Final Flashcards
where does the esophagus travel?
posteriorly to trachea and pierces through the diaphragm
where is the terminal esophagus?
posterior to the left lobe of liver
where the esophagus joins the stomach as known as what?
the GE junction
is the stomach intra or retro?
intra
what regions are the stomach located in?
- left hypochondrium
- epigastric
what are the parts of the stomach?
- fundus
- body
- antrum of pylorus near ML
- pyloric orifice
what does the antrum of pylorus blend into?
pyloric canal
the pyloric orifice communicates with what?
duodenum
what are the 3 sections of the small bowel?
- duodenum
- jejunum
- ileum
what is the shortest part of the small intestine?
duodenum
where does the duodenum extend from and to?
stomach to jejunum
how many sections is the duodenum separated into?
4
is the jejunum intra or retro?
intra
what regions is the jejunum located in?
umbilical and left iliac region
what regions is the ileum in?
- umbilical
- hypogastric
- right iliac
- pelvic region
Terminal ileum
opening of the ileum into the inner side of the large intestine (where the small and large bowel connect)
where does the large bowel originate?
right inguinal region
where does the large bowel extend from and to?
ilium to the anus
what is longer, small or large intestine?
small intestine
haustra
gives the large intestine a segmented appearance. it moves contents through the colon
what are the layers of the bowel?
- Superficical Mucosa/interface
- Muscularis mucosa
- Submucosa
- Muscularis Propria
- Serosa or Adventitia/interface
when looking at the bowel, what does US play a role in?
- **appendicitis
- acute diverticulitis
what diseases can be found if you look for it in the colon?
- bowel cancer
- crohns disease
- ulcerative colitis
when may we scan the bowel or appendix?
- increase WBC
- change in bowel patterns
- acute pain
what is the patient prep for scanning the colon?
- fasting
- fill bladder
- empty bladder
why must a patient fill their bladder when scanning colon?
visualize sigmoid colon and rectum
what do we do to look at areas of interest?
higher frequency transducer
what probes do we use when scanning the colon?
- linear
- convex linear
- some sector probes
- transvaginal for women (good sigmoid and rectum)
Is bowel compressible?
yes
how many layers of the gut might we see?
up to 5 layers
what echogenicity do we see for the muscular components of the gut wall?
hypoechoic
what are the muscular components of the gut wall?
- Muscularis mucosa
- Muscularis propria
what layers of the gut wall are hyperechoic?
1,3,5
what layers of the gut wall are hypoechoic?
2.4
what does the stomach look like in cross section?
bull’s eye
-echogenic central area and hypoechoic rim
normal gut wall is________
uniform and compliant
what is the average thickness of a distended and not distended gut wall?
distended-3mm
not distended-5mm
what is seen in small bowel and stomach?
peristalsis (we look for movement)
do we see peristalsis in large bowel?
no
intraluminal air
Gas content within gut lumen
Intraluminal fluid
mimik cystic masses
Fecal material can create ___________
artifacts and pseudotumors
what is abnormal is gut wall with doppler?
Hypervascular or hypovascular where tenderness felt
when is appendicitis more common?
young people
why do we use ultrasound to look at appendix?
- good at ruling out gallstones, cysts, e.t.c
- radiation with CT
what does the appendix look like?
Long, tubular structure that extends from the cecum
where is the appendix found?
Located on the abdominal wall under McBurney’s point
how do you find McBurney’s point?
- Draw a line from the right anterosuperior iliac spine to the umbilicus.
- At approximately the midpoint of this line lies the root of the appendix.
what is the normal size of an appendix?
less than 6mm in AP diameter
appendix has a __________
blind end or tip
where are we scanning on the body with the groin?
Between the iliac crest and pubic symphysis
what is our landmark when scanning the groin?
Inferior Epigastric vessels
where are the Inferior Epigastric vessels?
- Arise from the External iliac vessels
- Courses superomedially
why do we scan the groin?
hernias
- inguinal (indirect or direct)
- femoral
- spigelian
when are patients sent for ultrasound of the groin?
pain with a lump
what are US advantages to scanning the groin for hernias?
-Scan patient upright and supine
-Dynamic maneuvers
(Valsalva and
Compression)
what patient prep is required for scanning the groin?
no patient prep required
what organs have high metabolic rates?
- liver
- spleen
- kidneys
organs with high metabolic rates have ______ resistance vascular beds
low resistance
what organs have low metabolic rates?
- stomach
- small intestine
- muscle
organs with low metabolic rates have ______ resistance vascular beds
high resistance
what does red colour in colour doppler indicate?
- above baseline
- towards probe
what does blue colour in colour doppler indicate?
- below baseline
- away from probe
blood flow pattern has :
- low or high resistance
- monophasic, biphasic, triphasic
suprarenal aorta
- supplies low resistance organs
- continuous forward flow throughout cardiac cycle
intrarenal aorta
- supplies high resistance organs
- high resistance waveforms, triphasic
what resistance does the celiac trunk have
low resistance
what does the celiac trunk supply?
liver and spleen
how much oxygenated blood from the hepatic artery supplies the liver?
20-30%
what does the SMA supply?
- stomach
- small intestine
- colon
what resistance is there with fasting?
-high resistance flow
what resistance is there with postprandial (after eating)?
low resistance flow
what does the renal arteries supply?
kidneys
are the kidneys high or low resistance?
low resistance
do the kidneys have high or low resistance waveforms?
low resistance
what is the IVC proximal segment pattern?
- “w” pattern from back pressure
- variable depending on respiration and regurgitation from right atrium
hepatic veins are pulsatility from_____
cardiac reflection and respiration
renal veins empty from__________
kidneys to IVC
what is flow from renal veins influenced by?
systemic circulation
hepatic artery brings fresh __________blood from the aorta
oxygenated
what does hepatofugal mean?
blood flow away from liver
what does hepatopedal mean?
blood flow towards the liver
in hepatofugal is PW above or below baseline?
below baseline
in hepatopedal is PW above or below baseline?
PW above the baseline
what is the flow velocity of the main portal vein?
commonly somewhat phasic
look at the sizes of the endometrium
on powerpointd????
female slide 65
late proliferative
