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Preparation for Abdomen ARDMS Exam
Bulls eye sign - ✔Ultrasound appearance of gastroesophageal junction? Rugae - ✔irregular folds in stomach formed by mucosa and submucosal 5 mm's - ✔the undistended wall should not exceed how many mm's Haustrae - ✔what are the large sacculations of the colon called? Thickened loops with no change with compression - ✔slow graded transducer pressure is applied with evaluation of gi tract, what would these findings reveal? Target sign and pseudo kidney sign - ✔what is the classic appearance of adenocarcinoma? 6mm - ✔normal appendix has a target appearance and should not measure more than---------------mm in diameter? Adhesions - ✔what is most common cause of intestinal obstruction? Increased activity - ✔Evaluation of motor activity with obstruction will reveal? Chronic - ✔Is hashimoto's thryroiditis an acute or chronic condition? Calcium levels - ✔the parathyroid glands secrete PTH which is responsible for maintaining what levels? Papillary - ✔what is most common type of thyroid cancer? Increased PTH levels, hypophosphatemia and hypercalcemia - ✔The lab values with parathyroid adenoma's will reveal what? Longus coli muscle - ✔what is the muscle located posterior to the thyroid and adjacent to the trachea? External carotid artery - ✔The superior thyroid artery branches off what artery? Thyroid enlargement, protruding eyeballs - ✔Two features of Grave's disease? Multinodular Goiter - ✔What is the most common type of thyroid abnormality?
Innominate artery - ✔The right common carotid artery arises from which artery? Adventitia - ✔What is the outermost layer of the arterial wall called? Systemic hypertension - ✔What is most common cause of arterial dissection? Distal to stenosis - ✔maximum turbulence is usually detected distal or proximal to stenosis? Hyperechoic, hypoechoic, and free floating in vessel - ✔Characteristics of acute venous thrombosis? Tendon - ✔Fibrous cord that attaches muscle to bone is what? Enhancement - ✔An artifact that occurs when sound strikes a curved or cylindrical structure at less than 90 degrees is referred to as what? Perimysium - ✔A group of muscle fibers are bound together by a connective tissue layer called? Capillaries and nerves - ✔The endomysium consists of a network of? Superior to the bladder in the lower abdomen - ✔The usual location for a urachal cyst is where? Popliteal Space - ✔Where would a bakers cyst be located? Anechoic mass with good through transmission - ✔What is the most sonographic appearance of an acute hematoma? Lymphoma - ✔Multiple lobulated masses located around the porta hepatis, celiac trunk or SMA would most likely represent what? Fusiform - ✔What is most common type of abdominal aortic aneurysm? Saccular - ✔Type of abdominial aneurysm that has outpouching which is usually the result of trauma or infection is? Pseudoaneurysm - ✔The patient has a mass located in the groin region adjacent to the artery, which has mixed echogenicity and visable swirling blood, the most likely diagnosis would be what?
Sliced thickness - ✔An artifact that appears as echoes filling a fluid filled structure or vessel is? Clean shadows - ✔Shadowing produced from calcific structures are referred to as? Side lobe occur with single element transducers and grating lobes occur with multiple element transducers. - ✔What is the key difference between side lobe artifacts and grating lobe artifacts? 9 - 12 cm - ✔What does the normal adult kidney measure? True capsule - ✔What is the fibrous capsule surrounding the kidney referred to as? Columns of Bertin - ✔The cortical tissue extending into the space between adjacent pyramids appearing as a hypoechoic mass area is? Cortex - ✔What is outer portion of kidney referred to as? Nephron - ✔Structural and functional unit of kidney? 5 mm or less - ✔The renal cortex is considered abnormal if measures what mm? Dromedary Hump - ✔Normal renal anatomical variant which has a bulging appearance to the contour of the kidney is referred to as a? Angiomyolipoma or renal hematoma - ✔A renal mass composed of fat, blood vessels and smooth muscle tissue is called? Renal Cell Carcinoma - ✔Mr M is a 60 y/o man at the u/s dept with hematuria, pain and palpable mass, the u/s reveals a primarily solid renal mass with areas of cystic degeneration. Scattered calcifications were also present, what would the most likely diagnosis be? Nephroblastoma - ✔What is a Wilm's tumor also know as? Increased - ✔End stage renal disease wil reveal ____________ echogenicity of the renal cortex High resistance characteristics - ✔Doppler evaluation of a pt with renal parenchymal disease will reveal what? Ureter and bladder - ✔What is the most common site of obstruction by kidney stones?
