Abdomen Test #5

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Author:
marie78
ID:
251496
Filename:
Abdomen Test #5
Updated:
2013-12-10 18:54:04
Tags:
Abdomen Aorta IVC
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Description:
Abdomen, AAA, IVC
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  1. Aorta
    • <3 cm
    • PROX: 2-3 cm
    • MID: 2 cm
    • DIST: 0.5-1.5 cm
  2. Right Renal Artery
    • passes Posterior to the IVC
    • Branches off the aorta laterally @ the 12th lumbar vertebrae SUP to the umbilical region
  3. SMA
    • Branches off aorta but 1 cm BELOW the celiac trunk
    • Runs ANT and PARALLEL to the aorta
  4. IVC
    • Comes from confluence of CIV
    • Lies to the RT of the aorta
    • Courses ANT to enter RT Atrium of the heart
  5. USA of ACUTE APPENDICITIS
    • > 6mm in diameter
    • non-compressible sausage shape structure at area of max tenderness in RLQ
    • SAG: Blind End
  6. Max outer diameter of normal appendix
    6mm
  7. Branches of Celiac trunk
    • Lt. Gastric Art
    • Splenic Art
    • Common Hepatic Art
  8. McBurney's Point
    • RLQ
    • Located at the periumbilical region
    • Between umbilical region and 1/3 away from the Iliac crest (Hip bone)
  9. Signs & Symptoms of Acute Appendicitis
    • Pain @ McBurney's point
    • Rebound tenderness +McBurney's pt
    • Anorexia
    • Nausea
    • Vomitting
    • Diarrhea
    • Fever
    • Leukocytosis
  10. Appendicitis patient population
    Children and young adults
  11. TRV scanning plane of Acute Appendicitis USA
    Bulls Eye sign
  12. Gangrenous or Acute Appendicitis 
    • Measures 9mm in diameter
    • Non-compressible
    • Lumen distends w/ fluid
    • Appendicolith
    • Fecolith
  13. USA of FECOLITH (APPENDICOLITH)
    Echogenic Foci w/ Post. Shadowing
  14. USA of Bowel
    • Hypoechoic w/ echogenic wall rim representing outer serosal fat
    • TRV: Bulls Eye
    • SAG: Tubular
  15. Normal measurements of Testicles
    • 4x2x3 cm
    • SAG: 4-6 cm
    • POST: 2-3 cm
    • TRV: 3-5 cm
    • Oval in shape
  16. USA of Testicle
    • Homogeneous
    • Mid-gray echogenicity
    • Oval
    • Some Vascularity
  17. Location of Epididymis
    • Lies LATERAL (LAT to POST) to the testicles and reaches superiorly and inferiorly.
    • Composed of head, body and tail
  18. What does the Epididymis produce?
    Sperm
  19. Hydrocele
    • Fl. collection between layers of tunica vaginalis and tunica albuguinea
    • Painless, swelling
  20. USA of Hydrocele
    • Anechoic Fl collection surrounding testicle except Posteriorly where it is tacked to scrotal sac
    • Echoes and septations may related to presence of bl or infecton
  21. Spermatocele
    Cyst containing sperm fluids and debris
  22. USA of Spermatocele
    • Small & simple but can be complex and large
    • Usually in epididymal head & asymptomatic
  23. Orchitis
    Inflammation of the testicle
  24. USA of Orchitis
    • Enlarged
    • Incr. vascularity
    • Hypoechoic
    • Possible hydrocele
  25. Varicocele
    • Dilated tortuous veins of pampiniform plexus
    • More common on Left
    • May be cause of infertility
  26. USA of Varicocele
    Mass of tubular structures along POST aspect of testicle
  27. Scanning Technique of Varicocele
    Valsalva Maneuver may enhance appearance w/ pt standing
  28. Seminoma
    • Most common malignant neoplasms (40-50%)
    • Agressive
    • Common in young men 20-30 y/o
  29. USA of Seminoma
    • Hypoechoic
    • Focal, big homogenous mass
    • Intratesticular
  30. Most common cause of AAA
    Atherosclerosis (hardening of bl vessel)
  31. AAA Symptoms
    • Abdominal, back or groin pain
    • Palpable pulsatile abdominal mass
    • 30-60% are asymptomatic
    • Incidental finding
  32. USA of AAA
    • > 3 cm
    •  thrombus along the walls  
    • Distal AO of 1.5 cm is aneurysmal
  33. Aortic Ectasia
    • Failure of the AO to taper
    • NOT dilated
    •  
  34. IVC measurements
    <3.5 cm in the ANT/POST dimension
  35. Anatomy of Testicles
    • Surrounded by Tunica Albuginea and Vaginalis
    • Mediastinum is the thickened portion of tunica albuginea
  36. Efferent Duct
    • Set of tubules that fuse together
    • Transports seminal fl from the testis to the epididymis
  37. Bl supply of Testicles
    • Bl is drained via Pampiniform plexus
    • RT testicular vein drains to IVC
    • LT testicular vein drains to LT RV
  38. USA of Testicular Torsion
    • Enlarged
    • Decreased echogenicity
    • Scrotal wall thickening
    • Possible hydrocele
    • Lack of arterial flow on doppler
  39. What makes up breast tissue?
    • Fat
    • Small Ligaments
    • Functional layer (Parenchymal)
    • Cooper's Ligaments
    • Acini gland (milk production)
    • Terminal duct
  40. Cooper's Ligaments
    Echogenic, Linear striations in the breast
  41. Function of the breast
    Produce milk after pregnancy
  42. Things that can cause changes to breast tissue
    • Puberty/menses
    • Lactation
    • Menopause
    • Gaining/Losing weight
    • Age
    • Fibrocystic breast
  43. Exam Labeling of Breast U/S
    • Labeled by Quadrant like a clock
    • 12: Cephalad/ 6:caudal
    • Radial: ll to ducts (SAG)
    • Anti-Radial: Perpendicular to ducts (TRV)
  44. Indications for U/S
    • F/U after mammo
    • Eval w/o mammo
    • Eval dense tissue
    • Eval male breast
    • Family Hx of breast cancer
    • Palpable lump
    • Nipple discharge
  45. Fibroadenoma
    • Most common Benign solid growth in the breast
    • Seen in younger pts
    • Mobile
  46. USA of Fibroadenoma
    • Round/ovoid
    • Wider than tall
    • Well-defined borders
    • Hypo to Isoechoic
    • Homogeneous
    • May compress
    • Edge shadowing (pig tail)
  47. Risk Factors for Breast Cancer
    • Gender (F)
    • Age
    • Family Hx
    • Hormones
    • Prior Hx of breast/ovarian cancer
    • Obesity
    • Radiation Therapy
  48. USA of Breast Carcinoma
    • Solid mass
    • Angular, spiculated (sharp edges)
    • Ill-defined borders
    • Taller than wide
    • Heterogeneous
    • Very hypoechoic
    • Shadowing
    • Disruption of tissue planes
    • Dilated ducts
    • Possible Ca++

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