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761 terms

ARDMS Abdomen Review

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ascites
a collection of abdominal fluid within the peritoneal cavity
chromaffin cells
the cells in the adrenal medulla that secrete epinephrine and norepinephrine
endoscopy
a means of looking inside of the human body by utilizing an endoscope
exudate ascites
a collection of abdominal fluid within the peritoneal cavity that may be associated with cancer
hematocrit
the laboratory value that indicates the amount of red blood cells in blood
leukocytosis
an elevated white blood cell count
nuclear medicine
a diagnostic imaging modality that utilizes the administration of radionuclides into the human body for an analysis of the function of organs, or for the treatment of various abnormalities
oncocytes
large cells of glandular origin
paracentesis
a procedure that uses a needle to drain fluid from the abdominal cavity for diagnostic or therapeutic reasons
parietal peritoneum
the portion of the peritoneum that lines the abdominal and pelvic cavity
radiography
a diagnostic imaging modality that uses ionizing radiation for imaging bones, organs, and some soft tissue structures
thoracentesis
a procedure that uses a needle to drain fluid from the pleural cavity for either diagnostic or therapeutic reasons
transudate ascites
a collection of abdominal fluid within the peritoneal cavity often associated with cirrhosis
visceral peritoneum
the portion of the peritoneum that is closely applied to each organ
American Institute of Ultrasound in Medicine
what entity publishes the practice guidelines for sonograms
hematocrit
what lab value will be decreased if the patient has bleeding secondary to trauma or hemorrhage?
gallbladder, liver (except for the bare area), ovaries, spleen (except for the splenic hilum), stomach
list the intraperitoneal organs
peritoneum
what is the double lining of the abdominal cavity?
parietal peritoneum
forms a closed sac, except for two openings in the female pelvis (fallopian tubes)
visceral peritoneum
the serosal layer that covers each organ
greater sac and lesser sac
the abdominal peritoneum can be divided into two sections:
anteriorly
where are the retroperitoneal structures covered with peritoneum?
from the diaphragm to the pelvis
where is the greater sac located?
posterior to the stomach, anterior to the pancreas
where is the lesser sac located?
abdominal lymph nodes, adrenal glands, aorta, ascending and descending colon, duodenum, IVC, kidneys, pancreas, prostate gland, ureters, urinary bladder, uterus
what organs are considered retroperitoneal?
acute cholecystitis, cirrhosis, congestive heart failure, ectopic pregnancy, malignancy, portal hypertension, ruptured AAA
list some pathologies associated with ascites
complex fluid with loculations and produce matting of the bowel
what does exudate ascites look like?
simple and anechoic
how does transudate ascites appear?
inferior to the diaphragm
where is the subphrenic space?
right and left
how is the subphrenic space divided?
inferior to the liver
where is the subhepatic space?
anterior and posterior
how is the subhepatic space divided?
Morrison's pouch
what is another name for the posterior subhepatic space
paracolic gutters
what cavity space extends alongside the ascending and descending colon on both sides of the abdomen?
between the urinary bladder and rectum
where is the posterior cul-de-sac located on a male?
rectovesical pouch
what is another name for the posterior cul-de-sac on a male?
between the uterus and rectum
where is the posterior cul-de-sac located on a female?
rectouterine pouch
what is another name for the posterior cul-de-sac on a female?
between the urinary bladder and the uterus
where is the anterior cul-de-sac located?
benign tumor of glandular origin
define adenoma
benign tumor of blood vessels, muscle, and fat
define angiomyolipoma
kidneys
what is a common location of angiomyolipomas?
abnormal accumulation of cells within a focal region of an organ
define focal nodular hyperplasia
the liver
where is focal nodular hyperplasia commonly found?
benign tumor consisting of a group of inflammatory cells
define granuloma
liver and spleen
where are granulomas commonly found?
benign tumor that secretes gastrin
define gastrinoma
the pancreas
where are gastrinomas commonly found?
benign tumor consisting of an overgrowth of normal cells of an organ
hamartoma
kidneys
where are hamartomas usually found?
benign tumor consisting of blood vessels
define hemangioma
liver, spleen, kidney
where are hemangiomas usually found?
localized collection of blood
define hematoma
benign tumor that secretes insulin
define insulinoma
pancreas
where are insulinomas usually found?
benign tumor that consists of fat
define lipoma
liver, spleen, kidney
where are lipomas commonly found?
benign tumor consisting of oncocytes
define oncocytoma
kidney
where are oncocytomas commonly found?
benign tumor that consists of chromaffin cells of the adrenal gland
define pheochromocytoma
adrenal gland
where are pheochromocytomas usually found?
benign tumor that consists of tissue from all three germ layers
define teratoma
testicle and ovary
where are teratomas usually found?
localized collection of urine
define urinoma
next to a kidney transplant
where can urinomas be found?
cancer of glandular origin
define adenocarcinoma
pancreas and gastrointestinal tract
where are adenocarcinomas usually found?
cancer in the lining of vessels
define angiosarcoma
spleen
where are angiosarcomas usually found?
cancer that consists of trophoblastic cells
define choriocarcinoma
testicle
where is choriocarcinomas usually found?