Iliac fossa - ✔What is the normal location of the renal transplant? Hydronephrosis, fluid collections around kidney, abnormal renal size and ATN - ✔ Sonographic signs of renal transplant rejection would include? Lymphocele - ✔Mr B was referred to the U/S dept several mths after and renal transplant and the U/S exam revealed a lg fluid collection with internal echoes arising medial to the lower pole of the kidney, what is the most likely diagnosis? 200cm/sec - ✔A significant renal artery stenosis would be considered in a renal transplant pt when the peak systolic velocity exceeds? Supernumery kidney - ✔A completed duplication of the kidney and ureter is referred to as? Horseshoe Kidney - ✔Fusion of the upper or lower poles of the kidney during fetal development is called? Ligamentum Venosum and left portal vein - ✔The dividing landmarks for the left lobe and caudate lobe are the ?? PHA, MPV, and CBD - ✔What structures are located within the Portal Triad? Cystic and Common Hepatic ducts - ✔The CBD is formed by the confluence what two ducts? Right Hepatic vein - ✔The right lobe of the liver is divided into anterior and posterior segments by the? AST, ALT, and Alkaline phosphatase - ✔What lab values will increase with Hepatocellular adn obstructive diseases? Caput Madusal Sign - ✔Distended collateral veins visualized on the abdominal wall have been referred to as the what? Schistosomiasis - ✔A condition where the worm punctures the skin and migrates into the general circulation via the lymphatics or venous system is?? Cavernmatous Transformation - ✔Portal vein occlusion that occurs in infancy or the neonatal period will demonstrate a collection of collateral vessels in the region of the porta hepatis, this is referred to as? Thick walled cysts, hepatomegaly, calcification of cyst walls and possible thrombosis and infarction of blood vessels - ✔Sonographic characteristics seen with hydatid disease?
The cystic duct and common hepatic duct - ✔Common bile duct is formed by the confluence of?
3mm - ✔Gallstones will produce a shadow when what size? Inspissated bile - ✔Sludge is also known as? Hydrops - ✔Male pt presents with epigastric pain, nausea and vomiting, the u/s exam reveals a markedly dilated GB with thin walls, the most likely diagnosis would be? Acalculous Cholecystitis - ✔Pt presents with RUQ pain, nausea, and vomiting, positive murphys sign, enlarged thick walled GB containing echoes that did not layer or shadow, Pericholecystic fluid was also demonstrated, most likely diagnosis would be? Adenomyomatosis - ✔Small echogenic mass like areas with internal cysts are seen in the fundus of the GB that produces a comet tail artifact, what is this? Cholangitis - ✔Definition of stones in ducts? Confluence or right and left hepatic ducts - ✔A klatskins tumor occurs in the? Choledochal Cyst - ✔Anomalous insertion of the CBD into the pancreatic duct allowing reflux of pancreatic juice into the bile duct leading to dilatation and cholangitis is referred to as? 4mm - ✔Normal average size of the common hepatic duct of a pt under the age of 40 would be? True - ✔stones impacted in the gb neck will not move with changing patient positions, true or false? Perirenal Compartment - ✔The kidneys and adrenal glands are located in which compartment? SMA - ✔Enlarged lymph nodes in the para-aortic region may cause displacement of the? Sandwich sign - ✔When lymphoma involves the mesentery, there may be a layered appearance, this is called? Rounded appearance, hypoechoic mass, anechoic mass - ✔Usual appearance of enlarged lymph nodes?
Phenochromocytoma - ✔Large solid mass with well defined borders arising from the adrenal region, there are also areas of cystic degeneration, no other abnormalities in the abdomen found, most likely diagnosis would be? Neuroblastoma - ✔A heterogenous childhood adrenal tumor which frequently invades surrounding structures and presents with weight loss, malaise, abdominal protrusion and fever describes? Retroperitoneal fibrosis - ✔A pt presents with abdominal pain, nausea, vomiting, and hypertension, the u/s exam reveals a bulky midline mass, most likely the diagnosis is? Peritoneal or intraperitoneal - ✔Location of spleen? Hilum - ✔Accessory spleens are usually detected near the? Hemangioma - ✔Most common primary neoplasm of the spleen? Solid focal lesions, calcifications, bright echogenic lesions. - ✔U/S characteristics of Histoplasmosis and tuberculosis? Superior mesenteric vein and inferior mesenteric vein - ✔Splenic vein exits hilum of spleen and merges with the ________ and ____________ to form the portal vein. Left Hemidiaphragm - ✔What is at the superior border of the spleen? Subcapsular hematoma - ✔Post MV accident with LLQ pain, crescent shaped fluid collection that conforms to the spleen is identified, what is this? Peripheral zone - ✔70 % of prostatic tissue is located in which zone? 40 - ✔In older men prostate considered enlarged if weighs more than how many grams? BPH - ✔A prostate exam reveals an enlarged hypoechoic inner zone and calcifications in the transition zone, this is suggestive of? Anterior - ✔The common hepatic artery courses________________ To the portal vein. Anterolateral - ✔The gastroduodenal artery is located in the_________________ aspect of the head of pancreas Splenic, left gastric and common hepatic - ✔Which 3 arteries arise from the celiac trunk?
