-
Doppler flow pattern of a missed torsion
Increased testicular flow
-
Doppler flow pattern of an early testicular torsion
- Decreased blood flow
- Hypoechoic and enlarged
-
Sonographic pattern of a late torsion
Hypoechoic and smaller with no bloodflow
-
Sonographic pattern of epididymitis
- Epididymal enlargement with hypoechoic pattern
- Increased Doppler signal
-
Epididymoorchitis usually develop secondary to ____.
Epididymitis
-
Location of hydrocele
Abnormal fluid collection between visceral and parietal layers of the Tunica vaginalis
-
When the sonographer detects a right varicocele what should be looked at next
Check the IVC for obstruction
-
Prostate zone where the majority of cancer originates
The peripheral zone
-
Prostate zone where BPH generally originates
Transitional zone
-
Normal sonographic pattern of malignancy in the prostate
70% are hypoechoic and initiate in the peripheral zone
-
Sonographic sign of prostate cancer
- Asymmetry of peripheral zone
- Hyper vascular
-
Characteristics essential for the diagnosis of benign prostate hyperplasia
- Decreased force and caliber of urinary stream
- High postvoid residual volume
- Prosthetic enlargement of the transitional zone
-
Normal cause of prostatitis
Usually the result of a bacterial infection (UTI)
-
Site of origin for most breast pathology
Terminal ductolobular unit
-
Milk of calcium cyst of the breast is common with
Fibrocystic changes
-
Most common breast mass and women under 35
-
Most frequent cause of nipple discharge
Intraductal papilloma
-
Fothergill's sign
Hematoma does not cross midline and remains palpable with tense rectus muscle
-
Rectus sheath hematoma is associated with
A history of trauma
-
Most common benign finding of the abdominal wall
Lipoma
-
Most frequent site of a Baker's cyst
Posteriomedial aspect of the joint capsule
-
Most frequent condition associated with a Baker's cyst
Rheumatoid arthritis
-
Transudate pleural effusion is associated with
CHF, cirrhosis with ascites, urinary tract obstruction
-
Exudate pleural effusion is associated with
Inflammatory and the a plastic causes
-
Plural thickening greater than ____ suggests malignancy
1 cm
-
Normal size of the adult adrenal gland
4 x 2 x .5 cm
-
Most common adrenal neoplasm
Adenoma
-
Functional adenoma a.k.a.
- Cushing's syndrome
- secretes cortisol
-
Most common cause for abdominal mass in young children
Neuroblastoma
-
Most common medullary tumor of the adrenal gland
Pheochromocytoma
-
Sonographic patterns associated with pheochromocytoma
5 to 6 cm well-defined homogeneous hypoechoic mass
-
Metastasis to the adrenal gland generally arises from
Bronchogenic and breast primary cancers
-
Sonographic patterns of a hemorrhage from fresh to chronic
- Fresh: echogenic
- Older: hypoechoic/complex, smaller
- Chronic: calcifications
-
Normal measurement of the spleen
- 12 x 7 x 4 cm
- Mild splenomegaly measurement
- Length over 13 cm AP over 6 cm
-
Ashers sign
Spleen extends more than 2 cm anterior to the aorta
-
Relationship of the splenic vein branches to arterial tributaries
They do not accompany each other throughout splenic parenchyma
-
Splenic artery arises from
The celiac trunk
-
Lateral recess of the lesser sac is located
Medial to the spleen
-
Conditions the produce splenomegaly
- Neoplasms: Lymphoma, leukemia, metastasis
- Infections: hepatitis, Mono
- Immunologic: lupus, aids, portal hypertension
- Cirrhosis
- Anemias, sickle cell disease
-
Most frequent primaries associated with splenic metastasis
Melanoma, lymphoma, leukemia
-
Histoplasmosis
- Caused by mold produces granulomas within spleen
- Splenic abscess
-
Candidal abscess in the spleen
- AIDS patients
- Bull's-eye pattern, hyperechoic foci
-
What imaging modality is the method of choice for evaluation of splenic trauma
CT
-
Sonographic patterns of a hematoma
- Fresh: echogenic
- 1 to 2 days old: isoechoic
- Older: complex to cystic
-
Areas evaluated on an FAST exam
Morrison's pouch, posterior cul-de-sac, left and right paracolic gutters
-
Classic sonographic pattern of an infarction
- Wedge-shaped area with the base towards organ capsule
- Recent: Hypoechoic
- Chronic: hyperechoic
-
One of the most frequent causes for focal splenic mass
Infarction
-
Normal bowel wall thickness should not exceed _____ when distended
3 mm
-
Hypertrophic pyloric stenosis
Pyloric sphincter connects antrum of stomach with duodenum, hypertrophy produces constriction/obstruction of gastric outlet and projectile vomiting
-
Transverse pyloric muscle should not measure more than ___.
3mm
-
Pyloric canal length greater than ___ suggests pyloic stenosis.
