Abdomen Test #4

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Author:
marie78
ID:
247924
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Abdomen Test #4
Updated:
2013-11-22 01:42:20
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Abdomen
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Description:
Kidney and adrenal glands
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  1. Fascia that surrounds each kidney and adrenal gland
    Gerotas fascia
  2. Adrenal gland is intra or retro peritoneal?
    Retro peritoneal
  3. Where are the adrenal glands found?
    Ant/Sup aspect of kidneys @ the level of the 12th thoracic vertebra
  4. Adrenal glands endocrine or exocrine
    Endocrine
  5. How are Adrenal glands divided?
    • Cortex (Outer 80%)
    • Medulla (Inner 20%)
  6. What does the Adrenal Cortex produce
    • Cortisol
    • Corticosterone
    • Aldosterone
    • Androgens
    • Hormones that have an affect on metabolism
  7. What does the Adrenal Medulla produce
    • Epinephrine
    • Norepinephrine
    • "Fight or flight"
    • Help us cope with physical/emotional stress
  8. Adrenal Hypofunction (insufficiency)
    Addison's disease
  9. Signs/Symptoms of Addison's disease
    • Fatigue
    • Brownish discoloration of skin
    • GI disturbances
  10. Adrenal Hyperfunction
    • Cushing's Syndrome
    • Conn's Syndrome
    • Pheochromocytoma
  11. Pheochromocytoma
    Tumor that secretes adrenaline
  12. Signs/Symptoms of Pheochromocytoma
    • Uncontrollable Hypertension
    • Tachycardia
    • Excessive Sweating
    • Flushing
  13. Neuroblastoma
    Childhood tumor of the adrenal glands that has a poor prognosis
  14. Typical locations for Lymph nodes
    • Para-aortic 
    • Porta Hepatis
    • W/in Mesentery bowel (small)
    • Around Iliac Vessels (groin)
    • Axilla
    • Neck
  15. Are Lymph nodes typically seen on U/S?
    No, too small to be seen in U/S
  16. USA of Benign Lymph node
    • Hypoechoic w/ echogenic, fatty hilum
    • Oval
    • >1 cm
  17. USA of Malignant Lymph node
    • Oblong masses
    • Uniform Low to mid amplitude echoes
    • Extensive enlargement assoc w/ decr echogenecity
    • Post. Shadowing
    • No Fatty hilum
  18. Clinical signs & symptoms of Adrenal disease 
    • Hypertension
    • Weakness of muscle
    • Fatigue
    • Flank Pain
    • Hirsutism
  19. Hirsutism
    • Masculinizing features in women
    • Incr of androgens causes a male pattern of body hair, Chest, Abdomen, Back & Face
  20. Excessive hair growth in men/women is known as:
    Hypertrichosis
  21. Splenomegaly
    • Most common cause is Portal Hypertension
    • Heart failure, cirrhosis, Portal or Splenic Vn thrombus, cystic fibrosis
    • Splenic infections
    • > 13 cm in cranial caudal dimension
  22. Normal measurement of Spleen
    • 8-12 cm (SAG)
    • Similar size to Lt Kidney
  23. Norma USA of Spleen
    • Similar echogenicity to LIVER 
    • Homogenous echo texture
    • Med-Mid gray level echoes
    • Isoechoic or slightly hypoechoic to liver
    • Highly echogenic Lt Hemidiaphragm
    • Smooth contour
    • Splenic vessels in hilum
  24. Functions of Spleen
    • Filters blood
    • Plays a part in immune function
    • Initiates antibody production and production of lymphocytes
    • Macrophages
    • Phagocytose old RBC's
    • Blood reservoir
    • Hematopoesis (forms RBC's in embryonic life)
    • Produces plasma cells
  25. Anatomic location of structures adjacent to the spleen
    • Intraperitoneal
    • Lt Kidney lies inferior and medial to spleen
    • Inf/Ant to Diaph
    • Lat to tail of panc, splenic flexure of colon, Lt Kidney and adrenal gland
    • Post/Lat to stomach
    • Encapsulated
  26. Cysts of the Spleen are:
    • Infectious
    • Usually aquired
  27. Accessory Spleen
    • Most common near hilum and panc tail
    • Prominent bulge along medial surf of spleen
    • Well-defined, encapsulated nodular mass
    • Small like a donut hole
    • Isoechoic to splenic tissue
    • 1 cm in size
  28. Splenic Infarct
    • Occlusion of splenic art
    • Most common benign neoplasms in spleen
    • Emboli usually originate in Heart
  29. Early Splenic infarct USA
    Hypoechoic or isoechoic to spleen
  30. Late Splenic Infarct USA
    • Hyper/Hypoechoic
    • May be wedge-shaped w/ base toward splenic capsule
  31. Cystic Lymphangiomas
    • Lymphatic malformation
    • USA Similar to hemangioma
  32. Hamartoma
    • Rare
    • Lymphoid tissue
    • Solitary or mult.
