Superficial Structures

Question 1

Clinically, most abscess patients present with symptoms of…

Answer 1

fever and high WBCs.

Question 2

Sonographically, abscess appear as a ___ mass with ___ borders.

Answer 2

complex, irregular

Question 3

Gas within an abscess will produce a ___ artifact.

Answer 3

reverberation (comet-tail)

Question 4

This is the excessive accumulation of serous fluid in the peritoneal cavity.

Answer 4

ascites

Question 5

What two mechanisms produce ascites?

Answer 5

1. low serum osmotic pressure

2. high portal venous pressure

Question 6

The causes of ascites include:

Answer 6

1. cirrhosis*
2. hypoalbuminemia
3. Budd-Chiari syndrome
4. heart failure
5. cancer
6. nephrotic syndrome

Question 7

Ascites is commonly found at the ___ aspect of the RLL, in ___ pouch, in the pelvic ___, and ___ gutters.

Answer 7

inferior, Morrison’s, cul-de-sac, paracolic

Question 8

T/F? Gallbladder thickening is frequently seen with ascites.

Answer 8

true

Question 9

What intervention successfully treats ascites by lowering portal pressure?

Answer 9

TIPS

Question 10

What’s a normal diameter for TIPS?

Answer 10

8 mm or more

Question 11

This type of ascites is indicated by freely floating bowel and treated by therapeutic paracentesis.

Answer 11

benign

Question 12

In this condition, the bowels loops are tethered to the posterior abd wall by complex fluid collections.

Answer 12

malignant ascites

Question 13

Another phrase for malignant ascites is…

Answer 13

pseudomyxoma peritonei (PMP).

Question 14

Malignant ascites is caused by…

Answer 14

metastasis or the rupture of a mucinous ovarian or appendix tumor.

Question 15

T/F? Therapeutic paracentesis is frequently ordered for malignant ascites.

Answer 15

FALSE, the fluid is too thick.

Question 16

What’s the modality of choice for PMP?

Answer 16

CT, in which liver ‘scalloping’ can be seen

Question 17

This is an encapsulated collection of bile in the peritoneal cavity resulting from bile duct disruption.

Answer 17

biloma

Question 18

T/F? A biloma usually appears as a poorly-defined fluid collection within the liver.

Answer 18

FALSE, well-defined

Question 19

What are the differential diagnoses for a biloma?

Answer 19

liver cyst, need a needle aspiration to be sure

Question 20

T/F? Bilomas are predominantly cystic masses located in the LUQ.

Answer 20

FALSE, RUQ

Question 21

This is a collection of blood which is usually confined to an organ, tissue or space.

Answer 21

hematoma

Question 22

___ invasion causes hematomas to appear hyperechoic.

Answer 22

Fibrin

Question 23

Gradual ___ eventually causes a hematoma to appear anechoic.

Answer 23

hemolysis

Question 24

Organization of the clot or fragmentation of the hematoma will produce ___.

Answer 24

irregular echoes

Question 25

___ are often associated with longstanding hematomas.

Answer 25

Calcifications

Question 26

___ is the volume of RBCs found in 100 ml of blood.

Answer 26

Hemotocrit

Question 27

A ___ in the hematocrit indicates the presence of a hematoma.

Answer 27

decrease

Question 28

Sonographically, a hematoma looks like an ___ but without the patient having a fever or elevated WBCs.

Answer 28

abscess

Question 29

U/s is used in the thorax for…

Answer 29

1. IDing pleural effusions
2. IDing solid pleural masses
3. IDing loculated thoracic fluid
4. measurement of diaphragm motion
5. localization for a thoracentesis

Question 30

This is fluid outside the lung that tends to follow gravity and pool at the base of the thorax.

Answer 30

pleural effusion

Question 31

What’s the appropriate position for a thoracentesis patient?

Answer 31

Whatever the physician wants!

Question 32

This is a collection of synovial fluid in the popliteal fossa, usually in the medial aspect.

Answer 32

baker’s cyst

Question 33

Baker’s cysts are caused by ___ arthritis, ___arthritis, and ___ of the knees.

Answer 33

rheumatoid, osteo-, overuse

Question 34

These can be mistaken for a DVT due to pain and swelling behind the knee and in the upper calf.

Answer 34

baker’s cyst

Question 35

These are two longitudinal muscles extending from the zyphoid process to the pubic bone.

Answer 35

rectus abdominus

Question 36

These are encased in a sheath anteriorly and posteriorly that joins at the midline to form the linea alba.

Answer 36

rectus abdominus

Question 37

This is an uncommon and often clinically misdiagnosed cause of abdominal pain.

Answer 37

rectus sheath hematoma (RSH)

Question 38

RSH is caused by damage to the superior or inferior ___ arteries or a direct ___ of the rectus muscle.

Answer 38

epigastric, tear

Question 39

Blood cannot flow past the midline in a RSH because of the ___.

Answer 39

linea alba

Question 40

RSH occur in a variety of conditions such as…

Answer 40

1. trauma
2. pregnancy
3. surgical injury
4. anticoagulation tx
5. long-term steroid tx
6. heavy physical activity
7. violent coughing

Question 41

The posterior wall of the rectus abdominal sheath ends at the…

Answer 41

arcuate line.

Question 42

A RSH ___ to the arcuate line is contained and will not move.

Answer 42

superior

Question 43

A RSH ___ to the arcuate line will extend into the pelvis.

Answer 43

inferior

Question 44

This is a protrusion of intra-abdominal contents through defect in the posterior fascia.

Answer 44

umbilical hernia

Question 45

This is a separation of the rectus abdominal muscles.

Answer 45

diastasis recti