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Exam 1 Study Prep
Abdominal Sonography II
| Question | Answer |
|---|---|
| Which term describes a cavity formed by necrosis within a solid tissue or a circumscribed collection of purulent material? | Abscess |
| True statements about abdominal abscesses | presence of right subhepatic abscess generally implies previous contamination of right subhepatic space -Abscess collections appear varied in texture depending on length of time and space available for formation |
| What type of hernia is usually filled with fat? | Epigastric |
| What is a discrete, linear echogenicity in the deepest layer of the anterior abdominal wall? | Peritoneal Line |
| Where are the most common sites for abdominal abscess formation? | Hepatic recesses and perihepatic spaces |
| Fluid collections in the right posterior subphrenic space cannot extend between the bare area of the liver and what other structure because of the coronary ligament? | Diaphragm |
| What abdominal structure consists of peritoneum and hangs over the intestines like an apron? | Greater Omentum |
| Free fluid tends to collect in what areas of the abdomen and pelvis? | Most dependent |
| What ligament forms the posterior portion of the left lateral border of the lesser sac and separates the lesser sac from the renosplenic recess? | Splenorenal |
| What abdominal structures is able to adhere to diseases organs and "wall off" the spread of diseased fluid collections? | Greater Omentum |
| What structures on the right side of the liver form the subphrenic and subhepatic spaces? | Ligaments |
| What are clinical symptoms associated with infections? | Chills, localized tenderness, malaise (all are correct) |
| Which lobe of the liver is located in the lesser sac? | Caudate Lobe |
| What abdominal ligament is the left lateral extension of the greater omentum that connects the greater curvature of the stomach to the superior splenic hilum and forms a portion of the left lateral border of the lesser sac? | Gastrosplenic |
| What is the smooth tissue that lines the entire abdominal cavity and is reflected over the contained organs? | Peritoneum |
| What term describes an extrahepatic, loculated collection of bile? | Biloma Abscess |
| In which direction will subhepatic lesions displace abdominal structures? | Inferior and Posterior |
| Which pathological condition may mimic a gas-containing abscess? | Teratoma |
| Anterior displacement of the kidney and dilated ureter suggests a mass in which abdominal location? | Retroperitoneal |
| What are some differential diagnoses for a lesser-sac abscess? | Pseudocyst, gastric outlet obstruction, fluid-filled stomach (all of the above) |
| What is a lymphocele? | Collection of fluid that usually occurs after surgery |
| What are the sonographic image characteristics of inflammatory or malignant ascites? | Thickening of interfaces between the fluid and adjacent structures, clumping of bowel loops, fine or coarse internal echoes (all are correct) |
| What term describes a spread of infection from its initial site into the bloodstream? | Sepsis |
| What term describes a cystic mass located between the umbilicus and the bladder? | Urachal Cyst |
| Where are the primary sites of implantation for peritoneal metastases? | Ovaries, Stomach, Colon |
| True statements about adrenal carcinoma. | Produce steroids and associated with one of the hyperadrenal syndromes -hyperfunctional malignant tumors are more common in females -strong tendency for invasion into the adrenal vein, IVC, & lymph glands |
| Which structures are located in the retroperitoneal space? | Kidneys, aorta and IVC, Psoas muscles, etc. (all of these are retroperitoneal in their location) |
| Which disease process can cause anterior displacement of the abdominal aorta? | Lymphadenopathy |
| The medial section of the right adrenal gland lies posterior to which abdominal structure? | IVC |
| Which syndrome is characterized by adrenal hypofunction? | Addison's |
| True statement about the adrenal medulla | The medulla is not essential to life |
| Which muscles lie posterior to the kidneys? | Psoas and Quadratus Lumborum |
| True statement about Adrenal Cysts | They cause no clinical symptoms when they are small |
| What anatomy separates the adrenal glands from the kidneys? | Perinephric Fat |
| What is one of the most common malignant tumors in childhood? | Neuroblastoma |
| What is the name of the potential space between the bladder and rectum? | Rectovesical |
