final Flashcards
What are the landmark structures for locating the gb?
portal triad: portal vein, hepatic artery, CBD, gb fossa, main lobar fissure
What is the most common cause of acute pancreatitis?
biliary tract disease
What is Gerota’s Fascia?
surrounds the true capsule and perinepheric fat of kidney
What condition is increased pressure within the portal-splenic venous system?
extrahepatic portal hypertension
If you have a small, hyperechoic pancreas with calcifications, what is this?
chronic pancreatitis
What structure divides the left lobe into two segments?
falciform ligamnet and ligamentum teres
Cholecystokinin is stimulated once food reaches what structure?
released by the presence of fat in the intestine
If a patient presents with back pain, weight loss, and painless jaundice, what is this?
hepatitis
What structure surrounds the liver?
Glisson’s capsule
A fluid collection that contains bile is called?
biloma
(gallbladder?)
A liver pathology that may have splenomegaly is called?
cirrhosis
(portal hypertension?)
Enlargement of the gb caused by obstruction, what is this called?
Courvoisier’s sign
RUQ, nausea, and vomitting: predispossing factors of what?
acute cholelithiasis
What structure in the kidney could be mistaken for an extra renal pelvis?
hydronephrosis
What structure is located anterior-lateral portion of the pancreatic head?
gastroduodenal artery (GDA)
What’s the normal length of an adult spleen?
8-13cm
What type of aneurysm is most commonly associated with a bacterial infection?
mycotic aneurysm
To aide in demonstrating acoustic shadowing, what can a sonographer do?
raise frequency
add harmonics
Extensive pancreatic inflammation into surrounding tissues, what is it called?
phlegmon
If you have an elevation in aldosterone, what organ is affected?
adrenal gland
What structure is commonly mistaken as the pancreatic duct?
(splenic artery and vein)
Main renal arteries arise from the lateral aspect of the aorta inferior to what?
inferior to celiac axis
Know the portions of the gallbladder (include normal variants)
neck, body, fundus
hartmann pouch-outpouching of gb neck
bilobed gb-hourglass appearance
septated gb-thin separations within gb
phrygian cap-fundus is folded onto itself
junctional fold-fold at gb neck
What is termed an outward bulge to the renal cortex?
dromedary hump
What is the congenital anomaly where you have a fusion of both kidneys?
horeshoe kidney
What is the function of the spleen?
breakdown of hemoglobin
formation of bile pigment
formation of antibodies and immunity
red blood cell production
When you see a comet tail artifact in the gallbladder, what is this?
adenomyomytosis
Non-shadowing, low amplitude echoes in the gallbladder: what are we looking at?
sludge
What is the accessory duct of the spleen called?
splenunculus (accessory spleen)
What lab values will you assess for renal function?
Bun and creatinine
The pancreas lies in the lap of what structure?
C-loop of the duodenum
What’s another name for the portal triad?
portal confluence
Congenital anomaly of the pancreatic head circling the duodenum, what is this called?
annular pancreas
What’s the most common type of abdominal aortic aneurysm?
fusiform
An AAA is present when the diameter exceeds what?
over 3cm
Know the layers of the vascular system
tunica intima-inner
tunica media-middle
tunica adventitia-outer
Sonographic findings of acute hepatitis
normal liver texture
portal veins are more prominent
liver parenchyma slightly more echogenic
hepatosplenomegaly is present
gb wall is thickened
What is the most common benign tumor of the liver?
cavernous hemangioma
Patients who have liver cancer are likely to have had what?
cirrhosis
The right and left hepatic ducts emerge to form what?
common hepatic duct
What are the normal sizes of CBD? (Age relation?)
normal: <6mm for people 60 and under
1mm/decade after the age of 60
What is inflammation of the gallbladder?
cholecystitis
What hepatic mass is associated with oral contraceptives?
liver cell adenoma
(focal nodular hyperplasia-second most common benign mass)
Valves of heister are found where?
neck of gallbldder
What’s the most common system with acute thrombosis of the portal vein?
The liver is suspended from the diaphragm and interior abdominal wall by what structure?
falciform ligament
An ameobic abcess may enter the liver through what structure?
portal vein
Echinococcal cysts are more prevalent where?
sheep grazing countries
Fatty infiltration of the liver causes elevation of liver enzymes, can it be reversed?
benign process that may be reversible with correction of process, but is also a precursor for significant chronic disease
What’s the most common malignant adrenal mass?
adrenal neuroblastoma
What are the spaces called where fluid accumulates in the flank of the abdomen and pelvis?
subphrenic-pouch of Douglas
Typical symptoms of a patient with an abcess formation:
fever, pain, pleuritis, nausea, vomitting, diarrhea, elevated liver function tests, leukocytosis, anemia
A cyst containing urine
urinoma
Normal length of an adult kidney
9-12cm
Know the criteria in order to call a gallstone a gallstone
mobile
strongly echogenic
acoustic shadowing
Know about the portal veins (oxygenated or deoxygenated, flow)
flow is hepatopetal (towards the liver)
portal veins carry blood from bowel to liver
80% blood supply to the liver
50% oxygenated blood supply to the liver
What’s the condition where the portal veins are thrombosed?
