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Flashcards Davies Abdomen 3

1
Q

located at the hepatic hilum at the junction of the right and left hepatic ducts

A

Klatskin tumor

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2
Q

Where is a Klastkin tumor located?

A

at the hepatic hilum at the junction of the right and left hepatic ducts

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3
Q

Klatskin tumor is a specific type of:

A

cholangiocarcinoma

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4
Q

pneumobilia

A

air in the biliary tree

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5
Q

air in the biliary tree

A

pneumobilia

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6
Q

Describe the sonographic appearance of pneumobilia

A

variable length echogenic foci in the distribution of the biliary tree, resulting in acoustic shadowing and reverberation (comet tail) artifacts

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7
Q

Pneumobilia is most commonly seen where?

A

in the hilum of the liver, as this is the direction of bile flow

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8
Q

Most commonly seen in the hilum of the liver, as this is the direction of bile flow

A

Pneumobilia

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9
Q

What is the most common reason for pneumobilia

A

most commonly seen after an endoscopic retrograde cholangiopancreatogram (CEAP)

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10
Q

Reasons for pneumobilia

A

(most common)- endoscopic retrograde cholagiopancreatogram (CEAP)

surgically created biliary-enteric anastamosis

incompetence of the Sphincter of Oddi

wall erosion by a gallstone or ulcer into the common bile duct

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11
Q

Usually occur in Asian women

A

Choledochal cyst

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12
Q

Choledochal cyst symptoms

A

pain
jaundice
abdominal mass

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13
Q

What are the sonographic features associated with a choledochal cyst?

A

two cyst-like structures in the right upper quadrant. These are the gallbladder and the dilated common bile duct

Dilated intrahepatic biliary tree

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14
Q

What is the sonographic appearance of Caroli’s disease?

A

saccular, communicating intrahepatic bile duct dilatation

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15
Q

What other genetically acquired conditions are associated with Caroli’s disease?

A

infantile polycystic kidney disease

congenital hepatic fibrosis

choledochal cysts

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16
Q

infantile polycystic kidney disease, congenital hepatic fibrosis, and choledochal cysts are genetically acquired conditions that are associated with ______

A

Caroli’s disease

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17
Q

What is a Courvoisier gallbladder?

A

enlarged, nondiseased gallbladder, associated with an extrinsic obstruction of the distal common bile duct.

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18
Q

Courvoisier gallbladder is associated with an extrinsic obstruction of the ______

A

distal common bile duct

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19
Q

Describe the sonographic appearance of milk of calcium bile.

A

fluid-fluid level that produces acoustic shadowing

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20
Q

Bile duct carcinoma is also known as

A

cholangiocarcinoma

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21
Q

Cholangiocarcinoma is also known as

A

bile duct carcinoma

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22
Q

What predisposing conditions are associated with bile duct carcinoma?

A

ulcerative colitis
sclerosing cholangitis
Caroli’s disease
choledochal cyst
parasitic infections

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23
Q

What is the name of the cholangiocarcinoma located at the hepatic hilum?

A

Klatskin tumor

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24
Q

Cholangiocarcinoma is commonly located in the ____ and the ____

A

common hepatic duct
common bile duct

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25
Q

_______ is commonly located in the common hepatic duct and the common bile duct

A

cholangiocarcinoma

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26
Q

A ______ is a specific type of cholangiocarcinoma located at the hepatic hilum

A

Klatskin tumor

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27
Q

A Klatskin tumor is a specific type of cholangiocarcinoma located at the _____

A

hepatic hilum

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28
Q

With a ______, intrahepatic bile dut dilatation should be seen without extrahepatic bile duct dilatation

A

Klatskin tumor

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29
Q

The head of the pancreas is ____ to the inferior vena cava.

A

anterior

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30
Q

The head of the pancreas is _____ to the second portion of the duodenum.

A

medial

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31
Q

The common bile duct is _____ to the head of the pancreas.

A

posterolateral

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32
Q

The gastroduodenal artery is ____ to the head of the pancreas.