cancer of the bile ducts
define cholangiocarcinoma
biliary tree
where is cholangiocarcinoma found?
cancer that is fundamentally adenocarcinoma with cystic components
define cystadenocarcinoma
pancreas
where can cystadenocarcinoma commonly be found?
cancer that is of germ cell origin
define embryonal cell carcinoma and yolk sac tumor
testicle
where are embryonal cell carcinoma and yolk sac tumors usually found?
cancer of aggressive abnormal epithelial cells
define follicular carcinoma
thyroid
where is follicular carcinoma usually found?
cancer that originates in the hepatocytes
define hepatocellular carcinoma
liver
where is hepatocellular carcinoma found?
cancer that originates in the tubules of the kidney
define hypernephroma
hypernephroma
what is another name for renal cell carcinoma?
cancer of the lymphatic system
define lymphoma
spleen and kidney
where is lymphoma commonly found?
cancer that has formation of many irregular, fingerlike projections
define papillary carcinoma
thyroid
where is papillary carcinoma commonly found?
cancer that originates in the seminiferous tubules
define seminoma
testicle
where are seminomas usually found?
cancer that originates in the transitional epithelium of an organ or structure
define transitional cell carcinoma
bladder, ureter, kidney
where is transitional cell carcinoma usually found?
adrenal gland
where are neuroblastomas usually found?
liver
where are hepatoblastomas usually found?
kidney
where are nephroblastomas usually found?
kidney
where are Wilm's tumors usually found?
amebic abscess
an abscess that develops from a parasite that grows in the colon and invades the liver via the portal vein
anemia
the condition of having a deficient number of red blood cells
autosomal dominant polycystic kidney disease
an inherited disease that results in the development of renal, liver, and pancreatic cysts late in life
bare area
the region of the liver not covered by peritoneum
Beckwith-Wiedemann syndrome
a growth disorder syndrome synonymous with enlargement of several organs including the skull, tongue, and liver
Budd-Chiari syndrome
a syndrome described as the occlusion of the hepatic veins, with possible co-existing occlusion of the IVC
cavernous hemangioma
the most common benign liver tumor
cholangitis
inflammation of the bile ducts
cirrhosis
condition defined as hepatocyte death, fibrosis and necrosis of the liver, and the subsequent development of regenerating nodules
dysentery
infection of the bowel which leads to diarrhea that may contain mucus and/or blood
echinococcal cyst or hydatid liver cyst
a liver cyst that develops from a tapeworm that lives in dog feces; originates from echinococcus granulosis
echinococcus granulosus
the parasite responsible for the development of hydatid liver cysts
fatty liver
a reversible disease characterized by deposits of fat within the hepatocytes
gastroesophageal junction
the junction between the stomach and the esophagus
Glisson capsule
the thin fibrous casing of the liver
hemochromatosis
an inherited disease characterized by disproportionate absorption of dietary iron
hemopoiesis
the formation and development of blood cells
hepatic candidiasis
a hepatic mass that results from the spread of fungus in the blood to the liver
hepatitis
inflammation of the liver
hepatocellular adenoma
the primary form of liver cancer
hepatofugal
blood flows away from the liver
hepatoma
the malignant tumor associated with hepatocellular carcinoma
hepatomegaly
enlargement of the liver
hepatopetal
blood flows toward the liver
hepatosplenomegaly
enlargement of the liver and the spleen
hypovolemia
decreased blood volume
jaundice
the yellowish discoloration of the skin, mucous membranes, and sclerae; found in liver disease and/or biliary obstuction
Kupffer cells
specialized macrophages within the liver that engulf pathogens and damaged cells
leukocytosis
an elevated white blood cell count
liver hilum
the area of the liver where the common bile duct exits the liver and portal vein and hepatic artery enter the liver; also referred to as the porta hepatis
mass effect
the ability of a tumor or some other foreign entity to distort normal anatomy
periportal cuffing
an increase in the echogenicity of the portal triads as seen in hepatitis
porta hepatis
the area of the liver where the portal vein and hepatic artery enter and the hepatic ducts exit; also referred to as the liver hilum
portal hypertension
the elevation of blood pressure within the portal venous system
portal triads
an assembly of a small branch of the portal vein, bile duct, and hepatic artery that surround each liver lobule
portal vein thrombosis
the development of a clot within the portal vein
pyogenic hepatic abscess
the liver abscess that can result from the spread of infection from inflammatory conditions such as appendicitis, diverticulitis, cholecystitis, cholangitis, and endocarditis
quadrate lobe
the medial segment of the left lobe
recanalization
the formation of new canals or pathways
Riedel lobe
a tonguelike extension of the right hepatic lobe
sequela
an illness resulting from another disease, trauma, or injury
serpiginous
twisted or snakelike pattern
starry sky sign
the sonographic sign associated with the appearance of periportal cuffing in which there is an increased echogenicity of the walls of the portal triads
transjugular intrahepatic portosystemic shunt
the therapy for portal hypertension that involves the placement of a stent between the portal veins and hepatic veins to reduce portal systemic pressure
carbohydrate metabolism, lipid metabolism, aminoacid metabolism, removal of waste products, vitamin and mineral storage, drug inactivation, synthesis and secretion of bile
name the 7 vital functions of the liver
alkaline phosphate, alanine aminotransferase, aspartate aminotransferase, lactate dehydrogenase, serum bilirubin, prothrombin
name six lab values associated with liver disfunction
cirrhosis, extrahepatic biliary obstruction, gallstones, hepatitis, metastatic liver disease, pancreatic carcinoma
what abnormalities are associated with an elevated alkaline phosphate?