(portal hypertension?)
What artery do we see posterior to the IVC?
right renal artery
Absence of one or both of the kidneys is known as?
renal agenesis
Most common location of adenoma carcinoma of the pancreas?
(head?)
What is the most common tumor of the pancreas?
(adenocarcinoma?)
Where is the pancreas located?
(intra vs extra paratineal)
retroperitoneal cavity
What are the structures in the portal confluence?
portal vein, hepatic artery, CBD
(main lobar fissure, gb fossa)
Splenic artery and vein, where are they located in relation to the pancreas?
artery-superior border of pancreas
vein-posterior medial border of pancreas
Know about the celiac trunk
first branch off the aorta, lies anterior to the SMA
common hepatic artery-forms proper hepatic artery and GDA
left gastric artery-supplies stomach and esophagus
splenic artery(largest branch)-forms gastroepiploic artery-supplies stomach and spleen
Cystic mass between the umbilicus and the apex of the bladder, what might that be?
urachal cyst
What’s the space between the kidney and the liver?
Morrison’s pouch
A complex cyst that results from a paracitic infection is called?
echinococcal cyst
Inflammation of the peritoneum is known as?
peritonitis
What is the most common cause of splenomegaly?
(peritonitis?)
What’s the most common cause for renal failure?
Acute tubular necrosis
(chronic renal failure)
Most common malignant tumor of the kidney in peds
Wilm’s tumor
What is pyelonephrosis?
infection of the calyces and renal pelvis
benign fatty tumor of the kidneys
angiomyolipoma
What is the best description for a ureterocele?
cyst-like enlargement of the lower end of the ureter, which projects into the bladder when at the ureterovesical junction
The splenic artery originates from what?
celiac trunk(axis)
An area within an organ that has become necrotic due to lack of oxygen is called?
Ischemia
Most common location for a pancreatic psuedocyst
tail
What’s the procedure where we take a piece of tissue for microscopic analysis called?
biopsy
What are the functions of the pancreas?
exocrine function-produces pancreatic juice to aid in digestion
endocrine function-produces glucagons and insulin
What is thrombosis of the hepatic veins called?
Budd-Chiari syndrome
Where does the IVC terminate?
right atrium
What is considered a function of the lymph node?
returns tissue fluid to the blood
carries specific absorbed food molecules
defends body against infections
Gallbladder wall should not exceed what?
3mm
What quadrants are in a quad fluid assessment?
RUQ
RLQ
LUQ
LLQ
Aorta dissection
defect in intima and internal weakness in wall must exist
What are the sonographic findings of a renal transplant rejection?
Acute renal failure:
kidneys may appear normal in size or enlarged and may be hypoechoic with parenchymal disease
obstruction is responsible for aprox 5%
chronic renal failure:
diffusely echogenic kidney with loss of normal anatomy
if bilateral, small kidneys are identified
Tumor that has areas of sonolucence (hypoechoic), what is happening?
necrosis-blood supply has been cut off
What makes the splenic confluence?
splenic vein and superior mesenteric vein
Lab values:
kidney, liver, thyroid
kidney- Bun, creatine
Liver- AST, ALT, LDH, Alk-phos, Bilirubin, PT, Albumin, globulins
thyroid-THS, T3, T4
Primary blood flow to testicles
testicular arteries
When a patient has sickle cell, know what is going on and what the spleen looks like.
atrophy of the spleen
Kidney tumors
Functions:
kidneys, spleen, liver
kidneys-excretes waste, regulates composition of blood
spleen-storage of iron, blood reservoir, rarely a cause of systemic disease
liver-metabolism (carbs, protein), digestion, storage, detoxification
What happens to liver parenchyma in liver disease?
parenchyma becomes coarse with increased brightness of the portal triad
Liver ligaments
falciform ligament
ligamentum teres
ligamentum venosum
gastrosplenic ligament
splenorenal ligament
Liver nodules
Cells of the liver
hepatocytes
Sizes of normal bile ducts
normal: <6mm under 60
increase 1mm/decade after 60
Appendicitis:
symptoms, labs
McBurney’s sign (pain when pushed on, rebound tendernous)
Aneurysm
most common-fusiform
min size- >3cm
Marfan’s- most common ascending aorta
pseudoanerysms- after procedure, groin-most common location
Testicular torsion
comparison- between normal and torsed, look for arterial and venous (blood flow)
hematoma may be present in trauma
rupture
signs-pain
Time out procedure
patient’s name, procedure, location, legal action
Testicle
varicocele-dilated blood vessels, valsalva so vessels pop out
layers-
testie and scrotal wall-bell clapper
FNA: appropriate gauge
20-25
Breast
layers- subcutaneous layer, mammary (glandular) layer, retromammary layer
cooper’s ligaments- fibrous skeletal muscle that maintains the breast
most common mass- benign:fibroadenoma malignant:invasive ductal carcinoma
symptoms-
Procedures:
thoracentesis
why do we send fluid to lab?
to test for malignancy or infection
chest x-ray after?
make sure there is no pneumothorax
Cavities (retroperitoneum and introperitoneum)
GB diseases: How viewed under US?
