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Adults > U/S > Flashcards

U/S Flashcards

1
Q

Aorta enters diaphragm at what level

A

T12

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2
Q

Aorta bifurcates into common iliacs at what level

A

L4 or 1 to 2 cm below umbilicus

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3
Q

What is upper limit of normal for AA

A

3cm (actually its 2cm or 1.5X proximal uninvolved segment)

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4
Q

What three branches of aorta are routinely imaged in U/S?

A

celiac, superior mesenteric, renal aa

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5
Q

The celiac trunk has what two main branches visible on U/S?

A

splenic (to L) and hepatic (to R)

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6
Q

Once you identify the celiac and SMA, what is easiest way to see renal?

A

Fan up and down

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7
Q

What veins draining into IVC are routinely visualized on U/S?

A

renal and hepatic; portal, splenic, SMA

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8
Q

Describe view for seeing portal vein

A

sagital plane over liver, portal vein will be intrahepatic superior to IVC (which is longtiduinal); portal vein looks axial

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9
Q

How do you distinguish portal from hepatic veins?

A

PORTAL veins have thick echogenic walls

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10
Q

What vascular structure is just anterior to the SMA?

A

splenic VEIN

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11
Q

Classic liver ultrasound signature

A

ground glass

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12
Q

4 lobes of liver

A

R, L, quadrate, and caudate

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13
Q

Normal GB dimensions

A

2-3 X 7-8 cm

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14
Q

Normal GB wall thickness:

A

<3.5mm

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15
Q

Three parts of GB

A

neck, body, fundus

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16
Q

What common non-pathologic cause makes the GB bigger?

A

poor oral intake

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17
Q

What position improves scanning of the biliary system?

A

left lateral decub

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18
Q

Once the GB is located in a transverse view, what is the best way to obtain axial view?

A

rotate transducer counter-clockwise

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19
Q

What is the position of the bile duct relative to the portal vein?

A

CBD is parallel and superficial to portal vein

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20
Q

What CBD internal diameter usually indicates pathology?

A

1cm

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21
Q

What makes up the portal triad?

A

CBD, hepatic artery, portal vein

22
Q

If cystic duct is seen, can probably assume what?

A

it’s abnormal

23
Q

What can be used to help distinguish CBD from veins?

A

doppler

24
Q

Which is better for detecting injury of spleen, CT or U/S?

A

CT

25
Q

What vessels can be used to help locate the pancreas?

A

splenic artery and vein course along superior aspect

26
Q

AAA criteria

A

> 3cm (30mm) or >1.5X larger than proximal uninvolved segment

27
Q

AAA location

A

90% infrarenal; supra renal 40%; 1 in 3 involve both supra and infrarenal

28
Q

Most common AAA shape

A

fusiform; sac usually projects anteriorly and to the left with thrombus on the left anterior wall

29
Q

How do you measure AAA?

A

OUTSIDE to OUTSIDE (do NOT only measure internal lumen b/c thrombus may be occluding)

30
Q

Why not measure AAA in sagital plane?

A

May not be measuring along midline-may be gettign tangential cut

31
Q

When AAA is observed, where else should one look?

A

At Morison’s pouch to see if leaking blood

32
Q

What does CT add in the evaluation of AAA that is better than U/S?

A

detection of retroperitoneal bleeding; also better for judging proximal and distal extent of aneurysm

33
Q

What to do if see aneurysm?

A

If 4cm, outpt surgical consult

>5cm ED surgical consult

34
Q

DeBakey Classification system

A

1: both=surgica
2: ascending only=surgical
3. descending only=medical

35
Q

Stanford dissection classfication

A

A. involve ascending +/- descending=surgical

B. descending=medical

36
Q

What do you look for on U/S of dissection?

A

intimal flap

37
Q

Which type of gallstone is most common?

A

mixed (other main types are pure cholesterol and pigmented)

38
Q

Three processes of gallstone formation

A

abnormal bile composition, bile stasis, infection

39
Q

gallstone criteria on U/S

A

acoustic shadowing, gravitational dependence, echogenic

40
Q

What is wall-echo sign?

A

“WES” GB full of stones, examiner only seems rim of bladder and superficial surface of stones; may look similar tobowel gas; huge shadow behind

41
Q

What are U/S findings of cholecystitis?

A

GB wall thickening, pericholecystic fluid, U/S murphy’s sign; cholelithiasis

42
Q

Where do you measure GB wall?

A

at interface of the liver with the anterior wall of the GB (avoids distorting effects posterior acoustic enhancement, etc)

43
Q

How does diameter of CBD change with age?

A

increases; gains about 1mm/decade

44
Q

What causes false-positive wall thickening?

A

normal GB contraction; any condition that causes generalized edema (ie ascites, anasarca) can cause GB wall thickening

45
Q

How do polyps differ from stones

A

Not gravity dependent and usually don’t have shadows; need to consider cancer

46
Q

What size renal stone can be seen on U/S?

A

usually >1cm

47
Q

Can you usually see ureteral stones?

A

no

48
Q

If you think you see uerter (unlikely) what can help?

A

color doppler

49
Q

What can help you tell that a cystic structure does indeed have fluid in it?

A

posterior acoustic enhancement

50
Q

When might you want doppler to look at kidney?

A

transplanted kidney

51
Q

How sensitive is U/S for spleen?

A

very very poor; get a CT

Adults (9 decks)

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