Normal LFT's - ✔FNH lab values? LFT'S? Normal - ✔Benign solid tumors? LFT's normal or abnormal? Decreased hematocrit, leukocytosis - ✔Hematoma lab values? Varied depending on cause - ✔Fungal infection lab values? Leukocytosis, increased LFT's and anemia - ✔Infection abscess (Pyogenic) Lab Values? Jaundice and increased alkaline phosphatase if cysts cause billiary obstruction - ✔ Acquired Cysts Echinococcal cysts( Hydatid cause by a parasite) Lab Values? Normal - ✔How are LFT's with Polycystic disease? Normal - ✔Cysts-congenital, how are LFT'S? Decreased glucose-6 phosphatase - ✔Glycogen Storage Disease, Von Gierkes disease most common type, Lab Values? Normal or slightly abnormal LFT"S - ✔Chronic Hepatitis Congestion-Lab Values? LFT'S depend upon stage, increased ALT-AST-Alkaline Phosphatase-serum and urine conjugated billirubin values. - ✔With Cirrhosis, how are lab values effected and which ones? Increase in billirubin, ALT, AST, and alkaline phosphatase - ✔With Chronic Viral Hepatitis, what lab values increase? Increased billirubin, ALT higher levels than AST, alkaline Phosphatase - ✔With acute viral hepatitis, what lab values effected? Increased LFTS due to hepatocellular disease - ✔Lab values with Fatty liver? Serum amylase twice the normal values - ✔Lab values with acute pancreatitis? Lymphocele - ✔With a two week old renal transplant there are fluid collections with septations and internal debris adjacent to kidney, what is this? Interlobar - ✔what intrarenal arteries course alongside renal pyramids
Arcuate - ✔what arteries course on top of the renal pyramids and give rise to the tiny interlobar arteries? Anterior - ✔right renal vein lies____________ to the renal artery Posterior - ✔left renal artery normally located ____________ to left renal vein External iliac artery - ✔where is the renal artery anastomosed to in renal transplant? Iliac fossa - ✔where do you look for pancreas after transplant of? Phlegmon - ✔what is a nonencapsulated collection of necrotic and edematous peripancreatic tissue called? Obstruction of pancreatic duct by biliary calculi - ✔most common cause of acute pancreatitis? SMV - ✔which vessel courses anterior to the ucinate process? Anechoic acoustic enhancement, sharply defined smooth wall, round or ovoid shape - ✔sonographic criteria for a simple cyst in kidney? Superior mesenteric and splenic - ✔what vessels form the portal vein? Celiac trunk - ✔Vessel to study with median arcuate syndrome? Right atrium - ✔where does ivc empty into? Postprandial abd pain and weight loss - ✔symptoms of chronic mesenteric ischemia PV and hepatic vein - ✔with a tips shunt, it connects what two vessels? Posterior to ivc - ✔location of rt renal artery? Splenic - ✔smv joins which vein? Orchitis - ✔lg complex hydrocele commonly associated with? Testicular - ✔capsular artery of teste is a branch of what artery? Abdominal aorta - ✔testicular artery is a branch of? Peripheral - ✔which zone of prostate involved with cancer?
HCG - ✔with choriocarcinoma have high levels of what? Hepatocellular and obstructive disease - ✔AST increases with what disease> (SGOT)? Increase AST(SGOT) ALT (SGPT) and billirubin - ✔lab values with hep a, b, or c? AST, ALT and billirubin - ✔with cirrhosis what lab values increase? Schistosomiasis - ✔when you see echogenic bands while scanning along intrahepatic pv, what is this? Increased billirubin and alkaline phosphatase - ✔lab values increase with metastasis? Fetal antigen - ✔what is present with 50% of pts with hematomas? Intrahepatic ducts - ✔which ducts are associated with Caroli disease? Ucinate process - ✔portion of pancreas that lies posterior to the sma and vein is the ? Retroperitoneum - ✔location of pancreas? Anterior and superior to the pancreas - ✔location of lesser sac? Indirect billirubin - ✔hemolytic disorders may result in increase of what? Adrenal hemmorrhage - ✔what is the most common neonatal adrenal mass? Neuroblastoma - ✔what is most common childhood adrenal mass? Lung - ✔what is the most common primary carcinoma associated with adrenal metastasis? Crus of diaphragm - ✔what structure lies directly medial to both adrenal glands? Perirenal space - ✔adrenal glands lie within the ___________ Anterior pararenal space - ✔ivc and aorta are located in which retroperitoneum space?
