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DMST 254 Abd. and Superficial structures 1 > The Abdominal Mass > Flashcards

The Abdominal Mass Flashcards

1
Q

What are some indications for ultrasound examination of the abdominal walls? 4

A
  1. Palpable mass (wall vs abdominal cavity)
  2. Surgical wound assessment
  3. Trauma
  4. Findings on other imaging modalities
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2
Q

What kind of transducers do we use for abdominal scans?

A

High frequency linear transducer

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3
Q

What is the amount of pressure we need to use for abdomen wall scans?

A

Minimal pressure - a stand off pad may be needed

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4
Q

What is the patient prep for abdomen wall assessments?

A

No patient prep needed

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5
Q

What is the abdominal wall layers? 3

A
  1. Epidermis
  2. Subcutaneous tissue
  3. Muscle
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6
Q

How thick is the epidermis?

A

1-4 mm thick

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7
Q

What is the sonographic appearance of the epidermis? 2

A
  1. Highly reflective
  2. Appears echogenic
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8
Q

What is the subcutaneous layer consist of and how thick is it? And what does it look like sonographically? 3

A
  1. Consists of fat
  2. Variable thickness and echogenicity
  3. Typically less echogenic than muscle
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9
Q

The echogenicity of fat is influenced by what?

A

Water content

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10
Q

What does the anterior and lateral muscle walls consist of? 4

A
  1. Rectus abdominis
  2. External oblique
  3. Internal oblique
  4. Transversus Abdominis
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11
Q

What are the Posterior wall muscles layers? 2

A
  1. Psoas major
  2. Quadratus lumborum
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12
Q

What is the Rectus abdominis? Where is it located?

A
  1. Paired midline anterior muscles
  2. Extends from symphysis pubis and Punic crest to the diploid process
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13
Q

What is the rectus abdominis separated by?

A

Linea alba midline

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14
Q

What is the rectus abdominis enclosed by?

A

Rectus sheath

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15
Q

What is the rectus abdominis formed by?

A

By the aponeuroses of the internal, external and transverse abdominis

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16
Q

The rectus abdominis contains three tendinous insertions between what?

A

Xiphoid and just inferior to the umbilicus

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17
Q

What does the rectus abdominis attach to?

A

Rectus sheath anteriorly

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18
Q

What does the rectus abdominis do?

A

Localize hematomas

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19
Q

What is the linea alba? Where does it extend from? What does it fuse with? 3

A
  1. A fibrous band
  2. Extends from xiphoid to the symphysis
  3. Fuses with aponeuroses of the three anterolateral wall muscles
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20
Q

What is the linea alba wider then?

A

The umbilicus

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21
Q

What is the sonographic appearance of the linea alba?

A

Echogenic

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22
Q

What is the arcuate line?

A

A point between the umbilicus and symphysis where the posterior portion of rectus sheath passes in front of the rectus muscle

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23
Q

What is the external oblique? Where does it originate? How does it run?

A
  1. Outer layer
  2. Originates from outer surface of the lower 8 ribs
  3. Runs diagonally
24
Q

What does the internal oblique lie? 2

A
  1. Deep to the external oblique
  2. Runs diagonally 90 degrees to external oblique
25
Q

What is the transversus abdominis? Where does it lie? And how does it run?

A
  1. Innermost layer
  2. Lies deep to internal oblique
  3. Runs horizontally
26
Q

What is the sonographic appearance of muscles? 3

A
  1. Hyperechoic to sonolucent
  2. Specular reflectors
  3. Striated appearance
27
Q

What is the psoas muscles? Where does it originate? And where does it insert? 3

A
  1. Fan shaped muscle
  2. Originates in the sides of the vertebral column
  3. Inserts into the lesser trochanter of femur
28
Q

What is the u/s appearance of the psoas muscle?

A

Hyperechoic/ lateral to vertebra

29
Q

What is the Quadratus lumborum? Where does it originate? Where doe sit insert?

