Study guide test 3 Flashcards
What are the three layers of the breast?
subcutaneous layer
mammary (glandular) layer-functional portion
retromammary layer
functional portion of the breast consists of how may lobes?
15-20 lobes
What is the fibrous skeletal muscle that maintains the breast?
Cooper’s ligaments
As a woman ages, glandular breast tissue is replaced with what?
fatty tissue
Describe what Cooper’s ligaments look like under US?
echogenic and are dispersed in a linear pattern
Describe sonographic appearance of the retromammary layer:
similar in ehcogenicity and echotexture to the subcutaneous layer
hypoechoic
What are the most important signs to make sure a lesion is cystic?
anechoic
show smooth inner margins with an imperceptible capsule
posterior acoustic enhancement
If a patient has clinical findings of lumpy, bumpy, painful, and tender breasts during their cycle, what do they have?
fibrocystic condition
What are the characteristics of a papilloma?
small, multiple, multicenteric
consist of simple proliferations of duct epithelium projecting outward into a dilated lumen from one or more focal points
What is the most common solid, benign tumor of the breast?
fibroadenoma
What are the sonographic characteristics of a fibroadenoma?
smooth, rounded margins
low-level homogeneous internal echoes
may demonstrate intermediate posterior enhancement
Lymphatic drainage from the breast generally flows to what lymph nodes?
first or “sentinel” lymph node along axillary node chain
What is the most common malignant neoplasm of the breast?
Invasive ductal carcinoma
Describe the characteristics of breast carcinoma:
arise from the epithelium, in the ductal and glandular tissue, and usually has tentacles
ductal or lobular
invasive or noninvasive
What does skin dimpling suggest?
cancer
Most common clinical sign of breast cancer is?
Primary purpose of breast screening:
detection and diagnosis of breast cancer in its earliest and most curable stage
Know the clock face:
breast is viewed as a clock face
Normal extension of breast tissue into the axillary region
tail of Spence
According to the ACS, all women should begin annual mammogram screening at what age?
40
Which artery is responsible for supplying more than 1/2 of the breast?
anterior perforating branches of the internal mammary artery
What is the condition when a male has breasts?
gynecomastia
Appearance of breast cancer on US:
indistinct, fuzzy, spiculated
grow through tissue without compressing adjacent tissue and may cause retraction of the nipple or dimpling of the skin
sharp, angular microlobulations
taller than wide
hypoechoic, weak internal echoes, clustered microcalcifications
strong attenuating
firmly fixed
rigid, noncompressible
hypervascular; feeder vessel may be identified
US is often a benefit for what procedures?
cyst aspiration
fine needle aspiration cytology (FNAC)
drainage procedures
preoperative needle (wire) localization
large-core needle biopsy
sentinel node biopsy
If family hostory of breast cancer, when should you have a mammogram?
30
If you have a family history of breast cancer and are younger than 30 and/or pregnant, what is the modality of choice?
ultrasound
What other modalities are used besides US for the breast?
mammography-provides a sensitive method of screening for breast cancer
MRI- used along with US to provide additional characterization and further interrogation of breast lesions
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?
aneochic cyst with posterior acoustic enhancement
What are the advantages of breast US over mammography?
can differentiate structures within uniformly dense breast tissue
can visualize tissue adjacent to implants
What is the diameter of a varicocele?
more than 2mm in diameter
What is the fibrous capsule surrounding the testicle?
tunica albuginea
Normal measurements of the testicle:
3-5cm length
2-4cm width
3cm height
Sonographic characteristics of a testicle:
smooth, medium gray structures with a fine echo texture
What is the linear strip that is echogenic that runs through the testis?
mediastinum
Normal location of the epididymis:
begins superiorly and then courses posterolateral to the testis
What are the facts about undescended testes?
10 times more likely to be affected by torsion
2.5-8 times more likely to develop cancer
80% testis found in inguinal canal
more common in premature babies
bilateral in 10-25% of cases
can prohibit spermatogenesis and result in infertility
The most common cause of acute scrotal pain in an adolescent:
torsion
Some common causes for hydroceles:
epididymo-orchitis
torsion
trauma
development of a neoplasm
Know about varicoceles
abnormal dilatation of the veins of the pampiniform plexus
caused by incompetent venous valves within spermatic vein-called primary varicoceles
more common on the left
secondary varicoceles-caused by increased pressure on spermatic vein (result of renal hydronephrosis, abdominal mass, liver cirrhosis)
abdominal malignancy invading left renal vein may cause varicocele with noncompressible veins
What part of the epididymis is the spermatocele located?
head of epididymis
Common cause for scrotal pain in adults:
epididymo-orchitis
What almost always transpires secondary to epididymitis?
orchitis
What is tubular ectasia?
uncommon, benign condition
associated with the presence of a spermatocele, an epididymal or testicular cyst, or other epididymal obstruction
What is a seminoma and what does it look like on US?
most common type of germ cell tumor
homogeneous, hypoechoic masses with a smooth border
Epididymo-orchitis most commonly results from what?
spread of a lower urinary tract infection via the spermatic cord
A clinical history of vasectomy is associated with what?
spermatoceles
What is the primary source of blood supply to the testicle?
right and left testicular arteries
Intratesticular cysts have an association with what?
extratesticular spermatoceles
What is microlithiasis of the testis is associated with what?
testicular malignancy
How frequently is a follow up for patients with microlithiasis recommended?
annually
Attached at the superior pole of the testis between the epididymis and testis is what structure?
appendix
Hydrocele develops between what layers of the scrotum?
between the visceral and parietal layers of the tunica vaginalis
What is the location of the rete testis?
where the tubules converge at the apex of each lobule in the mediastinum
What is the echogenicity difference between the testes and epididymis?
epididymis appears as isoechoic or hypoechoic-compared with the testis
(echotexture is coarser)
