Study guide for breast/scrotal Flashcards
- Three layers of the breast
mammary layer, retromammary layer, subcutaneous layer
- Functional portion of the breast consists of how many lobes
15 - 20
- What is the fibrosis skeletal muscle that maintains the breast
Coopers Ligament
- As a women ages glandular breast tissue is replaced with what
Fat (JL PG 553)
- Describe cooper ligaments what it looks like under US
Echogenic (JL p 552)
- Describe songoragphic of the retromamorary layer
thin and consist of fat surrounded by connective tissue septa
the fatty tissue appears hypoechoic and the ducts, glands, and supporting ligaments appear echogenic
(MW pg. 550)
- What are the most important signs that a lesion is cystic
smooth walls, anechoic, posterior enhancement good through transmission
(MW breast slide #6)
- If a patient has clinically findings of lumpy bumpy painful breasts with their monthly cycles
Fibrocystic condition (EG pg 574)
- What are the characteristics of a papilloma
- Bloody discharge from single duct
- Tiny papilloma may not be detected
- May cause dilatation of a single duct
- arise from lining of breast ducts, retroareolar area most common
- Intracystic papillomas- soft tissue mass growing into lumen of cystic lesion
- May cause skin dimpling and retraction
(MW breast slide #11)
- What is the most common solid benign tumor of the breast
fibroadenoma
- What is the sonographic characteristics of fibroadenoma?
Smooth, rounded margins low level homogeneous internal echoes posterior enhancement typically hypoechoic but can be hyperechoic because of the fat within the breast (JL pg 5765)
- Lymphatic drainage usually flows to what lymph nodes
Axillary (JL pg 554)
- Most common malignant neoplasm Breast
Invasive Ductal Carcinoma (JL pg 578)
- Describe findings of the breast carcinoma
attenuation of sound
irregular borders
inhomogenous low level internal echo patterns with calcification
- Skin rippling what does that suggest
retraction of the tissue secondary to tumor infiltration
- Primary purpose of breast screening
provides early detection of breast carcinoma
- Know the clock face
Mid portion of rt medial and Lt lateral breast is annotated 3:00
- Most common of clinical signs of breast cancer is what
Palpable lump
- Normal extension of breast tissue into the axillary region
tail of spence
- According of ACS should began mamo screening at what age
40
- Which one of the following of the arteries responsible to supply more then half of the breast
anterior perforating branches of the internal mammary gland (JL pg 553) (internal mammary supplies have the blood supply to the breast)
- A condition when a male has breast?
gynecomastia (MW pg 556 and google)
- Appearance of breast cancer under US
Irregular margins and taller than wide
- US is often a benefit for procedures except what
large core needle biopsy of calcification
- Be able to answer/ ultrasound is exam of choice if your pregnant or at an younger age and have a family history/ not a mamogram
??
- Know other modalities that are used besides US for the breast and why would we use one of the other
Ultrasound of the breast is often performed as an
adjunctive imaging tool in all of the following situations
a. To assess a smooth mammographic mass as cystic or solid
b. To further evaluate a palpable breast lump in a patient with very dense breast tissue and a negative mammogram
c. To further evaluate a palpable breast lump in a patient with breast implants
- If you see a smooth mass on a mammogram and they want correlating images on US what do you think you’re going to see
Anechoic cyst with posterior acoustic enhancement
- What are advantages of breast US over mammography
Differentiation of cystic versus solid smooth masses
More comfortable examination for the patient
Better visualization of juxtathoracic deep tissues
Can better evaluate those hard-to-reach places, such as parasternal tissues and axilla, not well seen on mammography.
- What is the diameter of a varicocele
> 2mm (MW pg 619)
- What is the fibrous capsule surrounding the testicle
tunica albuginea
MW pg 606
- Normal measurements
Testis
3-5 cm in length
2-4 cm in width
3 cm in height
epididymis
6-7 cm
(MW pg 604)
- Sonographic characteristics of a testicle
smooth, medium gray structures with fine echo texture
(MW pg 605)
Homogeneous pattern with medium level echos
- What is the linear strip that is echogenic that runs through the testies
MEDIASTINUM TESTIS
MW slide 10
- Normal location of the epidymsis
beginning superiorly and then coursing posterolateral to the testis (MW)
- What are the facts about undescended testies
- AKA cryptorchidism if bilateral in 10% to 25% of cases
- testis has not descended into the scrotum and cannot be brought into the scrotum w/ external manipulation
- may be located in the ABD, inguinal canal (80%), or other ectopic location
- usually in premature babies cause balls descend in late pregnancy
- 40% to 50% association with cancer
- orchiopexy is surgical treatment
- if orchiopexy is not performed more likely to cause: spermatogensis and result in infertility, testicular cancer because they are not easily palpated so the lump may not be detected soon enough, testicular torsion
(MW pg 628)
- The most common of acute scrotal pain at an young age
Torsion (EG pg 617)
- Some common causes for hydro seals
- idiopathic but associated with epididymo-orchitis and torsion
- may also be found in patients following trauma or development of a neoplasm
(MW pg 621)
- Make sure you know about varicoceles
- tortuous dilated veins
- increased size w/ valsalva maneuver or patient standing
- dilated veins fill w/ color on valsalva
- spectral doppler confirms venous flow
- an abnormal dilatatation of the veins of the pampiniform plexus
- usually caused by incompetent venous valves in the spermatic vein called primary varicoceles, more common in the left
(MW, lots more info on pg 619)
- Know what part of the epydimisis the spermato seal is located
in the head (MW pg 614)
- Common cause for scrotal pain in adults
EPIDIDYMITIS
MW slide 38
- Almost always transpires with epdymsis
The question I have is…..transpires 2nd to epididamitis (MW)
Orchitis (pg 615)
- Tuburlar ectastia
uncommon, benign condition
associated with presence of spermatocele, epididymal or testicular cyst, or other epididymal obstruction on the same side of the dilated tubules
more commonly seen in patients 45 or older
appears as prominent hypoechic channels near the echogenic mediastinum testis
(MW pg 624)
- What is seminoma what does it look like under US
hypoechoic lesion
smooth
well defined borders
(MW pg 626)
- Epdydimal orchiatisis is most commonly results from what/ trauma bladder infection or STDs
most commonly results from the spread of a lower urinary tract infection via the spermatic cord
less common:
mumps, syphilis, tuberculosis, viruses, trauma, chemical causes
(MW pg 615)
- Clinical history of vasectomy is associated with what
Sperm granuloma
- Primary blood supply to the testicals
testicular artery (primary source, arise from AO just below the renal arteries pg 606) capsular artery centripetal artery recurrent rami (MW ph 607)
- Intra testicular cyst have association with what
extratesticular spermatoceles (MW pg 624)
- Microthiliaiss is associated with what
testicular malignancy (MW pg 625)
- Follow up examination for patients with microlithiasis is
annual (MW pg 625)
- Attached at the superior pole of the testie between the epydimsis and testie is what structure/ we have an organ that is named this as well (APPENDIX)
appendix testis (MW pg 605)
- Hydro seal develops between what layers of the scrotum
Visceral and Parietal layers of the tunica vaginalis
MW pg 620
- What is the location of rete testies
hilum of the balls where the mediastinum resides
MW pg 623
- Be able describe the echogenicity difference between testies and epydymisis
balls- smooth, medium gray structures with fine echo texture
epididymis- isoechoic or hypoechoic compared to the balls and the echo texture is coarser
(MW pg 605)
