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DRG3007 Sono > Week 10 > Flashcards

Week 10 Flashcards

1
Q

what organs are not routinely included in upper abdomen scans and why

A

stomach & large intestines due to presence of air which causes 99% of beam to be reflected from air-tissue interface and obstructs viewing of deeper structures

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2
Q

ALT

A

Alanine transaminase

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3
Q

AST

A

aspartate transaminase

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4
Q

ALP

A

alkaline phosphatase

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5
Q

GGT

A

gamma-glutamyl transferase

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6
Q

abnormal liver function tests include:

A

ALT, AST, ALP, GGT, serum bilirubin, albumin

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7
Q

why is fasting done

A
  • minimizes bowel gas & peristalsis
  • empty stomach
  • bowels not distended
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8
Q

why should one not smoke / chew gum

A

increases subcostal gas

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9
Q

transducer used for upper abdomen

A

low frequency curvilinear transducer for greater penetration

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10
Q

purpose of turning oblique and lateral for patient position of upper abdomen

A
  • makes liver fall away from ribs
  • gas in hepatic flexure rises away from liver
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11
Q

what planes are scanned for complete upper abdomen analysis

A

longitudinal, transverse, oblique

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12
Q

scanning is usually done with arrested __

A

deep inspiration

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13
Q

what is the purpose of deep inspiration

A
  • expands ribcage
  • diaphragm contracts
  • liver moves inferiorly
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14
Q

what organs are scanned transverse & longitudinal

A

right & left lobe of liver, kidneys, pancreas

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15
Q

what organs are scanned longitudinal

A

spleen, gallbladder & biliary system

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16
Q

liver is made up of 3 lobes which are __

A

right, left & caudate lobe

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17
Q

smallest lobe

A

caudate lobe

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18
Q

caudate lobe is delineated by fissure of __

A

ligamentum venosum

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19
Q

liver vessels include __

A

portal vein, hepatic artery & hepatic veins

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20
Q

liver blood supply

A

portal vein (75%) & hepatic artery (25%)

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21
Q

liver drains into __

A

right, middle & left hepatic veins

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22
Q

what divides liver into right & left lobes

A

middle hepatic vein

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23
Q

what does hepatic artery carry

A

oxygen

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24
Q

what does portal vein carry

A

nutrients

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25
how does liver appear compared to right kidney
hyperechoic
26
what is the transducer position for longitudinal imaging of left liver
transducer parallel to MSP at midline, inferior to xiphoid process
27
what is the transducer position for transverse imaging of right liver
transducer placed subcostal, oblique and angled cephaladly - patient must be LPO
28
what differentiates portal veins and hepatic veins in US images
portal veins have echogenic & reflective fibrofatty walls which are reflective
29
portal veins flow into __
liver / hepatopetal flow
30
hepatic veins drain into __
IVC / hepatofugal flow
31
how does fatty infiltration appear and why
liver echoes appear more echogenic compared to right kidney due to triglyceride deposition which increases sound wave reflection
32
how does liver cirrhosis appear
liver parenchyma appears coarse & irregular due to fibrosis / jagged edges
33
most common complication of liver cirrhosis
portal hypertension which causes - enlarged portal vein - reversed portal vein flow - splenomegaly
34
how does portal hypertension cause splenomegaly
- cirrhosis causes hardening - bloodflow resistance to liver increases; becomes sluggish - progression leads to reversed PV blood flow = increased tension to spleen = splenomegaly
35
how does liver simple cyst appear in US images
- round - anechoic - posterior enhancement due to low attenuation of sound beam - well-defined wall
36
how does liver complex cyst appear in US images
thick, irregular wall with septations / internal echoes / mass effect / bleeding
37
most common benign liver lesion
liver hemangioma
38
how does liver hemangioma appear in US images
- hyperechoic compared to liver parenchyma - well-defined wall - no vascularity on doppler
39
what is the 2nd most common benign lesion
focal nodular hyperplasia
40
how does liver focal nodular hyperplasia appear in US images
- isoechoic - peripheral & central vascularity seen
41
how does liver abscess appear in US images
irregular complex solid cystic area
42
common indications of liver abscess
- high fever - pain - nausea - raised WBC
43
most common liver carcinoma
liver hepatoma / hepatocellular carcinoma (HCC)
44
what is liver hepatoma associated with
chronic liver diseases - hepatitis B/C - cirrhosis
45
how does liver hepatoma appear in US images
- hypervascularity on doppler - wide range of US appearances
46
patients with liver hepatoma tend to complain about __
abdominal pain, weakness, weight loss
47
how does non-fasted GB appear compared to normal GB
contracted and thickened walls
48
portal triads contains __
bile ducts, hepatic artery, portal vein
49
where can portal traid seen in __ bile ducts
intrahepatic
50
what is commonly not visualized for IH bile ducts
bile ducts & hepatic artery
51
what forms CHD
right + left hepatic duct
52
what forms CBD
CHD + cystic duct
53
List the extrahepatic bile ducts
CBD, CHD, cystic duct
54
what is measured for CBD
internal lumen only
55
why could CBD appear dilated
post GB removal / cholecystectomy and obstructed
56
how are GB and CBD scanned in routine abdominal US
scanned 90 degrees to LCM
57
GB is __ to right kidney
anterior
58
CBD __ to portal vein
anterior
59
how does gallstone disease / cholelithiasis appear in US images
- echogenic with strong posterior shadowing - mobile which differentiates this from polyps
60
how does GB stones appear in supine, LPO and erect
supine = neck of GB LPO = body of GB erect = fundus of GB
61
how does acute cholecystitis appear in US images
- thickened GB wall - gallstones +/- sludge - presence of pericholecystic fluid around GB - positive Murphy's sign
62
what is Murphy's sign
GB is tender upon US probe palpation while in inspiration
63
acute cholecystitis complications
- perforation - gangrenous cholecystitis
64
how does GB sludge appear in US images
- echogenic material within GB - no posterior shadows - moves slowly when patient changes positions
65
how does GB polyps appear in US images
- protrude into GB lumen - does not gravitate with position changes - does not cast posterior shadows - less echogenic than gallstones
66
when is GB polyps surgically indicated
>1 cm
67
how does adenomyomatosis appear in US images
- overgrowth of mucosal wall - intramural sinus tracts formed - comet tail artifacts within sinus
68
how does GB carcinoma appear in US images
sizable intraluminal mass with internal vascular flow
69
how does dilated common duct appear in US images
- CBD dilatation - presence of stones in CBD / choledocholithiasis - intrahepatic bile duct dilatation / many tubes seen
70
The presence of comet tail artifacts in the gallbladder is a feature of
Adenomyomatosis
71
What is the most common benign liver tumor detectable with ultrasound?
Hemangioma
72
Which of the following structure divide the liver into anatomical RIGHT and LEFT lobe?
Middle hepatic vein

DRG3007 Sono (11 decks)

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