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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
_______ is commonly located in the common hepatic duct and the common bile duct
cholangiocarcinoma
26
A ______ is a specific type of cholangiocarcinoma located at the hepatic hilum
Klatskin tumor
27
A Klatskin tumor is a specific type of cholangiocarcinoma located at the _____
hepatic hilum
28
With a ______, intrahepatic bile dut dilatation should be seen without extrahepatic bile duct dilatation
Klatskin tumor
29
The head of the pancreas is ____ to the inferior vena cava.
anterior
30
The head of the pancreas is _____ to the second portion of the duodenum.
medial
31
The common bile duct is _____ to the head of the pancreas.
posterolateral
32
The gastroduodenal artery is ____ to the head of the pancreas.
anteriolateral
33
The superior mesenteric artery and vein are _____ to the neck of the pancreas.
posterior
34
The uncinate process is _____ to the superior mesenteric artery and vein.
posterior
35
The aorta is _____ to the body of the pancreas.
posterior
36
The celiac axis arises from the aorta ____ to the pancreas.
superior
37
The gastroduodenal artery and common bile duct run ____ to the first portion of the duodenum.
posterior
38
The splenic vein is ____ to the pancreas.
posteroinferior
39
The superior mesenteric artery arises from the aorta ____ to the pancreas.
inferior
40
The superior mesenteric artery and vein are ____ to the uncinate process of the pancreas.
anterior
41
The superior mesenteric artery and vein are ____ to the third portion of the duodenum.
anterior
42
The superior mesenteric vein is to the _____ of the superior mesenteric artery.
right
43
The portal vein is the result of the combination of the ____ and the _____
superior mesenteric vein splenic vein
44
What are the two most common causes of pancreatitis?
alcohol abuse biliary calculi
45
What is the sonographic appearance of acute pancreatitis?
mild acute pancreatitis- normal pancreas increasing severity pancreatitis- decreased echogenicity and increased gland size
46
What are sonographic signs of chronic pancreatitis?
small echogenic gland calcifications pancreatic duct dilatation pseudocyst formation
47
progressive, irreversible, destruction of the pancreas
chronic pancreatitis
48
What is chronic pancreatitis?
progressive, irreversible, destruction of the pancreas
49
Sonographically seen as a solid focal hypoechoic mass typically in the head of the pancreas
pancreatic adenocarcinoma
50
What findings are associated with pancreatic adenocarcinoma?
dilated biliary system dilated pancreatic duct liver metastases ascites lymphadenopathy pseudocyst formation
51
What sign is associated with an adenocarcinoma of the pancreatic head resulting in extrinsic compression of the common bile duct and an enlarged gallbladder?
Courvoisier's sign
52
palpable, nontender gallbladder due to an adenocarcinoma of the pancreatic head obstructing the biliary tract resulting in jaundice
Courvoisier's sign
53
Is the pancreas intraperitoneal or retroperitoneal?
retroperitonal
54
The pancreas is located between the ______ and the _____
second portion of the duodenum splenic hilum
55
What space in the retroperitoneum is the pancreas located?
anterior pararenal space
56
Name the 5 different parts of the pancreas
head neck body tail uncinate process
57
What is the endocrine function of the pancreas?
secretion of insulin
58
The endocrine portion of the pancreas consists of the ______ which secrete ______
islet cells of Langerhans insulin
59
What are the branches of the celiac axis?
left gastric artery common hepatic artery splenic artery
60
What are the branches of the common hepatic artery?
hepatic proper artery gastroduodenal artery
61
What two veins join to for the main portal vein?
superior mesenteric vein splenic vein
62
What are islet cell tumors?
small, well circumscribed masses, usually found within the pancreatic body and tail
63
small, well-circumscribed masses, usually found within the pancreatic body and tail
islet cell tumors
64
Are islet cell tumors benign or malignant?
benign
65
Most common benign tumors of the pancreas
islet cell tumors
66
Name the two most common islet cell tumors
insulinoma gastrinomas
67
______ are characterized by hyperinsulinism and hypoglycemia
insulinomas
68
insulinomas are characterized by _____ and _____
hyperinsulinism hypoglycemia
69
____ are associated with gastric hypersecretions and peptic ulcer disease (Zollinger-Ellison syndrome)
Gastrinomas
70
Gastrinomas are associated with _____ and _____
gastric hypersecretions peptic ulcer disease (Zollinger-Ellison syndrome)
71
Name six tumors associated with multiple endocrine neoplasia syndrome
pituitary adenoma parathyroid adenoma medullary thyroid carcinoma pancreatic islet cell tumors pheochromocytoma ganglioneuromatosis
72
What are pancreatic pseudocysts?
collections of pancreatic fluid encapsulated by fibrous tissue
73
collections of pancreatic fluid encapsulated by fibrous tissue
pancreatic pseudocysts
74
What are some causes of pancreatic pseudocysts?
acute pancreatitis chronic pancreatitis trauma pancreatic cancer
75
Name five possible locations of pancreatic pseudocysts
pancreas (most common) intraperitoneal retroperitoneal intraparenchymal (within liver, spleen, kidney) thorax (passage through diaphragm)
76
What are four functions of the spleen?
breakdown of hemoglobin formation of bile pegment formation of antibodies a reservoir for blood
77
The stomach is _____ to the splenic hilum
anterior and medial
78
The tail of the pancreas is ____ to the stomach
posterior
79
The left kidney is ____ to the spleen.
inferior and medial
80
The tail of the pancreas is _____ to the upper pole of the left kidney
anterior
81
Name five structures that appear as cystic splenic masses
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
Describe the sonographic appearance of a splenic infarct
peripheral wedge-shaped hypoechoic lesion
83
What type of hematoma is the result of splenic trauma in which the splenic capsule remains intact
intraparenchymal or subcapsular hematoma
84
What type of hematoma is the result of splenic trauma in which the splenic capsule ruptures
perisplenic or intraperitoneal hematoma
85
True pancreatic cysts are uncommon. Multiple pancreatic cysts are associated with what two syndromes?
autosomal dominant (adult) polycystic kidney disease Von Hippel-Lindau syndrome
86
characterized by viscous secretions leading to pancreatic insufficiency
cystic fibrosis
87
When severely affected, what is the sonographic appearance of the pancreas in a patient with cystic fibrosis?
increased echogenicity of the pancreatic parenchyma
88
Name four sonographic indications of portal vein thrombosis
echogenic thrombus within vessel lumen an increase in portal vein diameter portosystemic collateral circulation cavernous transformation
89
Name 3 notable structures posterior to the kidneys
diaphragm quadratus lumborum muscle psoas muscle
89
What is the orientation of structures that enter and exit the renal hilum?
the vein exits anteriorly the artery enters between the vein and ureter the ureter exits posteriorly
90
The renal vein exits _____ at the renal hilum
anteriorly
91
The renal artery enters between the _____ and _____
renal vein ureter
92
The ureter exits _____ to the renal hilum.
posteriorly
93
The main renal artery branches from the _____
aorta
94
Upon entering the hilum of the kidney, the main renal artery divides into five ______ arteries, which in turn divide into ______ arteries.
segmental interlobar
95
The _____ arteries are seen between the medullary pyramids.
interlobar
96
The interlobar arteries are seen between the ______.
medullary pyramids
97
At the base of the medullary pyramids, the _____ arteries branch perpendicular from the interlobar arteries.
arcuate
98
At the base of the medullary pyramids, the arcuate arteries branch perpendicular from the ______ arteries.
interlobar
99
The _____ arteries are seen running parallel to the renal capsule.
arcuate

ARDMS (55 decks)

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