1.2 cm
-
Inner layer of bowel wall
Superficial mucosa
-
Outer layer of bowel wall
Serosa
-
Most frequently performed G.I. ultrasound exam
Acute appendicitis
-
Maximum outer diameter and wall thickness of the appendix
- Outer wall diameter 6 mm or less
- Wall thickness 2 mm or less
-
Crohn's disease usually affects what parts of the GI tract
Terminal ileum and colon
-
Paralytic ileus
- Destruption in nervous stimulation for peristalsis
- Common with acute pancreatitis
-
Intussusception
Portion of bowel loops telescopes into adjacent bowel
-
Most frequent primary cancer of the bowel
Adenocarcinoma
-
Potential spaces of the greater sac
- Paracolic gutters
- Right and left subphrenic spaces
- Posterior and anterior cul-de-sac
- Right and left colic spaces
- Right and left subhepatic spaces
- Morrison's pouch
-
Inferior borders of the lesser sac
- Caudate lobe
- Phrenicosplenic ligament
- First portion of duodenum
- Gastrosplenic ligament
- Transverse mesocolon
- Foramen of Winslow
-
Cause of Chylous ascites
Lymphatic obstruction
-
Echogenic ascites is most commonly the result of
- Mucinous cystadenoma carcinoma
- Rarely associated with appendicitis
-
Peritoneal metastasis is the most frequently associated with primaries from
G.I. tract, kidney, pancreas, breast and pelvic organ primaries
-
Contents of the retroperitoneal cavity
Kidneys, adrenal gland, pancreas, aorta, IVC, lymph nodes, major portion of duodenum, asending in transverse colon
-
Superior and inferior borders of the retroperitoneal cavity
- Superior: diaphragm
- Inferior border: pelvic brim
-
Gerotas fascia
Posterior border of the anterior pararenal space
-
Organs contained in the posterior pararenal space
Contains no organs
-
Fascia of Zuckerkandl
Separates pararenal space from posterior pararenal space
-
As a general rule lymph nodes should never be located ____ in relation to the aorta
Posterior
-
Lymph nodes enlarge in the presence of
- Infection
- Malignancy
- Hyperplasia
-
Most common pathway for metastasis
Lymphadenopathy
-
Most common primary is that metastasize to the lymph nodes
Renal, testicular, cervical, prostate
-
Normal diameter of the proximal and distal aorta and iliac arteries
- In general: 1 to 3 mm
- Proximally order: 2 to 3 cm
- Distal aorta: 1 to 2 cm
- Iliac arteries: less than 2 cm
-
An aneurysm is considered ___ cm, with an increased risk of rupture at __ cm.
- Aneurysm: 3 to 4 cm diameter
- Risk of rupture significantly increases greater than 5 cm
-
Fusiform aneurysm
Most common type of anyurism entire diameter is dilated
-
Saccular aneurysm
Localized portion of wall weakens
-
Dissecting aneurysm
Along the plane of the aortic wall, normal intra-lunar diameter and greatly increased outer two outer measurement
-
Mycotic aneurysm
Due to infection
-
Symptoms of leaking or ruptured aneurysm
Moderate to severe abdominal/groin pain that increases in severity of the patient sits or stands
-
Pseudoaneurysm
- Blood collection outside vessel wall that communicates with an artery via a neck
- Produces swirling flow was in mass "ying yang" pattern with color Doppler on
-
Doppler flow pattern of an aortic stenosis
- Increased pulsatility proximal to stenosis
- Increased PI and RI
- Increased peak systolic and diastolic velocities at stenosis
- Post stenotic turbulence
- Damping of waveform distal to the stenosis
-
Normal velocity and waveform of the hepatic artery
Monophasic flow 20 to 30 cm/s
-
Most common form of portal hypertension
Intrahepatic (cirrhosis)
-
Most sensitive Doppler sign of cirrhosis
Enlarge collaterals
-
Decreased velocity less than _____ puts a patient at increased risk for thrombosis thronbosis
10 cm/s
-
Sonographic characteristics of thrombosis
- Acute thrombus: anechoic/hypoechoic
- Chronic thrombosis: hyper cook
- Complete occlusion: no flow
-
Most common cause of hepatic congestion
CHF
-
Normal resistive index of the hepatic artery
0.6 to 0.7
-
Hepatic veins have what type of flow
Triphasic flow
-
Tumor invasion of the portal vein is most frequently caused by
-
Hepatocellular carcinoma- lable the W wave form
A. S. V. D. A
-
Causes of Budd-Chiari syndrome
Trauma, medications, sickle cell anemia, neoplasm
-
Most common in a stenosis of TIPS
Between right hepatic vein and right portal vein
-
A well functioning shunt has what type of flow pattern and speed
- High velocity flow 70 to 200 cm/s
- Hepatofugal flow in portal branches: complete diversion of flow into shunt
-
Doppler criteria signifying shunt stenosis
Velocity drop by 50 cm/s or more over baseline examination
-
Most common condition requiring a liver transplant
Hepatitis C
-
Most frequent location of hepatic artery stenosis following transplant of the liver
At anastomotic site
-
Sonographic criteria of hepatic artery stenosis
- Peak systolic velocity greater than 2 to 3 cm/s
- Turbulent distal flow
- Tardus parvus anywhere in hepatic artery
-
Criteria for renal artery stenosis
- Renal/aortic ratio greater than 3.5
- Peak stock velocity greater than 200 cm/s
-
Indirect Doppler examination of renal arteries
Sample segmental arteries in renal hilum
-
Two most common causes of renal artery disease
- Atherosclerotic renal artery stenosis
- Fibromuscular dysplasia
-
Abnormal resistive index of the renal artery post transplant
Greater than .9
-
Velocity threshold for stenosis
Greater than 200 cm/s
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