Superficial Structures Flashcards
Gas causes what type of sonographic artifact
Reverberation (comet tail )
Extra hepatic collection of bile
Caused by: trauma, gb disease, biliary sx
Biloma
Sonographic findings of a biloma
Predominately cystic mass in ruq
2 mechanisms that produce ascites
Decrease serum osmotic pressure
Increase in portal vein pressure
Most common cause of ascites
Cirrhosis
Causes of ascites
Cirrhosis Hypoalbunemia Budd-chiari Heart failure Cancer Nephrotic syndrome (protein loss)
Successful treatment of ascites
TIPSS
Benign ascites
Free floating bowel
Bowel loops tethered or matted to posterior abdominal wall with complex or loculated fluid collections
Malignant ascites
Lymphoceles are caused by:
Lymph leakage from renal allograft & surgery disruption of lymphatic channels
Lymphoceles differentials:
4
Presence of internal echoes are more consistent with_______&_______.
Any fluid collection: ascites
Urinoma
Hematoma
Abscess
Tendon separation from distal pole of patella
Patellar tendon rupture
Irregular borders , complex, debris, septations,and possible gas
Patient presents: fever with increased WBC
Abscess
Cause of patellar tendon rupture :
Occurs more with systemic dz such as:____,____,&_____.
“Jumping”- sports
Lupus, renal failure, rheumatoid arthritis
Patellar tendon rupture:
Pt is unable to______
Palpable defect known as______
Extend the knee
“Dimple sign”
Achilles’ tendon rupture occurs where?
Approx. 3-4cm sup
Thompson test
Prone position with knee at 90 degrees squeeze calf
Sonographic presentation for Achilles’ tendon rupture
C/ or s/ fluid collection
Disrupted normal striations
Pseudomyxoma peritonei : aka
Malignant ascites
Pseudomyxoma peritonei: sonographic presentation
Causes:
Bowel loops matted to post abdominal wall
Mets
Rupture of mutinous cystadenocarcinoma of ovary
Mutinous tumor of appendix
Hematoma:
Lab-
Fibrin invasion presentation-
Decrease in hematocrit
Hyperechoic
Hematocrit :
Volume of RBC found in 100ml of blood
Types of lymphoma
Non-hodgkins
Hodgkins
Sonographic sign for lymphadenopathy
“Sandwich” or “mantle”
Lymphoma displaces the IVC & SMA________.
Anteriorly
Finding assoc. with Non-Hodgkin’s lymphoma (5)
Lymphadenopathy Hsm Cytopenia Abd mass ( bowel obstruction) Hydronephrosis d/t retro nodes
Causes of bakers cyst (3)
Rheumatoid arthritis
Osteoarthritis
Over use of knee
2nd most common tumor of hand & (wrist)
Presentation:
Giant cell tumor
Solid
Most common tumor of hand/wrist
Presentation
Ganglion cyst
Simple with enhancement
Sheath encasing rectus bad onus from xiphoid to pubic bone
Linea alba
Midway btwn umbilicus and symphysis pubis
Arcuate line
Rectus muscle hematoma ____ to arcuate line should not move across the midline d/t the _________.
Superior
Lines alba
Rectus Muscle hematoma ______ will extend into the pelvis mimicking pelvic pathology
Inferior
Rectus sheath hematoma lab value?
Decrease in hematocrit
Causes of rectus sheath hematoma (5)
Trauma Sx trauma Muscle contraction Vassal a coughing/ vomiting Pregnancy
Name in order of decreasing echogenicity: Spleen/liver Renal sinus Pancreas Renal cortex
Renal sinus
Pancreas
Spleen/liver
Renal cortex
Granulomas are caused by________or_________
Histoplasmosis or tuberculosis
__________is common in North America in the Great Lakes basin and in mid-western US
Histoplasmosis
Hepatitis may result in the elevation of these for lab values
Alt, ast, conjugated, unconjugated bilirubin
Hep. Route of infection
Hep a
Fecal/oral
Hep. Route of infection
Hep b
Blood/ body fluids (terminal)
Hep. Route of infection
Hep c
Blood/body fluids(terminal)
Most frequent indication for liver transplant
Hcv- associated chronic liver disease
Sonographic findings of acute hepatitis
“Starry night” peri portal cuffing
Hypoechoic
Enlarged liver size
Hyperechoic pv walls
Sonographic appearance of chronic hepatitis
Hyperechoic liver
Small in size
Decreased echo of pv wall
Complex mass,echogenic gas,reverb artifact
Pyogenic (bacterial) abscess
Symptoms of Pyogenic abscess
Run pain
Leukocytosis
Fever
Elevated lft
3 major forms of liver abscess
Pyogenic:( bacterial)-80% of cases in us
Amebic: d/t entamoeba hyst. 10%
Fungal: candida>10%
Occurs when a parasite from the intestine reaches the portal vein.
Occurs in immigrants and travelers : 8-12wks from date if travel.
Amebic abscess
Ruq pain Diarrhea fever Leukocytosis Elev. lfts Elev. rt dome of diaphragm on x-Ray
Amebic abscess
A fungal( mycotic) infection of blood that results in small abscess in the liver. Typically asymptomatic.
Fungal abscess (aka-candidias)
Sonographic presentation of fungal abscess
“Wheel within a wheel” - earliest and most recognizable: anechoic center separates from mets.
“Bulls eye”- calcified center
“Uniformly hypoechoic focus”-most common presentation
“Echogenic focus”