A

anteriolateral

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33
Q

The superior mesenteric artery and vein are _____ to the neck of the pancreas.

A

posterior

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34
Q

The uncinate process is _____ to the superior mesenteric artery and vein.

A

posterior

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35
Q

The aorta is _____ to the body of the pancreas.

A

posterior

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36
Q

The celiac axis arises from the aorta ____ to the pancreas.

A

superior

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37
Q

The gastroduodenal artery and common bile duct run ____ to the first portion of the duodenum.

A

posterior

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38
Q

The splenic vein is ____ to the pancreas.

A

posteroinferior

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39
Q

The superior mesenteric artery arises from the aorta ____ to the pancreas.

A

inferior

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40
Q

The superior mesenteric artery and vein are ____ to the uncinate process of the pancreas.

A

anterior

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41
Q

The superior mesenteric artery and vein are ____ to the third portion of the duodenum.

42
Q

The superior mesenteric vein is to the _____ of the superior mesenteric artery.

43
Q

The portal vein is the result of the combination of the ____ and the _____

A

superior mesenteric vein
splenic vein

44
Q

What are the two most common causes of pancreatitis?

A

alcohol abuse
biliary calculi

45
Q

What is the sonographic appearance of acute pancreatitis?

A

mild acute pancreatitis- normal pancreas

increasing severity pancreatitis- decreased echogenicity and increased gland size

46
Q

What are sonographic signs of chronic pancreatitis?

A

small echogenic gland
calcifications
pancreatic duct dilatation
pseudocyst formation

47
Q

progressive, irreversible, destruction of the pancreas

A

chronic pancreatitis

48
Q

What is chronic pancreatitis?

A

progressive, irreversible, destruction of the pancreas

49
Q

Sonographically seen as a solid focal hypoechoic mass typically in the head of the pancreas

A

pancreatic adenocarcinoma

50
Q

What findings are associated with pancreatic adenocarcinoma?

A

dilated biliary system
dilated pancreatic duct
liver metastases
ascites
lymphadenopathy
pseudocyst formation

51
Q

What sign is associated with an adenocarcinoma of the pancreatic head resulting in extrinsic compression of the common bile duct and an enlarged gallbladder?

A

Courvoisier’s sign

52
Q

palpable, nontender gallbladder due to an adenocarcinoma of the pancreatic head obstructing the biliary tract resulting in jaundice

A

Courvoisier’s sign

53
Q

Is the pancreas intraperitoneal or retroperitoneal?

A

retroperitonal

54
Q

The pancreas is located between the ______ and the _____

A

second portion of the duodenum
splenic hilum

55
Q

What space in the retroperitoneum is the pancreas located?

A

anterior pararenal space

56
Q

Name the 5 different parts of the pancreas

A

head
neck
body
tail
uncinate process

57
Q

What is the endocrine function of the pancreas?

A

secretion of insulin

58
Q

The endocrine portion of the pancreas consists of the ______ which secrete ______

A

islet cells of Langerhans
insulin

59
Q

What are the branches of the celiac axis?

A

left gastric artery
common hepatic artery
splenic artery

60
Q

What are the branches of the common hepatic artery?

A

hepatic proper artery
gastroduodenal artery

61
Q

What two veins join to for the main portal vein?

A

superior mesenteric vein
splenic vein

62
Q

What are islet cell tumors?

A

small, well circumscribed masses, usually found within the pancreatic body and tail

63
Q

small, well-circumscribed masses, usually found within the pancreatic body and tail

A

islet cell tumors

64
Q

Are islet cell tumors benign or malignant?

65
Q

Most common benign tumors of the pancreas

A

islet cell tumors

66
Q

Name the two most common islet cell tumors

A

insulinoma
gastrinomas

67
Q

______ are characterized by hyperinsulinism and hypoglycemia

A

insulinomas

68
Q

insulinomas are characterized by _____ and _____

A

hyperinsulinism
hypoglycemia

69
Q

____ are associated with gastric hypersecretions and peptic ulcer disease (Zollinger-Ellison syndrome)

A

Gastrinomas

70
Q

Gastrinomas are associated with _____ and _____

A

gastric hypersecretions
peptic ulcer disease (Zollinger-Ellison syndrome)

71
Q

Name six tumors associated with multiple endocrine neoplasia syndrome

A

pituitary adenoma
parathyroid adenoma
medullary thyroid carcinoma
pancreatic islet cell tumors
pheochromocytoma
ganglioneuromatosis

72
Q

What are pancreatic pseudocysts?