hepatitis, hepatocellular disease, obstructive jaundice
what abnormalities are associated with an elevated alanine aminotransferase?
cirrhosis, fatty liver, hepatitis, metastatic liver disease
what abnormalities are associated with an elevated aspartate aminotransferase?
hepatitis, cirrhosis, obstructive jaundice
what abnormalities are associated with an elevated lactate dehydrogenase?
acute hepatocellular disease
what abnormality is associated with an increased unconjugated (indirect) bilirubin?
biliary tract obstruction
what abnormality is associated with an increased conjugated (direct) bilirubin?
cirrhosis and other chronic liver cell disease
what abnormalities are associated with a total increase in bilirubin?
metastases to the liver
what abnormality is associated with a prolonged prothrombin time?
extrahepatic duct obstruction
what abnormality is assoicated with a shortened prothrombin time?
the liver
what is the largest parenchymal organ in the body?
hepatocytes, biliary epithelial cells, Kupffer cells
what types of cells compose liver lobules?
The Couinaud system
which system separates the liver into eight surgical segments?
between the gallbladder fossa and the round ligament
where is the quadrate lobe located?
3 (right, left, and caudate)
the liver can fundamentally be divided into how many lobes?
anterior and posterior
how is the right lobe of the liver divided?
right hepatic vein
what divides the right lobe of the liver into its two segments?
main lobar fissure (also the middle hepatic vein)
what separates the right and left lobes of the liver
medial and lateral
how is the left lobe of the liver divided?
medial segment of the left lobe
what is another name for the quadrate lobe?
true
true or false? the caudate lobe has its own separate blood supply and venous drainage
70%
what percentage of the liver's total blood supply comes from the portal vein?
it is derived from the intestines
why is the blood within the portal vein partially oxygenated?
30%
what percentage of the liver's total blood supply comes from the hepatic artery?
<13mm
what is the typical ap measurement of the main portal vein?
portal hypertension
enlargement of the main portal vein is indicative of:
decrease
normal portal veins ________ in size as they approach the diaphragm
an increase in the amount of collagen within the walls
why are the walls of the portal veins echogenic?
increase
hepatic veins ________ in size as they approach the diaphragm
monophasic
what phasicity do the portal veins have?
triphasic
what phasicity do the hepatic veins have?
right sided heart abnormalities
what does enlarged hepatic veins signify?
main portal vein, common bile duct, hepatic artery
what structures are located within the porta hepatitis?
women
is the Riedel lobe more commonly seen in men or women?
papillary process of the caudate lobe
an inferior extension of the caudate lobe that can resemble a mass
15.5 cm
hepatomegaly is suspected if the mid-hepatic line measures greater than:
obesity, alcohol abuse, chemotherapy, diabetes mellitus, pregnancy, glycogen storage disease, and the use of some drugs
what are some causes of a fatty liver?
typically asymptomatic
what are the symptoms of a fatty liver?
diffusely echogenic with increased attenuation of the sound beam
how does diffuse fatty liver appear sonographically?
hyperechoic area adjacent to the gallbladder, near the porta hepatis, or the entire medial segment of the left lobe may appear echogenic
how does fatty focal infiltration appear sonographically?
hypoechoic area adjacent to the gallbladder, near the porta hepatis, or the entire medial segment of the left lobe may be spared. Can appear much like pericholecystic fluid when seen adjacent to the gallbladder
how does focal sparing appear sonographically?
cirrhosis, portal hypertension, and hepatocellular carcinoma
what can hepatitis ultimately lead to?
A & B
what are the two most common forms of hepatitis?
fecal-oral route in contaminated food or water
how is hepatitis A spread?
contact with contaminated body fluids, mother to infant transmission, or inadvertent blood contact
how is hepatitis B spread?
contact with blood and body fluids
how is hepatitis C spread?
chills, dark urine, elevated LFTs, fatigue, fever, hepatosplenomegaly, jaundice, nausea, vomiting
what are the symptoms of hepatitis?
normal liver, enlarged hypoechoic liver, periportal cuffing, gallbladder wall thickening
what are the sonographic findings of hepatitis?
nonobstructive jaundice
the type of jaundice that is on a cellular level, no associated with biliary obstruction
alcoholism
what is the most common cause of cirrhosis?
ascites, diarrhea, elevated LFTs, fatigue, hepatomegaly, jaundice, splenomegaly, weight loss
what are the symptoms of cirrhosis?
hepatomegaly (initial), shrunken right lobe of liver, enlarged caudate and left lobe, nodular surface irregularity, coarse echotexture, splenomegaly, ascites, monophasic flow within the hepatic veins, hepatofugal flow within the portal veins
what are the sonographic findings of cirrhosis?