    • USA: Echogenic and well-define
  33. Metastases of Spleen
    • Common fr Melanoma
    • Possible fr primary in lung, breast, colon and ovary
  34. USA of Spleen METS
    • Variable (hypo/hyperechoic)
    • bulls-eye or target lesions
  35. Abdominal Lymphoma
    • Malignant
    • Assoc w/ Hodgkin's and non Hodgkin's lymphoma
    • Splenomegaly indicates intrinsic involvement of spleen
  36. USA of Abdominal Lymphoma
    Hypo/hyperechoic lesions w/in spleenCa++ or Splenomegaly may or may not be present
  37. Ectopic Spleen
    • AKA: Wandering spleen, aberrant spleen, floating spleen
    • Not where it's supposed to be
    • Prone to torsion
    • Asymptomatic abdominal or pelvic mass
  38. Subcapsular Hematoma of Spleen
    Splenic Capsule remains intact
  39. USA of Intracapsular Hematoma of Spleen
    Variable or complex as related to age
  40. Retroperitoneal space is between:
    • Posterior portion of the parietal peritoneum 
    • Posterior to abdominal wall muscles
  41. Retroperitoneum structures
    • Aorta
    • IVC
    • Adrenal glands
    • Kidneys
    • Lymph nodes
    • Panc
    • Uterus
    • Crus and psoas muscles
  42. Retroperitoneal Hemorrhage
    • An anechoic mass w/irregular borders
    • Can be caused by trauma or iatrogenic
    • Decr blood
  43. USA of Retroperitoneal Hemorrhage
    • Variable
    • Hypoechoic,
    • Internal echoes
    • Residual Ca++
  44. Best imaging modality for Splenic trauma and suspected rupture
    CT
  45. Splenic Ca++ Causes
    • Healed granulomas-punctuate echogenic foci
    • Splenic Art/aneurysm Ca++
    • Splenic Infarct
    • Old Hematomas
    • Cysts w/ Ca++ walls
  46. Thyroid Adenoma
    • Benign neoplasm
    • <4 cm in diameter
    • Most common Thryoid mass
    • AKA: Nodules
    • Usually mult.
    • Encapsulated by fibrous tissue (well-defined borders)
  47. USA of Thyroid Adenoma
    • Varies
    • Majority solid and hypoechoic
    • May also be isoechoic or hyperechoic
    • Classically has peripheral Echolucent halo
    • May be complex for degenerating adenomas
  48. USA of Hashimoto's Thyroiditis
    • Hypofunction
    • Enlarged
    • Heterogeneous
    • Hypoechoic Coarse texture
    • Hypervascularity
    • May have discrete nodules
    • Might have Ca++
    • Difficult to distinguish from Multinodular goiter
  49. Hashimoto Thyroiditis
    • Most common cause of Hypothyroidism
    • Lymphocitic inflammatory disease
  50. Grave's Disease signs and symptoms
    • Hyperfunction
    • Wt loss
    • Incr. heart rate
    • Anxiety
    • Excess Energy
    • Exophthalmos (bulging eyes)
  51. Parathyroid Adenoma
    • Benign
    • Produces excess PTH (Parathyroid Hormone)
    • Produces excess Ca++ (labs)
    • Assoc w/ Nephrocalcinosis
    • Genetic mutations
  52. Esophagus
    Most Likely to be mistakenly interpreted as a mass in the thyroid or parathyroid gland
  53. Papillary Thyroid
    • Most Common type of Thyroid Carcinoma
    • 60-70%
  54. USA of Thyroid Carcinoma
    • Irreg. borders
    • Tiny Ca++
    • Hypoechoic
    • Cystic and solid components
    • Thick incomplete halos
  55. Isthmus of Thyroid Gland
    • Connects the Rt/Lt lobes of thyroid gland
    • Mid Line anterior to trachea
  56. Hypothyroidism
    • Common in 40-50 y/o women
    • Low T3 and T4
    • Thyroid under produces thyroid hormone
    • Assoc w/ non-toxic goiter
  57. Signs and Symptoms of Hypothyroidism
    • Fatigue
    • Flakey dry skin
    • Weight gain
    • Heavy menstrual period
    • Intolerance to cold
  58. Pyramidal Lobe
    • Finger-like lobe of tissue that extends
    • Ant/Sup of the Isthmus
    • More often on Left side
    • 40% of population has a third thyroid lobe
  59. Thyroid Gland Function
    • Endocrine gland
    • Secretes hormones T4 (Thyroxine), T3, TSH

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