the drainage system of the body, returning extracellular fluid to the bloodstream. The anatomy is similar to the circulatory system with what three exceptions?

A
  1. No pump
  2. Fluid moves in one direction
  3. Nodes
56
Q

The lymphatics are located throughout the body and course along the ___________ system

A

Circulatory

57
Q

Name the four functions of the lymphatic system

A
  1. Phagocytosis
  2. Immunity
  3. Tissue drainage
  4. Secretion (the absorption and circulation of end produces of fat digestion)
58
Q

Name the sites where lymph nodes may be identified on ultrasound

A
  1. Para- aortic and para- caval
  2. Mesenteric and celiac areas
  3. Around the pancreas
  4. Splenic and renal hilum
  5. Porta hepatis
  6. Along the iliac vessels
59
Q

Describe the sonographic appearance of the lymph nodes on an abdominal ultrasound

A
  1. Normal nodes are often not visualized
  2. < 1cm in size
  3. Homogenous with low level echoes
60
Q

Which of the following images represent the appearance of abnormal nodes on ultrasound?

A

They all do!

Top left: abnormal nodes surrounding the celiac and SMA
Top right: Abnormal nodes surrounding the aorta
Bottom Left: Abnormal nodes encasing the aorta transverse image
Bottom right: Enlarged nodes in the region of the renal hilum can cause hydronephrosis (The nodes are not seen in this iamge- just the hydro they are causing)

61
Q

Name all the organs/ components of the GI tract

A
  1. Esophagus
  2. Stomach
  3. Small bowel
  4. Large bowel
62
Q

What are the components of the Small bowel?

A
  1. Duodenum
  2. Jejunum
  3. Ileum
63
Q

What is the components of the large bowel?

A
  1. Cecum
  2. Colon (Ascending, transverse, descending)
  3. Sigmoid
  4. Rectum
  5. Anal canal
64
Q

What the following segments of the GI tract state whether they are intraperitoneal or retroperitoneal

  1. 1st part of the duodenum
  2. 2nd part of the duodenum
  3. 3rd and 4th part of the duodenum
  4. Ascending and descending colon
  5. Transverse colon
A
  1. Intraperitoneal
  2. Retroperitoneal
  3. Retroperitoneal
  4. retroperitoneal
  5. Intraperitoneal
65
Q

The gut has how many distinct histological layers?

66
Q

On ultrasound, we may perceive as many as _______layers of the gut? and what? What is this refered to?

A
  1. 5 layers because the lumen may look like a layer
  2. This is referred to as the gut signature
67
Q

For each of the following layers, state whether it will appear hypoechoic or hyperechoic on ultrasound
1. Lumen
2. Mucosa
3. Submucosa
4. Muscularis
5. Serosa

A
  1. Hyperechoic
  2. Hypoechoic
  3. Hyperechoic
  4. Hypoechoic
  5. Hyperechoic
68
Q

What are the distinct folds or markings associated with the stomach and how it can or can not be identified on ultrasound?

A

Rugae - Disappear when the stomach is distended

69
Q

What are the distinct folds or markings associated with the small bowel and how it can or can not be identified on ultrasound?

A

Valvulae conniventes: folds that are 3-5 mm apart and, most prominent in the duodenum and visible even when the bowel is distended

70
Q

What are the distinct folds or markings associated with the large bowel and how it can or can not be identified on ultrasound?

A

Haustral markings - located 3-5 cm apart

71
Q

List the three things a sonographer should assess when performing an ultrasound of the GI tract:

A
  1. Diameter (normal or distended)
  2. Content (excessive fluid)
  3. Motor activity (Increased or decreased peristalsis)
72
Q

What are these arrows pointing to?

73
Q

What is gastrin?

A
  1. Endocrine hormone released by the stomach
  2. Stimulates secretion of gastric acid
74
Q

What is CCK?

A
  1. Released by the duodenum into the blood when fats are ingested
  2. Controls GB contractions
75
Q

What is secretin?

A
  1. Released by the duodenal mucosa
  2. Stimulates the secretion of bicarbonate by the pancreas
76
Q

Identify the subcutaneous layer in the image provided and describe its typical sonographic appearance

A
  1. Subcutaneous layer of fat
  2. Fat or variable thickness and echogenicity (echogenicity is related to water content)
  3. Typically less echogenic than muscle
77
Q

Identify the three anterolateral muscles in the image provided and describe their typical sonographic appearance

A

These anterolateral muscles are
1. Hypoechoic to sonolucent
2. Striated in appearance

78
Q

The adjacent image was taken from an anterior midline abdominal window. What muscles and associated and midline structures can be identified?

A

The rectus abdominis muscles and the linea alba

79
Q

Three muscles make up the posterior abdominal wall; two can be well seen on ultrasound. Name the three muscles of the posterior wall and identify the two represented in the adjacent image?

A
  1. Psoas major
  2. Quadratus lumborum
  3. Iliacus
80
Q

The diaphragm is the dome shaped musculotendinous partition separating the ______________ from the _____________ cavity. It is the major active muscle in ___________. It is commonly associated with ________ artifact.

A
  1. Thorax
  2. Abdominal
  3. Respiration
  4. Mirror image
81
Q

The inguinal canal is an obliquely oriented tunnel that runs _______ and ________. It has an opening at either end; the _____ and ______ inguinal rings. The most common abnormality involving the inguinal canal is a ______.

A
  1. Inferior
  2. Medial
  3. Deep
  4. Superficial
  5. Hernia

DMST 254 ABD 1 (26 decks)

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