abnormal LFTs, ascites, diarrhea, fatigue, hepatomegaly, jaundice, weight loss
what are the symptoms of portal hypertension?
hepatomegaly (initial), shrunken right lobe of liver, enlarged caudate and left lobe, nodular surface irregularity, coarse echotexture, splenomegaly, ascites, monophasic flow within the hepatic veins, hepatofugal flow within the portal veins, enlargement of the portal vein, enlargement of SMV, enlargement and reversed flow within the coronary vein, abdominal varicosities and the splenic hilum, renal hilum, and gastroesophageal junction, patent paraumbilical vein, collateral development at the splenic and renal hilum
what are the sonographic findings of portal hypertension?
hepatocellular carcinoma, portal hypertension, pancreatitis, cholecystitis, pregnancy, oral contraceptive use, surgery
what conditions are associated with portal vein thrombosis?
abdominal pain, elevated LFTs, hypovolemia, leukocytosis, low grade fever, nausea, vomiting
what are the symptoms of portal vein thrombosis?
echogenic thrombus within the portal vein, cavernous transformation of the portal veins
what are the sonographic findings of portal vein thrombosis?
cavernous transformation of the portal vein
what is the term for the tiny mesh of blood vessels in the area of the portal vein that occurs with portal vein thrombosis
ascites, elevated LFTs, hepatomegaly, splenomegaly, upper abdominal pain
what are the clinical findings of Budd Chiari syndrome?
nonvisualization or reduced visualization of the hepatic veins, thrombus within the hepatic veins, enlarged caudate lobe, lack of flow within the hepatic veins, narrowing of the IVC
what are the sonographic findings of Budd Chiari syndrome?
middle age
what portion of life are true hepatic cysts usually encountered?
asymptomatic, normal LFTs, polycystic kidney disease
what are the clinical findings of hepatic cysts?
anechoic mass or masses with smooth walls and posterior enhancement, may have irregular shapes, clusters of cysts may be noted
what are the sonographic findings of hepatic cysts?
leukocytosis, low grade fever, nausea, obstructive jaundice, RUQ tenderness
what are the clinical findings of hydatid liver cysts?
complex anechoic mass or masses containing some debris
what are the sonographic findings of hydatid liver cysts?
fever, hepatomegaly, leukocytosis, possible abnormal LFTs, RUQ pain
what are the clinical findings of a pyogenic hepatic abscess?
complex cyst with thick walls, mass with debris, septations, or air
what are the sonographic findings of a pyogenic abscess?
hepatomegaly, RUQ pain, general malaise, diarrhea, fever, leukocytosis, elevated LFTs, mild anemia
what are the clinical findings of an amebic hepatic abscess?
round, hypoechoic or anechoic mass or masses that contain debris with acoustic enhancement
what are the sonographic findings of an amebic hepatic abscess?
cancer patients, recent organ transplant patients, HIV patients, RUQ pain, fever, hepatomegaly
what are the clincal findings of hepatic candidiasis?
multiple hyperechoic masses with hypoechoic halos
what are the sonographic findings of hepatic candidiasis?
asymptomatic, oral contraceptive use
what are the clinical findings of hepatocellular adenomas?
hypoechoic, hyperechoic, isoechoic, or mixed echogenicities
what are the sonographic findings of hepatocellular adenomas?
hepatocellular adenomas
what rare benign liver tumors are usually removed because of the propensity to become malignant
trauma, recent surgery, decreased hematocrit
what are the clinical findings of a hepatic hematoma?
fresh clot is more echogenic than the surrounding liver, may appear cystic or complex
what are the sonographic findings of hepatic hematomas?
asymptomatic
what are the clinical findings of a cavernous hemangioma?
small, hyperechoic mass
what are the sonographic findings of a cavernous hemangioma?
focal nodular hyperplasia
what is the 2nd most common benign liver tumor?
asymptomatic
what are the clinical findings of focal nodular hyperplasia?
isoechoic, hyperechoic, or hypoechoic mass with a central scar
what are the sonographic findings of focal nodular hyperplasia?
asymptomatic
what are the clinical findings of lipomas?
hyperechoic mass
what are the sonographic findings of a lipoma?
elevated a-fetoprotein, abnormal LFTs, cirrhosis, chronic hepatitis, weight loss, hepatomegaly, fever, palpable mass, ascites
what are the clinical findings of hepatocellular carcinoma?
solitary, small hypoechoic mass, hetergeneous masses scattered throughout the liver, mass with a hypoechoic halo
what are the sonographic findings of hepatocellular carcinoma?
gallbladder, colon, stomach, pancreas, breast, lung
what are the common primary cancers that metastasize to the liver?
weight loss, jaundice, RUQ pain, hepatomegaly, ascites
what are the clinical findings of hepatic metastasis?
hypoechoic or hyperechoic masses, target or bullseye lesion
what are the sonographic findings of hepatic metastasis?
children under 5, palpable abdominal mass, hepatomegaly, abdominal pain, weight loss, anorexia, elevated serum a-fetoprotein, jaundice
what are the clinical findings of hepatoblastoma?
