Gastrointestinal Tract

Question 1

What is NL intestinal wall thickness?

Answer 1

3-5mm

Question 2

What are the 5 different intestinal layers and their echogenicty?

Answer 2

Mucosa - Hyper
Muscularis Mucosa - Hypo
Submucosa (thickest) Hyper
Muscularis Propria - Hypo
Serosa - Hyper

Question 3

What is the intestinal hypoechoic rim and hyperechoic center appear as

Answer 3

target sign or pseudokidney

Question 4

what is the segment of esophagus between the diaphragm and the stomach called?

Answer 4

Gastroesophageal junction.

Question 5

When is the gastroesophageal junction seen?

Answer 5

Long midline of the epigastrum. seen as a target sign posterior to the left lobe of the liver

Question 6

What is pneumoperitoneum and what is the most common cause ?

Answer 6

Air in the peritoneal cavity.
perforation of abdominal viscus by ulcers

Question 7

What is the signs of appendicitis and where is the appendix located?

Answer 7

Periumbilical pain shifting to RLQ, loss of appitie, Increase WBC, rebound tenderness.
- Posterior to the terminal ileum and Anterior to iliac vessels

Question 8

What is Mcburney’s point?

Answer 8

RLQ location of the appendix between the umbilicus and the iliac crest

Question 9

What is the size of a inflammatory appendix?

Answer 9

noncompressable >6mm

Question 10

What can mimic appendicitis?

Answer 10

Mesenteric adenitis

Question 11

What is mesenteric adenitis?

Answer 11

inflamed mesenteric lymph noes in the RLQ

Question 12

A neonatal patient (3-8w) comes into the ER with vomiting, visible peristalsis, and olive shape pylorus. what is it ?

Answer 12

Pyloric stenosis

Question 13

What is the pyloric size criteria?

Answer 13

Channel length- >17 mm ( 14-24mm)
Muscle thickness >3mm ( 3-4mm)
Diameter >15mm

Question 14

What is the most accurate measurement for determining pyloric stenosis?

Answer 14

Muscle wall

Question 15

What do you need to be caution of when scanning a pylorus at 4weeks or younger?

Answer 15

you can see pylorospasm and the possibility of under diagnosing cases evolving into pyloric stenosis

Question 16

Sonographically you see thick walled outpouching with hypoechoic thickening of the adjacent bowel. what is this?

Answer 16

DIverticulitis

Question 17

Where is diverticulitis most often found?

Answer 17

sigmoid colon

Question 18

A patient comes in with LLQ pain, fever and leukocytosis. what is the possible diagnosis?

Answer 18

Diverticulitis

Question 19

What is a bowel obst. caused by?

Answer 19

extrinsic (hernia/adhesions)
volvulus (twistinging)
wall lesion (tumor crohns)
intraluminal (food bolus)

Question 20

What is ileus SBO?

Answer 20

Bowel obst. related to adnamic function of the bowel.

Question 21

A patient comes in with Acute ABD pain, vomiting, bloody diarrhea (jelly) Palpable abdominal mass. What do you think?

Answer 21

Intussusception.

Question 22

What is the difference between intusscipiens vs intusseusceptum?

Answer 22

Intussuscipiens- exterior loop
Intussusceptum- Interior loop

Question 23

Where are the most intussusception found?

Answer 23

Right suphepatic region and ileocolic

Question 24

Sonographically you see a psuod kidney/ target sign in the abdomen. what am I?

Answer 24

Intussusception

Question 25

How do you treat insussuscption?

Answer 25

Barium or air therapeutic enema