| The retroperitoneal space is located between what two abdominal structures? | Posterior portion of the parietal peritoneum and posterior abdominal wall muscles |
| What does the "sandwich" sign represent? | Enlarged lymph nodes anterior and posterior to the mesenteric vessels |
| What is the length (in cm) of the normal adult adrenal gland? | < 3cm |
| A left adrenal mass may displace the splenic vein in which direction? | Anteriorly |
| True statement about adrenal malignancies | Primary adrenal carcinomas are rare |
| Which adrenal medulla tumor is occasionally found in patients with intermittent hypertension? | Pheochromocytoma |
| Which abdominal structure can be confused with the normal right adrenal gland? | Crus of the diaphragm |
| In which abdominopelvic muscles may a retroperitoneal abscess form? | Quadratus Lumborum, Psoas, Iliacus (all of the above) |
| What is one of the sonographic findings of a retroperitoneal hemorrhage? | Displacement of abdominal organs |
| What disease process usually causes adrenal insufficiency? | Metastases |
| Which syndrome is characterized by excessive secretion of aldosterone? | Conn's |
| The esophagus enter the stomach at which orifice? | Cardiac |
| True statements about gastric carcinoma. | 1/4 occur in body & fundus of stomach -90% of malignant stomach tumors are carcinomas -1/2 occur in pylorus |
| Which term describes the segments of the colon? | Haustra |
| True statements about Chron's disease. | Symmetrically swollen bowel loops -absent or sluggish peristalsis -matted appearance of the bowel loops |
| Metastatic disease to the stomach may be secondary to which primary malignancies? | Breat, lung, melanoma (all of these malignancies can metastasize to the stomach) |
| Which condition is associated with small bowel obstruction? | Dilation of the bowel loops PROXIMAL to the site of obstruction |
| What structure is often imaged on a sagittal ultrasound to the left of the midline as a "bulls-eye" or target pattern, anterior to the aorta and posterior to the left lobe of the liver? | Gastroesophageal Junction |
| The celiac axis, superior mesenteric artery, and what other major abdominal artery supply both the small and the large intestines? | Inferior mesenteric artery |
| What is the most common benign tumor of the stomach? | Leiomyoma |
| What is the maximum outer diameter (in mm) of a normal appendix? | 6.0 |
| What are the sonographic indications of lymphoma of the stomach? | Relatively large, hypoechoic mass -marked thickening of the gastric walls -spoke-wheel pattern within the mass (all of the above) |
| What is the sonographic appearance of acute appendicitis? | Target (bulles eye) lesion |
| The "pseudo kidney" sign may be seen in which malignancy of the upper GI tract? | Gastric carcinoma |
| Where is the appendix located when viewing the patient's exterior abdominal wall? | Posterior to McBurney's point |
| Where in the alimentary canal does the absorption of sodium and water occur? | Colon |
| Where is the most common location for a diverticulum in the alimentary canal? | Colon |
| Progression of acute appendicitis to frank perforation is more rapid in which age group? | Younger children |
| True or False: Appendicitis is easily diagnosed due to its unique signs and symptoms. | False |
| The sonographic "keyboard" sign is seen in which alimentary canal structure? | Duodenum |
| Most of the digestion of food and the absorption of nutrients takes place in which section of the GI tract? | Small Intestine |
| How many sections make up the duodenum? | Four |
| Portal venous gas is a common finding in the early days post-liver transplant but has a poor prognosis if it persists. What is another relatively benign condition that can mimic portal venous gas? | Pneumobilia |
| Which of the following is commonly seen post liver transplant? | Biliary Stent |
| Which of the following is an urgent finding in the immediate post transplant period? | Portal Vein Thrombosis |
| What is the most common cause for elevation of hepatic artery RI post liver transplant? | Edema |
| Which of the following is a sonographic sign of liver transplant rejection? | Elevated RI |
| Velocities in the hepatic artery post liver transplant should be below? | 200 cm/sec |
| What is the difference between a cadaver liver transplant and living donor liver transplant? | Living donor transplant involves only part of the liver |
| You are asked to image a transplant liver patient 3 months after surgery to rule out hepatic artery thrombosis. Which of the following would confirm this diagnosis? | Absence of color and spectral Doppler waveforms |
