Fill in the Blanks

Question 1

Because of the _____________ ligament attachments, collections in the right posterior subphrenic space cannot extend between the bare area of the liver and the diaphragm.

Answer 1

Coronary

Question 2

The pleural fluid tends to distribute ____________ in the chest.

Answer 2

posteromedially

Question 3

Subcapsular liver and splenic collections are seen when they are ____________ to the diaphragm unilaterally and conform to the shape of an organ capsule.

Answer 3

inferior

Question 4

A mass is confirmed to be within the retroperitoneal cavity when anterior renal displacement or anterior displacement of the dilated _______________ can be documented.

Answer 4

ureters

Question 5

The mass interposed ______________ or superiorly to kidneys can be located either intraperitoneally or retroperitoneally.

Answer 5

anteriorly

Question 6

Fatty and collagenous tissues in the perirenal or anterior pararenal space produce echoes that are best demonstrated on ____________ scans.

Answer 6

sagittal

Question 7

Retroperitoneal lesions displace echoes ____________ and cranially.

Answer 7

ventrally

Question 8

Hepatic and subhepatic lesions produce _____________ and posterior displacement.

Answer 8

inferior

Question 9

A large, right-sided retroperitoneal mass rotates the intrahepatic portal veins to the ____________.

Answer 9

left

Question 10

The peritoneal cavity is made up of multiple peritoneal ligaments and folds that connect the ___________ to each other and to the abdominopelvic __________.

Answer 10

viscera; walls

Question 11

Within the cavity are found the lesser and greater ______________, the ____________ and multiple fluid spaces (lesser sac, perihepatic and subphrenic spaces).

Answer 11

omentum; mesenteries

Question 12

The ____________ is a smooth membrane that lines the entire abdominal cavity and is reflected over the contained organs.

Answer 12

peritoneum

Question 13

The part that lines the walls of the cavity is the ____________ peritoneum, whereas the part covering the abdominal organs to a greater or lesser extent is the ____________ peritoneum.

Answer 13

parietal; visceral

Question 14

The general peritoneal cavity is known as the ___________ sac of the peritoneum.

Answer 14

greater

Question 15

With the development of the stomach and the spleen, a smaller sac, called the _____________ sac (omental bursa), is the peritoneal recess posterior to the stomach.

Answer 15

lesser

Question 16

This sac communicated with the greater sac through a small vertical opening known as the _____________ foramen.

Answer 16

epiploic

Question 17

When the patient is lying supine, the lowest part of the body is the _____________.

Answer 17

pelvis

Question 18

A double layer of the peritoneum extending from the liver to the lesser curvature of the stomach is known as the ____________ omentum.

Answer 18

lesser

Question 19

The _________ omentum is an apron-like fold of peritoneum that hangs from the greater curvature of the stomach.

Answer 19

greater

Question 20

Ligaments on the right side of the liver form the ____________ and _____________ spaces.

Answer 20

subphrenic; subhepatic

Question 21

The subphrenic space is divided into right and left components by the _______________ ligaments.

Answer 21

falciform

Question 22

The __________________ hepatis ascends from the umbilicus to the umbilical notch of the liver within the free margin of the falciform ligament before coursing within the liver.

Answer 22

ligamentum teres

Question 23

The paired ___________ abdominis muscles are delineated medially in the midline of the body by the linea alba.

Answer 23

rectus

Question 24

The amount of intraperitoneal fluid depends on the _____________, ________________, and the patient ______________.

Answer 24

location; volume; position

Question 25

The ascitic fluid first fills the ______________, then the lateral paravesical recesses before it ascends to both paracolic gutters.

Answer 25

pouch of Douglas

Question 26

The small bowel loops _____________ or _____________ in the surrounding ascitic fluid, depending on relative gas content and amount of fat in the mesentery.

Answer 26

floats; sinks

Question 27

Inflammatory or malignant ascites appears with ________________ echoes; loculation; unusual distribution, matting or clumping of bowel loops; and thickening of interfaces between the fluid and neighboring structures.

Answer 27

fine or coarse internal

Question 28

A cavity formed by necrosis within a solid tissue or a circumscribed collection of purulent material is a(n) ______________.

Answer 28

abscess

Question 29

Name the five major pathways through which bacteria can enter the liver and cause abscess formation.

Answer 29

1. through the portal system
2. by way of ascending cholangitis of the common bile duct
3. via the hepatic artery secondary to bacteremia
4. by direct extension from an infection
5. by implantation of bacteria after trauma to the abdominal wall

Question 30

Extrahepatic loculated collections of bile that may develop because of iatrogenic, traumatic, or spontaneous rupture of the biliary tree are _______________.

Answer 30

bilomas

Question 31

An abscess that forms within the renal parenchyma is a(n) _______________. Clinical symptoms vary from none to fever, leukocytosis, and flank pain.

Answer 31

Renal carbuncle

Question 32

The most common abdominal pathologic process is ____________, which requires immediate surgery.

Answer 32

acute appendicitis

Question 33

A mass or lesion within the mesentery and omentum may have solid or cystic characteristics, whereas a mass within the peritoneum may show a(n) _________________ pattern.

Answer 33

infiltrative

Question 34

Mesenteric and omental cysts may be uniloculated or _________________ with smooth walls and thin internal septations.

Answer 34

multiloculated

Question 35

An incomplete regression of the urachus during development is a(n) ____________ cyst.

Answer 35

urachal

Question 36

An encapsulated collection of urine, or ______________, may result from a closed renal injury, from surgical intervention, or it may arise spontaneously secondary to an obstructing lesion.

Answer 36

urinoma

Question 37

The most common primary sites of peritoneal metastases are the ______________, ______________ and ______________.

Answer 37

ovaries; stomach; colon

Question 38

The _______________ sign of lymphoma represents a mass infiltrating the mesenteric leaves and encasing the superior mesenteric artery.

Answer 38

sandwich

Question 39

A key factor in determining if an abdominal wall mass is present is the ________________ of the rectus sheath muscles.

Answer 39

symmetry

Question 40

A collection of fluid that occurs after surgery in the pelvis, retroperitoneum, or recess cavities is known as a(n) _____________.

Answer 40

lymphocele

Question 41

Extraperitoneal rectus sheath ____________ are acute or chronic collections of blood lying either within the rectus muscle or between the muscle and its sheath.

Answer 41

hematomas

Question 42

An abdominal __________ is the protrusion of a peritoneal-lined sac through a defect in the weakened abdominal wall.

Answer 42

hernia

Question 43

A variant of the ventral hernia that is found more laterally in the abdominal wall is a(n) _____________ hernia.

Answer 43

spigelian

Question 44

List the four sonographic criteria for a hernia.

Answer 44

1. demonstration of an abdominal wall defect
2. presence of bowel loops or mesenteric fat within a lesion
3. exaggeration of the lesion with strain (Valsalva)
4. reducibility of the lesion by gentle pressure