Posterior parietal peritoneum and posterior abd wall muscles. - ✔definition of retroperitoneal space? Hydronephrosis - ✔most common secondary finding with retroperitoneal fibrosis? Left renal vein - ✔which vessel is imaged between the SMA and aorta? Left gonadal vein - ✔which vessel does not drain directly into IVC? Superior vena cava - ✔the azygos vein connects the proximal abd ivc to the? Adenoma's - ✔the halo sign is defined as a sonolucent rim surrounding a thyroid mass, commonly seen in? Anterior to trachea - ✔location of thyroglossal duct cysts? Lymphoma - ✔the most common primary source of testicular metastasis is? Intussusception - ✔a 4 month old presents with abd pain, rectal bleeding,and palpable abd mass, what is most likely the pathology> Alanine amniotransferase - ✔SGPT is same lab value as? Hepatic metastasis - ✔what is most likely the diagnosis in a pt with elevation of CEA, alkaline phosphatase and GGT? Posterior superior - ✔seminal vesicles are located on which surface of the prostate? Hepatitis - ✔what is most likely the diagnosis with a pt with elevated AST and ALT? Gastric Hypersecretion and peptic ulcer disease - ✔Islet cell tumors are related to what two diseases? Hyperlipidemia and hypercalcemia - ✔Predisposing factors to chronic pancreatitis? Fluid filled stomach, dilated pancreatic duct or tortuous dilated left portal vein. - ✔ What can mimic and pacreatic psuedocyst/ Spreading diffuse inflammatory edema of subcutaneous connective tissue that can lead to necrosis - ✔what is phlegmonous pancreatitis? Increased serum amylase lipase, decreased hematocrit and serum calcium levels also seen. - ✔what are the lab values for hemmorhagic pancreatitis?
Necrotizing entercolitis - ✔in infants what is portal vein gas due to? Pathology in distant common bile duct - ✔what is biliary obstruction due to? Gallstones and carcinoma of head of pancreas - ✔two most common lesions associated with biliary obstruction? Anterior surface of psoas muscles - ✔location of ureters? The splenic vein - ✔what does the inferior mesenteric vein drain into? Renal corpuscle - ✔what do we call the glomerulus and bowmans capsule together? Calculi, benign prostatic hypertrophy, prostate cancer, pelvic malignancies, pregnancy, and uteropelvic junction obstructions. - ✔what are some of the causes of hydronephrosis? On the right - ✔where are the azygos veins located? On the left - ✔where are the hemiazygos veins located? Dense fibrous tissue proliferation confined to paravertebral region, Also known as inflammatory aneurysm or ormonds disease. - ✔what is retroperitoneal fibrosis? Aorta to renal artery to segmental artery to interlobar arteries to arcuate arteries to interlobar arteriole to afferent arteriole - ✔what are the branches of the renal artery? On the top of the pyramids - ✔what is the location of the arcuate arteries? Between the pyramids and then curves around the top of the pyramids. - ✔what is the location of the interlobar arteries? The interlobar arteries course through the cortex - ✔what do the interlobar arteries course through? It is a tube connecting the renal pelvis to the calyx steven and don't forget this for the test - ✔what is the infundibulum or major calyx? Bilateral renal agenisis - ✔hello steven, what is classic potters syndrome? Right upper quadrant mass with painless jaundice indicates there is cancer in the head of the pancreas causing biliary obstruction, the palpable mass is due to an enlarged gallbladder buddy. - ✔what is courvoisiers sign and what is it associated with?