A
  1. Flat muscle which is posterolateral to psoas
  2. Originates in the iliac crest
  3. Inserts directly into the 12th rib, upper 4 lumbar vertebrae
30
Q

What organ is the Quadratus lumborum posterior to?

A

Kidneys

31
Q

What is the origin of the illacus? Where does it insert? 2

A
  1. Originates at the iliac fossa, sacrum and SI joints
  2. Inserts into the psoas major and lesser trochanters
32
Q

What is the deep ring of the inguinal canal? Where is it located? 3

A
  1. Opening at superior end
  2. Located midway between ASIS and symphysis
  3. Anterior to femoral vessels
33
Q

What is the deep ring defect in?

A

Transversalis fascia

34
Q

What is the superficial ring? Where does it travel though?

A
  1. Opening at inferior end
  2. Travels through external oblique aponeurosis
35
Q

What does the inguinal canal contain?

A

The spermatic cord in males and the round ligaments in females

36
Q

What is the diaphragm? What does it separate?

A
  1. Dome shaped musculotendinous sheets
  2. Separates the thoracic from the abdominal cavity
37
Q

What is the importance of the diaphragm?

A

It is a major active muscle of respiration

38
Q

What is the origin of the diaphragm?

A

Periphery of thoracic cage

39
Q

What are the three groups of muscle fibres that forms the diaphragm?

A
  1. Lumbar spine
  2. Lower sternum
  3. Lower 6 ribs
40
Q

What does the lumbar spine (Curran) consist of in the diaphragm? Where does it join to form? 3

A
  1. 2 Curran (singular -crus)
  2. Right (broader and longer) and left
  3. Join in middle to form arcuate ligaments
41
Q

What does the diaphragm insert into?

A

Central tendon
the three groups of muscle fibres converge radially and insert into a central tendon

42
Q

What is the Crura? Where is it located? (Aorta and at the level of the celiac axis, what does the aorta, and IVC look like?) 4

A
  1. Thin hypoechoic band
  2. Superior to celiac axis- anterior to Ao
  3. At celiac axis - lateral to aorta
  4. Posterior to IVC
43
Q

What are two scanning approaches to scan the pleural space?

A
  1. Abdominal approach (subcostal)
  2. Intercostal
44
Q

What is the abdominal approach to see the pleural space? What will we see? 3

A
  1. We use a curvilinear transducer
  2. We will see the inferior area of pleural space
  3. We will see windows of the liver and spleen
45
Q

What is the intercostal approach to see the pleural space? 3

A
  1. Use a linear transducer
  2. Use ribs as a landmark
  3. Pleural space within 1 cm of rib interface
46
Q

What kind of rib landmarks will we see when we take the inter coastal approach? 2

A
  1. Curved hyperechoic lines
  2. Posterior shadowing
47
Q

When we take a intercostal approach what will we see? 2

A
  1. Visceral pleura
  2. Parietal pleura
48
Q

What does the visceral pleura look like? And how does it move? 2

A
  1. Bright linear interface
  2. Moves with respiration (gliding sign)
49
Q

What does the parietal pleura space look like? 2

A
  1. Weak echogenic line or observed
  2. Hypoechoic separation of parietal and visceral pleura
50
Q

What is the gliding sign?

A

The movement of the visceral pleura back and forth as the patient breathes during a live sonographic assessment

51
Q

Label the
1. External oblique
2. Internal oblique
3. Transversus abdominis
4. Transversalis fascia
5. Parietal peritoneum
6. Subcutaneous tissue

A
52
Q

Label the
1. Anterior layer of rectus sheath
2. Linea alba
3. Parietal Peritoneum
4. Extraperitonal fat
5. Rectus abdominis

A
53
Q

Label the black areas

A
54
Q

Label the black areas

A
55
Q

Label the Quadratus lumborum and the Psoas major

A

DMST 254 Abd. and Superficial structures 1 (26 decks)

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