solid, hyperechoic, or hetergeneous mass with calcifications
what are the sonographic findings of hepatoblastoma?
biliary strictures, cholangitis, biliary sludge and stones, hepatic artery thrombosis, hepatic artery stenosis, hepatic artery pseudoaneurysms, celiac artery stenosis, portal vein stenosis and thrombosis, fluid collections
what are the sonographic signs of rejection of a liver transplant?
acalculous cholecystitis
the inflammation of the gallbladder without associated gallstones
acute cholecystitis
the sudden onset of gallbladder inflammation
adenomyomatosis
benign hyperplasia of the gallbladder wall
biliary colic
pain located in the right upper quadrant in the area of the gallbladder
cholecystectomy
the surgical removal of the gallbladder
cholecystokinin
the hormone produced by the duodenum that causes the gallbladder to contract
choledocholithiasis
the presence of a gallstone or gallstones within the biliary tree
cholelithiasis
gallstones
chronic cholecystitis
cholecystitis that results from the intermittent obstuction of the cystic duct by gallstones
comet tail artifact
a form of reverberation artifact in which there is a band of echoes that taper distal to a strong reflector
Courvoisier gallbladder
the clinical detection of an enlarged, palpable gallbladder caused by a biliary obstruction in the area of the pancreatic head
cystic duct
the duct that connects the gallbladder to the common hepatic duct
Hartmann pouch
an outpouching of the gallbladder neck
hydropic gallbladder
an enlarged gallbladder
hyperalimentation
the intravenous administration of nutrients and vitamins
junctional fold
a fold in the neck of the gallbladder
parity
the total number of completed pregnancies that have reached the age of viability
pericholecystic fluid
the fluid around the gallbladder
peritonitis
inflammation of the peritoneal lining
Phrygian cap
gallbladder variant when the gallbladder fundus is folded onto itself
porcelain gallbladder
the calcification or all of part of the gallbladder wall
Rokitansky-Aschoff sinuses
tiny pockets within the gallbladder wall
sepsis
a life-threatening condition caused by the body's response to a systemic infection
spiral valves of Heister
folds located within the cystic duct that prevent it from collapsing and distending
total parenteral nutrition
the feeding of a person intravenously
tumefactive sludge
thick sludge
wall-echo-shadow sign
shadowing from the gallbladder fossa produced by a gallbladder that is completely filled with gallstones
mucosal, fibromuscular, serosal
what are the three distinct layers of the gallbladder?
cystic artery
what artery feeds the gallbladder?
8-10 cm in length and <5 cm in diameter
what is the normal range of gallbladder size?
<3mm
how thick should the gallbladder wall measure?
postprandial state, acute cholecystitis, chronic cholecystitis, adenomyomatosis, benign ascites, hepatitis, congestive heart failure, gallbladder carcinoma
what are some causes of diffuse gallbladder wall thickening?
gallbladder polyp, adenomyomatosis, gallbladder carcinoma
what are some causes of focal gallbladder thickening?
cholesterol, calcium bilirubinate, calcium carbonate
what do gallstones consist of?
fat, female, fertile, flatulent, fair, forty
6 F's of higher incidence of gallstones?
Crohn disease, sickle cell disease
what pediatric diseases are associated with gallstones?
obesity, pregnancy, increased parity, gestational diabetes, estrogen therapy, oral contraceptive use, rapid weight loss programs, hemolytic disorder, total parenteral nutrition
what are some predisposing conditions for gallstone development?
asymptomatic, biliary colic, abdominal pain after fatty meals, epigastric pain, nausea, vomiting, pain that radiates to shoulders
what are some clinical findings of gallstones?
echogenic, nonshadowing, and nonmobile mass that projects from the gallbladder wall into the gallbladder lumen
describe the sonographic appearance of gallbladder polyps
gallbladder carcinoma
a rapidly growing or large gallbladder polyp is worrisome for what condition?
asymptomatic
what are the clinical findings of gallbladder polyps?
chronic, gangrenous, emphysematous, gallbladder perforation
what is the sequela of acute cholecystitis?
nontender gallbladder, intolerance to fatty foods, nausea, belching
what are the clinical findings of chronic cholecystitis?
possible gallbladder wall thickening, gallstones
what is the sonographic finding for chronic cholecystitis?
elevated symptoms of acute cholecystitis
what are the clinical findings of gangrenous cholecystitis?
linear echogenic membranes within the lumen of the gallbladder, striated gallbladder wall
what are sonographic findings of gangrenous cholecystitis?
elevated symptoms of acute cholecystitis, diabetes
what are the clinical findings of emphysematous cholecystitis?
gas within the gallbladder wall that leads to ring-down artifact
what are the sonographic findings of emphysematous cholecystitis?
elevated symptoms of acute cholecystitis
what are the clinical findings of gallbladder perforation?
small opening or tear in the gallbladder wall
what are the sonographic findings of gallbladder perforation?