The splenic vein and superior and inferior mesenteric veins my friend. - ✔okay, what will the portal of confluence give you? Klatskins tumor - ✔what is a malignant tumor of the common hepatic duct biff called? Right hepatic duct and left hepatic duct will be dilated and don't forget this for the test buddy. - ✔when you have a malignant tumor at the biff of hepatic duct biff. Klatskins tumor, what will be dilated? Bifurcates into the proper hepatic artery and the gastroduodenal artery - ✔as the common hepatic artery courses toward the liver, what does it bifurcate into? Common hepatic artery and splenic artery which is the seagull sign. - ✔the celic axis terminates with the bifurcation of what? Branches of celiac axis are the common hepatic, left gastric and splenic artery. - ✔ what are the branches of the celiac axis? Celiac axis and it is located superior to the pancreas - ✔what is the first branch of the aorta and its location? Between the ivc and azygos vein posterior - ✔what is the location of the right crus? Large gallbladder filled with mucous in the wall and measures more than five centimeters and is caused by chronic obstruction of neck or cystic duct of gallbladder by stones or a tumor. - ✔what is hydrops of the gallbladder? Vitelline vein - ✔where did the portal vein come from? Abscess due to poorly defined border is the key, if it was a cyst, it would have well defined borders - ✔patient with a high fever and right upper quadrant pain has a large hemogenous mass with low level echoes and poorly defined borders in right lobe with increased through transmission, what is it? Aortic arch - ✔on the left side the common carotid artery originates from where? Phlegmon - ✔what is a nonencapsulated collection of necrotic and edematous peripancreatic tissue termed? It will have a normal appearance - ✔most common ultrasound appearance of acute pylonephritis?
Polysplenia and asplenia - ✔what are two classifications of heterotaxia? Symptoms of congestive heart failure or jaundice due to biliary tract abnormalities - ✔presentation of heterotaxia in a neonatal patient? Lesser sac, between the liver, pancreas and stomach. And greater sac the rest of peritoneum cavity, when imaging floating bowel, this is greater sac. - ✔what are the two separate compartments of the peritoneal cavity and their locations? Epiploic foramen - ✔what is the entrance to the lesser sac called? Stomach, liver, spleen, first part of duodenum, kidneys, appendix, cecum, sigmoid colon uterus, ovaries and fallopian tubes, aorta, - ✔What are the retroperitoneal structures? Hint, Neumonic.. (Some live splendid during kings and castles singing under open flowers always) Anterior pararenal space, perirenal space and posterior pararenal space. - ✔two layers of renal fascia divides the retroperitoneum into what three compartments? Central, transitional and peripheral - ✔what are the three zones of the prostate? Corpora amylacea - ✔what are the calcifications in the inner gland of the prostate called? Verumontanum - ✔what are small elevations of urethral crest in which orfices of ejaculatory ducts are located on either side? Pass through the central zone and not the twilight zone like I feel like where I am at studying this stuff. And empty into the urethra - ✔ejaculatory ducts pass through what zone of the prostate and empty into what? Adenomyomatosis, just remember A for Aschoff buddy. - ✔Rokitansky Aschoff sinuses are associated with what conditon? Superior mesenteric vein - ✔during isonation of the pancreas,you routinely image a vessel coursing anterior to the ucinate process,what is this vessel? The left renal vein can be seen coursing transversely - ✔what structure can be seen coursiing transversely at the level of the upper pancreatic head? Junction of the cystic duct and common hepatic duct - ✔what forms the common bile duct?
Avascular mass with low level echoes - ✔what is the appearance of tumefactive sludge within the gallbladder? Caput medusae - ✔paraumbilical vein drains into a network of varices that can be seen on the abdomen radiating from the umbilicus, these varices are known as what? Greater than three point five - ✔renal aortic stenosis ratios greater than what is detection of stenosis? Superior mesenteric and splenic veins - ✔what is the portal vein formed by, junction of what two veins? Posterior to the body of the pancreas - ✔what is the location of the superior mesentric artery? At the aortic bifurcation - ✔generally retroperitoneal fibrosis is centered where? In perirenal space, located superior, anterior and medial aspect of the kidney - ✔ what is the location of the adrenal glands? Hypoechoic midline mass - ✔sonographic appearance of retroperitoneal fibrosis? Bilateral ureteral obstruction - ✔what is retroperitoneal fibrosis associated with? Medial and posterior - ✔what is location of crus of diaphragm in relation to the right adrenal gland? Anterior to the aorta, superior to the celiac axis and posterior to the ivc - ✔crus of diaphragm is located what to the aorta, what to the celiac axis and what to the ivc? Kidneys, adrenal glands and proximal ureter - ✔perirenal space is separated by two fascia layers and contains? Splenic vein and the tail of the pancreas - ✔the left pararenal space includes the ---- -----vein and? Ivc, pancreas and segments of the duodenum. - ✔what is located within the right pararenal space? Lymph nodes, fat, vessels of abdomen and pelvis, ureters and segments of colon - ✔anterior renal space extends into the pelvis and contains? Renal artery - ✔Crus of diaphragm is seen as a hypoechoic tubular structure posterior to what?
