ARRT abdomen 10 Flashcards
hypokalemia
low potassium
low potassium
hypokalemia
hyperfunctioning medullary tumor of adrenal gland
pheochromocytoma
too much epinephrine and norepinephrine, like a constant adrenaline rush
pheochromocytoma
Clinical symptoms of pheochromocytoma
uncontrollable hypertension
tachycardia
tremors
sweating
headaches
anxiety
Sonographic appearance of pheochromocytoma
large
hyperechoic
may be heterogeneous
____ is rare in adults and typically will present with Cushing syndrome
Adrenal carcinoma
Ectopic or accessory adrenal tissue
Adrenal rests
Adrenal rests may be found on the _____
testicles
most common extracranial malignancy in pediatrics
neuroblastoma
Neuroblastoma is most common “extracranial” because it technically can be in any location as it is a _____ cancer.
nervous system
The most common location of a neuroblastoma is:
adrenal glands
Neuroblastomas are typically found in children aged:
less than 5 years old
clinical symptoms of neuroblastoma
palpable mass
pain
Neuroblastoma may be related to:
Beckwith-Wiedemann syndrome
Sonographic appearance of neuroblastoma
large, heterogeneous mass
liver metastasis
Neuroblastoma is the most common _____ cancer in pediatrics.
EXTRACRANIAL
Nephroblastoma is the most common ____ cancer in pediatrics.
ABDOMINAL
______ is the most common abdominal cancer in pediatrics
nephroblastoma
most common adrenal pathology in newborns
adrenal hemorrhage
spontaneous hemorrhage in stressed neonates especially after traumatic birth or perinatal anoxia
adrenal hemorrhage
clinical symptoms of adrenal hemorrhage:
neonate
decreased hematocrit
drop in blood pressure
Sonographic appearance of adrenal hemorrhage
varied echotexture depending on age
The abdominal aorta originates at the:
crus of the diaphragm
The first branch of the abdominal aorta is:
celiac artery/axis/trunk
Celiac artery branches:
common hepatic artery
left gastric artery
splenic artery
“seagull” sign
celiac trunk with common hepatic artery and splenic artery in transverse
Superior mesenteric artery arises ____ to celiac artery
inferior
Renal branches arise just below or distal to the:
superior mesenteric artery
The renal arteries are ____ to the renal veins
posterior
The right renal artery is ____ to the IVC
posterior
innermost layer of artery, covered by endothelium
intima
Thickest layer of the artery, made of smooth muscle and connective tissue, middle layer
media
outer, fibrous connective tissue of the artery, contains vasa vasorum
externa/adventitia
3 layers of an artery
intima
media
externa/adventitia
tiny vessels that supply blood to vessel walls
vasa vasorum
Organs require ____ perfusion (flow)
constant
Any artery feeding an organ will be ___ resistance
low
Low resistance means more ____ flow.
volume
The greater the diastolic flow, the ____ the resistance.
lower
The ___ diastolic flow, there is, the higher the pulsatility
less
increased end diastolic velocity
decreased resistive index
decreased pulsatility index
decreased impedance
low resistance
decreased end diastolic flow
diastolic flow reversal
absent diastole
increased resistive index
increased pulsatility index
increased impedance
high resistance
Low resistance arteries (5)
celiac trunk
hepatic artery
splenic artery
renal arteries
post-prandial SMA
High resistance arteries (3)
infrarenal aorta
iliac arteries
fasting/pre-prandial SMA
AAA measures greater than
3 cm
True aneurysm
all 3 layers are dilated
Most common AAA
fusiform
Most common location AAA
infrarenal
Most common cause of AAA
atherosclerosis
Clinical symptoms of AAA
abdominal/back pain
bounding abdominal pulsation
Sonographic appearance of AAA
dilatation >3cm
may have internal thrombus
overall vessel enlargement AAA
fusiform
most common type of AAA
fusiform
sac-like dilatation or outpouching of aorta
saccular
AAA with high risk of rupture, critical report needed
> 6cm
Normal iliac arteries measurement
1.0-1.2 cm
True lumen measured ____ wall to ____ wall and ____ to axis of aorta
outer
outer
perpendicular
separation or tear of intima from the medial layer aorta
aortic dissection
weakening of walls of aorta
increased risk of aneurysms and dissections
Marfan Syndrome
Clinical symptoms of aortic dissection
severe abdominal, chest, and back pain
Sonographic appearance of aortic dissection
intimal flap or lining floating inside aorta
puncture through all 3 layers creating a pulsating hematoma connected by a neck or channel to the native artery
pseudoaneurysm
When do pseudoaneurysms often occur?
procedure or trauma
Sonographic appearance of pseudoaneurysm
pocket of swirling blood with communicating neck or channel to artery
bidirectional flow/ to and fro pattern
connection between artery and vein most often following trauma or interventional procedures
arteriovenous malformation/fistula
flow patterns will be low resistance in the artery, high velocity/turbulent through the connection with arterial-like and pulsatile waveform of the outflow vein
arteriovenous malformation/fistula
arterial obstruction in celiac trunk and SMA
mesenteric ischemia
Signs of arterial stenosis
elevated velocities
spectral broadening
Clinical symptoms of mesenteric ischemia
post-prandial pain
weight loss
Sonographic signs of mesenteric ischemia
abnormal flow patterns
elevated velocities in CA or SMA
abnormal waveform resistance in post-prandial SMA
prominently seen IMA
The IVC is formed by the union of:
common iliac veins
The renal veins drain into the ___
IVC
The left renal vein crosses ___ to the aorta and ____ to the SMA
anterior
posterior
The most superior contribution to the IVC
hepatic veins
The IVC terminates when draining into:
right atrium
The normal IVC measures up to ___ cm and varies in size with respiration
2.5
Venous flow becomes more ____ as it gets closer to the heart
pulsatile
The ____ system is unrelated to the IVC system.
portal venous
“playboy” sign
hepatic vein and IVC enlargement
The IVC is considered enlarged if measures more than:
2.5 cm
IVC enlargement is caused by:
right sided heart failure
IVC tumor thrombus is related to ____ or hypernephroma and _____ or nephroblastoma
renal cell carcinoma
Wilms tumor
IVC tumor thrombus happens because of cancer invasion via:
renal veins
venal caval filter or Greenfield tumor placed in ____ IVC
infrarenal
reduces risk of pulmonary embolism in high risk patients
IVC filter
Where do you look for Nutcracker syndrome?
left renal vein
Where do you look for tardus parvus renal artery stenosis?
segmental artery
Where do you look for post-prandial pain?
SMA or celiac
Where do you look for solid renal mass?
IVC by the renal artery
Where do you look for Greenfield filter?
IVC or infrarenal IVC
Where do you put the calipers to measure for AAA?
outer borders perpendicular to axis of aorta
_____ sonography useful in determining normal from abnormal bowel.
Graded compression
GUT SIGNATURE inner to outer
superficial mucosa
deep mucosa
submucosa
muscularis
serosa
Superficial mucosa sonographic appearance
Echogenic
Deep mucosa sonographic appearance
hypoechoic
Submucosa sonographic appearance
echogenic
Muscularis sonographic appearance
hypoechoic
Serosa sonographic appearance
echogenic
inflammation of the vermiform appendix
acute appendicitis