RUQ tenderness, epigastric or abdominal pain, leukocytosis, elevation of alkaline phosphate, aminotransferase, bilirubin, fever, pain that radiates to the shoulders, nausea and vomiting
what are the clinical findings for acute cholecystitis?
gallstones, +Murphy's sign, gallbladder wall thickening, pericholecystic fluid, sludge
what are the sonographic findings for acute cholecystitis?
asymptomatic
what are the clinical findings of adenomyomatosis?
focal or diffuse thickening of the gallbladder wall, comet tail artifact
what are the sonographic findings of adenomyomatosis?
peritonitis
when gallbladder perforation occurs, the patient is at risk of developing what?
children, hopitalized patients, immunocompromised people
what types of patients commonly develop acalculous cholecystitis?
gallbladder wall thickening, pericholecystitis, sludge
what are the sonographic findings of acalculous cholecystitis?
>5 cm in diameter, or >8-10 cm in length
what measurements constitute an enlarged gallbladder?
gallbladder carcinoma
Porcelain gallbladders have been associated with the potential to develop what?
calcification and shadowing from the gallbladder wall
what are the sonographic findings of a porcelain gallbladder?
weight loss, RUQ pain, jaundice, nausea and vomiting, hepatomegaly
what are the clinical findings of gallbladder carcinoma?
nonmobile mass within the gallbladder lumen, gallstones >2cm, diffuse or focal gallbladder wall thickening, irregular mass that may completely fill the gallbladder fossa, invasion of the mass into surrounding lier tissue
what are the sonographic findings of gallbladder carcinoma?
acute pancreatitis
inflammation of the pancreas secondary to the leakage of pancreatic enzymes from the acinar cells into the parenchyma of the organ
ampulla of Vater
the merging point of the pancreatic duct and common bile duct just before the sphincter of Oddi
biliary atresia
a congenital disease described as the narrowing or obliteration of all or a portion of the biliary tree
biliary stasis
a condition in which bile is stagnant and allowed to develop into sludge or stones
bilirubin
a yellow pigment found in bile that is produced by the breakdown of old red blood cells by the liver
Caroli's disease
a congenital disorder characterized by segmental dilatation of the intrahepatic ducts
cholangiocarcinoma
primary bile duct cancer
cholangiography
a radiographic procedure in which contrast is injected into the bile ducts to assess for the presence of disease
cholangitis
inflammation of the bile ducts
chronic pancreatitis
the recurring destruction of the pancreatic tissue that results in atrophy, fibrosis, scarring, and the development of calcification within the gland
chyme
partially digested food
dirty shadowing
shadowing seen posterior to gas or air; possibly referred to as a ring-down artifact
endoscopic retrograde cholangiopancreatography
endoscopic procedure that utilizes fluoroscopy to evaluate the biliary tree and pancreas
hepatopancreatic ampulla
the level of the biliary tree where the common bile duct and main pancreatic duct meet; AKA ampulla of Vater
hepatopancreatic sphincter
the muscle that controls the emptying of bile and pancreatic juices into the duodenum; may also be referred to as the sphincter of Oddi
Klatskin tumor
a malignant biliary tumor located at the junction of the right and left hepatic ducts
Mirizzi syndrome
a clinical condition when the patient presents with jaundice, pain, and fever secondary to a lodged stone in the cystic duct
pneumobilia
air within the biliary tree
pruritus
severe itchiness of the skin
1-7 mm
what is the normal ap measurement for the CBD?
within the liver
where is the origin of bile?
the liver
what is considered the proximal portion of the biliary tree?
proximal
biliary dilation is occur ________ to the level of obstruction
distal common bile duct
where is the most common site for a biliary obstruction?
choledocholithiasis, chronic pancreatitis, acute pancreatitis, pancreatic carcinoma
what are the most common causes of common bile duct obstruction
jaundice, elevated bilirubin, elevated alkaline phosphate, RUQ pain
what are the clinical findings of choledocholithiasis?
echogenic foci within the bile duct that may or may not shadow; may have biliary dilation but not always
what are the sonographic findings of choledocholithiasis?
5 mm
at what measurement of the bile duct wall should one suspect some form of cholangitis?
fever, leukocytosis, jaundice, RUQ pain, elevated alkaline phosphate, elevated bilirubin
what are the clinical findings of cholangitis?
biliary dilation, biliary sludge, choledocholithiasis, bile duct wall thickening
what are the sonographic findings of cholangitis?
recent biliary or gastric surgery, emphysematous or prolonged acute cholecystitis, fistula formation
what can pneumobilia be associated with?
recent biliary surgery, symptoms of acute cholecystitis
what are the clinical findings of pneumobilia?
echogenic linear structures within the ducts that produce ring-down artifacts and may have dirty shadowing
what are the sonographic findings of pneumobilia?
