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DI > Normal U/S abdomen > Flashcards

Normal U/S abdomen Flashcards

1
Q

T/F: Gastric gas hampers evaluation

A

TRUE

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2
Q

Where do you clip fur for an abdominal ultrasound?

A

10th-12th ICS

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3
Q

What veins/arteries are visible in the abdomen?

A
  • Veins are Visible, arteries are not
  • Portal veins
    • hyperechoic wall
    • enlarged = possible liver disease
  • Hepatic veins
    • isoechoic wall
    • enlarged = possible CHF (congestion)
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4
Q

What are the arrows pointing to?

A
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5
Q

What 6 things should you evaluate when examining the liver?

A
  1. Size
  2. Margins
  3. Margination
  4. Echogenicity
  5. Architecture
  6. Lesions
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6
Q

T/F: Parenchymal changes are often unspeific and a biopsy should be taken for definitive diagnosis.

A

TRUE

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7
Q

When evaluating parenchymal changes, what other changes should you look for?

A
  • Hepatomegaly
    • Irregular margins
  • Lymph node changes
  • Ascites
  • Assessment of other organs
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8
Q

What are the differential diagnoses for a diffusely hypoechoic parenchyma?

A
  • Acute hepatitis
  • Venous congestion (would also see enlarged hepatic veins)
  • Lymphosarcoma
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9
Q

What are the differential diagnoses for a diffusely hyperechoic parenchyma?

A
  • Diabetes mellitus
  • Hyperadrenocorticism
  • Hepatic lipidosis
  • Lymphosarcoma
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10
Q

What diseases can be present even with a normal liver/parenchyma on an ultrasound?

A
  • Acute hepatitis
  • Toxic hepatopathy
  • Diffuse infiltrative disease
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11
Q

What abdominal organ is this?

A

Gall bladder (both are normal–one on the right has ‘slush’)

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12
Q

What approaches can be used to examine the gall bladder on U/S?

A
  • Retrocostal approach
  • Intercostal approach
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13
Q

How does a normal gall bladder appear on U/S?

A
  • The gall bladder is readily visualized
  • Anechoic content, but sludge can be seen normally
  • Gets bigger with anorexia or fasting
  • Thin wall (1-2 mm), Isoechoic to liver parenchyma
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14
Q

Are intrahepatic biliary ducts normally seen on U/S?

A

No–they are not detected in the normal dog and cat

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15
Q

Can the common bile duct be seen in a normal U/S?

A
  • Can be traced in the normal cat
  • Usually not apparent in the normal dog due to overlying gas in the GI tract
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16
Q

How do the following appear on U/S of the gall bladder and biliary tree?

  • Sludge
  • Cholecystitis
  • Choleliths
  • Obstruction
A
  • Sludge = normal
  • Cholecystitis = thickened GB wall
  • Choleliths = mineral: hyperechoic casting a clean shadow
  • Obstruction = Dilation of GB and common bile duct
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17
Q

This is a normal gall bladder. What species is this?

A

Pussy cat

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18
Q

Where can you find the spleen for U/S?

A
  • Splenic head fixated at the greater curvature of the stomach
    • At the level of the costal arch
  • Body and tail
    • Position very variable
    • Left and ventral abdominal wall
  • The entire spleen must be examined!
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19
Q

What is the normal anatomy of the spleen on an U/S?

A
  • Size very variable
  • Hyperechoic capsule
  • Smooth margins
  • Splenic vein at hilus
  • Homogenous fine granular appearance (liver has coarser appearance)
  • Interior echo finer and denser than liver
  • Compare echogenicity to left kidney
    • Spleen > left kidney
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20
Q

What two organs are shown? Which has greater echogenicity?

A

Spleen and kidney

The spleen is hyperechoic to the kidney

21
Q

What organ is this? is the structure outlined in red normal?

A

Spleen

Outlied structure is fat at the hilus–it is NORMAL!

22
Q

What organ is this? What is represented by the red and blue areas?

A

Spleen (cat)

Red = artery, blue = vein (both at the hilus)

23
Q

What is the normal ultrasonographic anatomy of the kidney?

A
  • Renal medulla is segmented
  • Clear cortico-medullary distinction
  • Renal cortex < spleen
  • Renal cortex > renal medulla
  • Renal pelvis usually 1-2 mm wide
  • Proximal ureter is enlarged if greater than 3-4 mm
24
Q

T/F: Pelvic fat is causes the renal pelvis to be hypoechoic and is easily misdiagnosed.

A

FALSE–pelvic fat causes the renal pelvis to be HYPERechoic. DON’T misdiagnose this!

25
Q

What organ is this? Which plane is it being viewed in?