| A renal transplant patient presents three weeks post procedure with fever and pain over the allograft. Sonographic imaging reveals a complex fluid collection near the transplant. what does this most likely represent? | Abscess |
| What is the most common location for a renal transplant to be located? | Right iliac fossa |
| What is the most common location for a peritransplant urinoma? | Between the kidney and the bladder |
| While performing a sonographic study on a post renal transplant patient, you notice low-level echoes in a dilated collecting system. The patient has complaints of fever and pain. What is the most likely diagnosis? | Pyonephrosis |
| Which of these is the most common vascular complication following renal transplantation? | Renal artery stenosis |
| Native kidneys in a renal transplant patient are typically? | Left in their position in the retroperitoneum |
| A low RI in a transplant kidney can be a strong indicator for what condition? | Proximal Stenosis |
| What is the most common site for IVC thrombosis or stenosis post liver transplant? | Anastomosis |
| Which of the following post transplant findings may resolve spontaneously? | Hematoma |
| What is the most common complication after a liver transplant biopsy? | Bleeding |
| What is the normal gray scale appearance of the liver parenchyma post transplant? | Isoechoic to right renal cortex |
| What is the most common reason for liver transplantation in the United States? | Cirrhosis due to chronic hepatitis C |
| What is the most common renal peritransplant fluid collection? | Lymphocele |
| Which of the following is a sonographic sign of acute renal transplant rejection? | The kidney is enlarged and edematous |
| What is the typical appearance of a renal transplant infarct? | Hypoechoic wedge shape |
| True or False: Cadaveric renal transplants have a better allograft survival than living donor transplants. | False |
| Which of the following is a normal RI of the arcuate artery in a renal transplant? | 0.6-0.7 |
| What cavity can fluid be contained superior to the liver? | Pleural Cavity |
| Retroperitoneal masses can displace ureters and kidneys... | Anteriorly |
| What is the most common fluid collection found post-operatively? | Lymphocele |
| Which of the following hernias is most likely to contain bowel? | Inguinal |
| The outer portion of the adrenal gland is called? | Cortex |
| What is the length of the normal adult adrenal gland? | < 3cm |
| Hyperfunctional malignant adrenal tumors are more common in? | Females |
| Which adrenal tumor can cause intermittent hypertension? | Pheochromocytoma |
| What is a walled off collection of extravasated urine called? | Urinoma |
| What muscles lie posterior and medial to the kidneys? | Psoas |
| What syndrome is characterized by excessive secretion of aldosterone? | Conn's |
| The sonographic "keyboard" sign is seen in which structure? | Duodenum |
| The appendix is located posterior to what abdominal wall landmark? | McBurney's Point |
| What is the maximum diameter of a normal appendix? | 6mm |
| What is the most common reason for liver transplantation in the US? | Cirrhosis due to Hep C |
| Elevated RI's post-transplant can indicate? | Rejection & Venous Congestion |
| Which of the following can be identified post liver transplant? | Biliary Stent & Hepatic Artery |
| What is the most common cause for elevated RI's post liver transplant? | Edema |
| What is the most common vascular complication post renal transplant? | Renal Artery Stenosis |
| Transplant renal artery to iliac artery ratio should be? | Less than 3 |
| What vessels comprise the portal triad? | Portal Vein, Hepatic Artery, Common Bile Duct |
| Which of the following does not drain directly into the IVC? | Splenic Vein |
| Which of the following drains directly into the IVC? | Right renal vein, right hepatic vein, and common iliac vein |
| Which of the following describes the anatomic course of the GDA? | Caudal, anterior to the pancreatic head |
| The hepatic veins drain into what vessel? | IVC |
| What term describes the normal flow pattern in hepatic veins? | Triphasic |
| Which vessel provides the greatest amount of oxygenated blood to the liver? | Portal Vein |
| Which hepatic vein divides the liver into two lobes? | Middle Hepatic Vein |
| Which of the following would indicate pyloric stenosis? | Muscle Width >3mm and Canal Length >1.2cm |
| What term is used to describe bowel that has telescoped on itself? | Intussusception |
Created by:
marissagirl