Klatskin tumors
what are the most common manifestation of cholangiocarcinoma?
jaundice, pruritus, weight loss, abdominal pain, elevated bilirubin, elevated alkaline phosphate
what are the clinical findings of cholangiocarcinoma?
dilated intrahepatic ducts that abruptly terminate at the level of the tumor
what are the sonographic findings of cholangiocarcinoma?
cystic dilatation of the CBD
what is the most common type of choledochal cyst?
jaundice, pain, fever
what are the clinical findings of choledochal cysts?
cystic mass in the area of the porta hepatis
what is the sonographic appearance of choledochal cysts?
cystic renal disease
what condition is Caroli's disease usually seen with?
acinar cells
the cells of the pancreas that carry out the exocrine function and therefore produce amylase, lipase, and sodium bicarbonate
double-duct sign
co-existing enlargement of the common bile duct and pancreatic duct
duct of Santorini
the accessory duct of the pancreas
duct of Wirsung
the main pancreatic duct
duodenum
the first segment of the small intestine
hyperamylasemia
elevated amylase
isles of Langerhans
small islands of tissue found within the pancreas that produce insulin and glucagon
islet cell tumors
tumor found within the isles of Langerhans of the pancreas
pancreatic adenocarcinoma
the most common form of pancreatic malignancy; typically found within the head of the pancreas
pancreatic pseudocyst
a cyst surrounded by fibrous tissue that consists of pancreatic enzymes that have leaked from the pancreas
pancreaticoduodenectomy
the surgical procedure in which the head of the pancreas, the gallbladder, some of the bile ducts, and the proximal duodenum are removed because of a malignant pancreatic neoplasm; aka Whipple procedure
phlegmon
the peripancreatic fluid collection that results from the inflammation of the pancreas
uncinate process
the posteromedial extension of the pancreatic head
von Hippel-Lindau disease
a hereditary disease that includes the development of cysts within the pancreas and other organs
Zollinger-Ellison syndrome
the syndrome that includes an excessive secretion of acid by the stomach caused by the presence of a functional gastrinoma within the pancreas
aids in digestion
what is the pancreas' exocrine function?
amylase, lipase, sodium bicarbonate, trypsin, chymotrypsin, carboxypolypeptidase
what are the 6 enzymes that assist in the pancreas' exocrine function?
digests carbohydrates
what does amylase do?
digests fats
what does lipase do?
neutralizes stomach acids
what does sodium bicarbonate do?
digests proteins
what do trypsin, chymotrypsin, and carboxypolypeptidase do?
isles of Langerhans
what performs the endocrine function of the pancreas?
alpha, beta, delta cells
what types of cells make up the isles of Langerhans?
glucagon
what do alpha cells produce?
insulin
what do beta cells produce?
somatostatin
what do delta cells produce?
promotes the release of glucose by the liver which increases blood sugar level
what does glucagon do?
stimulates the body to use up glucagon to produce energy
what does insulin do?
restrains insulin and glucose levels
what does somatostatin do?
gastroduodenal artery
where does the pancreatic head blood supply come from?
splenic and superior mesenteric arteries
where does the pancreatic body and tail blood supply come from?
splenic vein, superior mesenteric vein, inferior mesenteric vein, portal vein
what veins drain the pancreas?
lack of fat surrounding the pancreas
why does a pediatric pancreas appear more hypoechoic?
2 mm
what should the main pancreatic duct measure ap?
2-3 cm
what should the pancreatic head and body measure ap?
1-2 cm
what should the pancreatic tail measure ap?
retroperitoneal
is the pancreas considered peritoneal or retroperitoneal?
pancreatic head
what pancreatic structure lies right lateral to superior mesenteric vein, anterior to IVC, inferior to portal vein
uncinate process
what pancreatic structure lies posterior to SMV and anterior to aorta
pancreatic neck
what pancreatic structure lies anterior to portal confluence
pancreatic body
what pancreatic structure lies anterior to SMV, splenic vein, and SMA
pancreatic tail
what pancreatic structure's posterior border is marked by the splenic vein
elevated amylase (within 24 hours), elevated lipase (within 72 hours), abdominal pain, back pain, fever, nausea, vomiting, leukocytosis
what are the clinical findings of acute pancreatitis?
can be diffuse or focal, enlarged, hypoechoic, fluid collections, possible pseudocyst
what are the sonographic findings of acute pancreatitis?
persistent epigastric pain, jaundice, back pain
what are the clinical findings of chronic pancreatitis?
heterogeneous atrophic pancreas with poor margins, calcifications, pseudocyst, dilated pancreatic duct
what are the sonographic findings of chronic pancreatitis?
pancreatic adenocarcinoma
what is the most common primary pancreatic malignancy?
head
in what part of the pancreas is pancreatic adenocarcinoma most commonly found?
double duct sign
obstruction of the pancreatic duct and common bile duct is known sonographically as:
elevated amylase and/or lipase, loss of appetite, weight loss, jaundice, epigastric pain
what are the clinical findings of pancreatic adenocarcinoma?
hypoechoic mass, double duct sign, enlarged gallbladder
what are the sonographic findings of pancreatic adenocarcinoma?
serous (microcystic) and mucinous (macrocystic)
what are the two types of cystadenomas found in the pancreas?
serous
which type of cystadenoma is small and always benign?
mucinous
which type of cystadenoma is large and has malignant potential?
body and tail
in what part of the pancreas are mucinous cystadenocarcinomas most commonly found?
asymptomatic, epigastric pain, weight loss, palpable mass, jaundice
what are the clinical findings of pancreatic cystadenomas?
cystic mass that may appear solid due to small size of cysts
what are the sonographic findings of serous cystadenomas?
multilocular cystic masses
what are the sonographic findings of mucinous cystadenomas?
within the Isles of Langerhans
where can endocrine tumors be found?
insulinoma and gastrinoma
what are the two types of islet cell tumors?
insulinoma
what is the most common type of islet cell tumor?