A

collections of pancreatic fluid encapsulated by fibrous tissue

73
Q

collections of pancreatic fluid encapsulated by fibrous tissue

A

pancreatic pseudocysts

74
Q

What are some causes of pancreatic pseudocysts?

A

acute pancreatitis
chronic pancreatitis
trauma
pancreatic cancer

75
Q

Name five possible locations of pancreatic pseudocysts

A

pancreas (most common)
intraperitoneal
retroperitoneal
intraparenchymal (within liver, spleen, kidney)
thorax (passage through diaphragm)

76
Q

What are four functions of the spleen?

A

breakdown of hemoglobin
formation of bile pegment
formation of antibodies
a reservoir for blood

77
Q

The stomach is _____ to the splenic hilum

A

anterior and medial

78
Q

The tail of the pancreas is ____ to the stomach

79
Q

The left kidney is ____ to the spleen.

A

inferior and medial

80
Q

The tail of the pancreas is _____ to the upper pole of the left kidney

81
Q

Name five structures that appear as cystic splenic masses

A

cystic degeneration of infarcts or hematomas
cysts associated with adult polycystic kidney disease
parasitic cysts of the spleen (echonicoccals cysts)
epidermoid cyst of the spleen
pancreatic pseudocysts

82
Q

Describe the sonographic appearance of a splenic infarct

A

peripheral wedge-shaped hypoechoic lesion

83
Q

What type of hematoma is the result of splenic trauma in which the splenic capsule remains intact

A

intraparenchymal or subcapsular hematoma

84
Q

What type of hematoma is the result of splenic trauma in which the splenic capsule ruptures

A

perisplenic or intraperitoneal hematoma

85
Q

True pancreatic cysts are uncommon. Multiple pancreatic cysts are associated with what two syndromes?

A

autosomal dominant (adult) polycystic kidney disease

Von Hippel-Lindau syndrome

86
Q

characterized by viscous secretions leading to pancreatic insufficiency

A

cystic fibrosis

87
Q

When severely affected, what is the sonographic appearance of the pancreas in a patient with cystic fibrosis?

A

increased echogenicity of the pancreatic parenchyma

88
Q

Name four sonographic indications of portal vein thrombosis

A

echogenic thrombus within vessel lumen

an increase in portal vein diameter

portosystemic collateral circulation

cavernous transformation

89
Q

Name 3 notable structures posterior to the kidneys

A

diaphragm
quadratus lumborum muscle
psoas muscle

89
Q

What is the orientation of structures that enter and exit the renal hilum?

A

the vein exits anteriorly
the artery enters between the vein and ureter
the ureter exits posteriorly

90
Q

The renal vein exits _____ at the renal hilum

A

anteriorly

91
Q

The renal artery enters between the _____ and _____

A

renal vein
ureter

92
Q

The ureter exits _____ to the renal hilum.

A

posteriorly

93
Q

The main renal artery branches from the _____

94
Q

Upon entering the hilum of the kidney, the main renal artery divides into five ______ arteries, which in turn divide into ______ arteries.

A

segmental
interlobar

95
Q

The _____ arteries are seen between the medullary pyramids.

A

interlobar

96
Q

The interlobar arteries are seen between the ______.

A

medullary pyramids

97
Q

At the base of the medullary pyramids, the _____ arteries branch perpendicular from the interlobar arteries.

98
Q

At the base of the medullary pyramids, the arcuate arteries branch perpendicular from the ______ arteries.

A

interlobar

99
Q

The _____ arteries are seen running parallel to the renal capsule.

ARDMS (25 decks)

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