A

Kidneyyyyyyyy

It is in the transverse plane!

26
Q

What is the normal renal size in the cat and dog?

A
  • Cat–3.66 +/- 0.46 cm
  • Dog–??
27
Q

What are the indications for ultrasound of the lower urinary tract?

A
  • The urinary bladder and parts of the urethra not obscured by the pelvis are easily detected and identified
  • Ultrasound is very useful for examining bladder neoplasia and calculi
28
Q

Lower urinary tract examination

A
  • Full urinary bladder
  • Positional scanning
    • Do both transverse and sagittal scan
  • Ballottement
  • Causing turbulences
29
Q

What are the ultrasound features of the urinary bladder?

A
  • U/S examination reveals an anechoic fluid-filled structure with a well defined wall visible
  • Wall thickness, shape, contents are easily evaluated
  • Normal wall thickness varies with bladder distention and weight of patient
  • An empty bladder can appear thickened artifactually
30
Q

Ultrasonographic anatomy of the stomach

A
  • In close apposition with the liver cranially
  • In the normal dog and cat the empty stomach lies cranial to the last pair of ribs
  • May extend slightly caudal to costal arch
  • Lies in a transverse plane, usually to the left of the midline
31
Q

Let’s review the anatomy of the stomach:

A
  • Cardia (gastroesophageal junction)
  • Fundus
  • Body (largest portion)
  • Pyloric portion:
    • Antrum (2/3 oral)
    • Canal (1/3 aboral) contains double sphincter
32
Q

Why perform an ultrasonographic exam on the stomach?

A
  • May eliminate the need for gastric series
    • Faster, gives more info
  • Useful and complementary modality
  • Less expensive and faster
  • 12-hour fast
33
Q

Normal measurement for the stomach on U/S?

What is the echogenicity of the various layers?

A

= 5 mm in diamter (must measure in the middle of the lumen space)

34
Q

What are the ultrasonographic features of the stomach?

A
  • With decreasing distention the rugal folds are more prominent
  • Stomach wall thickness in a dog is 3-5 mm
  • Stomach wall thickness in a cat is 2 mm
  • Measure between rugal folds
  • Peristaltic contractions 4-5 per minute
35
Q

How do you assess the stomach on U/S?

A
  • Combination of factors:
    • Peristalsis
    • Stomach content
    • Wall appearance
    • Symmetry
    • Extend
    • Other findings
    • Major obstacle is gas in GIT
36
Q

What organ is this?

A

Stomach

37
Q

What is the intestinal wall thickness in dogs and cats?

A
  • Duodenum
    • Dog–5 mm
    • Cat–3 mm
  • Jejunum
    • Dog–2-4 mm
    • < 2.3 mm
  • Ileum
    • Dog–4 mm
    • Cat–3 mm
38
Q

What are the 5 layers of the intestine?

A
  1. Serosa–hyperechoic
  2. Muscularis–hypoechoic
  3. Submucosa–hyperechoic
  4. Mucosa (thickest)–hypoechoic
  5. Lumen-mucosa-interface–hyperechoic
39
Q

Where is the normal feline ileum found? Which is the prominent layer?

A
  • In right cranial abdomen, medial and ventral to right kidney
  • Prominent hyperechoic submucosal layer
40
Q

What is the mucous pattern of the small bowel?

A
  • Collapsed state
  • Hyperechoic
  • Without acoustic shadowing
41
Q

What is the fluid pattern of the small bowel?

A

Anechoical luminal content

42
Q

What is the gas pattern of the small bowel?

A
  • Hyperechoic
  • With acoustic shadowing
  • Walls often appear less distinct
43
Q

What is the alimentary pattern of the small bowel?

A
  • Appearance depends on type of food
44
Q

What are the 2 comparisons for the ileus?

A
  1. Mechanical vs. functional
  2. Complete vs. partial
45
Q

What organ is this? Why does it look like this?

A

Corrugated ileus

Secondary to peritonitis/pancreatitis

46
Q

Normal wall layering of the large bowel?

A
  • 5 layers: hyper, hypo, hyper, hypo, hyper
  • More challenging to see due to a thinner wall
  • Need a high resolution probe to resolve layering
47
Q

Large bowel wall thickness?

A
  • Dog–2-3mm
  • Cat– <2mm
  • Always appears thinner than adjacent small bowel
48
Q

U/S features of large bowel (2)

A
  • Often can only evaluate near the wall due to the presence of gas and feces
  • Cecum in dogs is often difficult to identify due to intraluminal gas
49
Q

What organs are these?

A

Small (left) and large bowel (right)

DI (17 decks)

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