Zollinger-Ellison syndrome
what syndrome is produced by functional gastrinomas?
low blood sugar symptoms
what are the clinical findings of insulinomas?
hypoechoic mass
what are the sonographic findings of islet cell tumors?
von Hippel-Lindau disease, autosomal dominant polycystic disease
what diseases can cause true pancreatic cysts?
accessory spleen
a small, round island of splenic tissue often located near the splenic hilum or tail of pancreas
angiosarcoma
a rare malignant tumor of the spleen that is derived from blood vessels
bacterial endocarditis
an infection of the surface of the heart that can spread to other organs
Epstein-Barr infection
a herpes virus that can lead to infectious mononucleosis
histoplasmosis
a disease that results from the inhalation of an airborne fungus that can affect the lungs and may spread to other organs
red pulp
specialized tissue within the spleen that performs its phagocytic function
sarcoidosis
a systemic disease that results in the development of granulomas throughout the body
sickle cell anemia
an inherited disease in which the body produces abnormally shaped red blood cells
splenic infarct
an area within the spleen that has become necrotic because of a lack of oxygen
white pulp
specialized lymphatic tissue within the spleen
spleen
what is the largest structure of the reticuloendothelial system?
intraperitoneal
is the spleen retro or intra peritoneal?
filter the peripheral blood
what is the primary objective of the spleen?
spleen
what is the largest lymphatic organ?
5th
at what gestational week does the spleen begin to develop?
erythropoiesis
what is the spleen responsible for in the fetus?
red bone marrow
what primarily produces red blood cells in the adult?
severe anemia; extramedullary hematopoiesis
in what cases would the spleen's hematopoietic function return to an adult? and what is this called?
lymphocytes
what does white pulp produce?
culling
the spleen removes irregular cells from the bloodstream and retains them through a process called what?
pitting
the spleen cleans red blood cell of unwanted material in a process called what?
superior mesenteric vein
the splenic vein joins with the ________ posterior to the pancreatic neck to form the portal vein
splenomegaly
what is the most common abnormality of the spleen?
12cm; 5cm
the spleen should never measure more than ___ in length and ____ in thickness
portal hypertension
what is the most common cause of splenomegaly?
palpable enlarged spleen, hemolytic abnormalities, trauma, infection
what are the clinical findings of splenomegaly?
sudden onset of LUQ pain
what are the clinical findings of splenic infarct?
hypoechoic wedge-shaped mass
what are the sonographic findings of an acute splenic infarct?
hyperehcoic wedge-shaped mass
what are the sonographic findings of chronic splenic infarct?
trauma, severe LUQ pain, decreased hematocrit
what are the clinical findings of splenic trauma?
hemangioma
what is the most common benign tumor of the spleen?
small, echogenic foci that may shadow
what are the sonographic findings of granulomatous disease of the spleen?
asymptomatic
what are the clinical findings of granulomatous disease of the spleen?
angiosarcoma
although exceedingly rare, what is the primary malignant tumor of the spleen?
lymphoma
what is the most common malignancy of the spleen?
Hodgkin lymphoma
the presence of Reed-Sternberg cells indicate:
Hodgkin lymphoma
what type of lymphoma can be treated and has a high recovery rate?
non Hodgkin lymphoma
what type of lymphoma is not easily managed but is more common?
breast, lung, skin, ovary
what are the primary cancer locations for splenic metastasis?
mononucleosis, Sickle cell disease
what two diseases can cause splenomegaly in children?
Epstein-Barr infection
what herpesvirus can lead to infectious mononucleosis?
acquired renal cystic disease
a cystic disease of the kidney that is often the result of chronic hemodialysis
acute pyelonephritis
an inflammation of the kidney or kidneys
acute tubular necrosis
damage to the tubule cells within the kidneys that results in renal failure
angiomyolipoma
a common benign renal tumor that consists of a network of blood vessels, muscle, and fat
autosomal dominant polycystic disease
an inherited disease that results in renal, liver, and pancreatic cysts late in life
autosomal recessive polycystic disease
an inherited renal disease that results in bilateral enlargement of the fetal kidneys and microscopic renal cysts
azotemia
an excess of urea or other nitrogenous compounds in the blood
bacteruria
the presence of bacteria in the urine
benign prostatic hypertrophy
benign enlargement of the prostate gland
bladder diverticulum
an outpouching of the urinary bladder wall
blood urea nitrogen
a measure of the amount of nitrogen in the blood in the form of urea
chronic pyelonephritis
a chronic inflammation of the kidney or kidneys
chronic renal failure
the gradual decrease in renal function over time
columns of Bertin
an extension of the renal cortex located between the renal pyramids
congenital hydronephrosis
the dilation of the renal collecting system at birth
cortical nephrocalcinosis
the accumulation of calcium within the cortex of the kidney
creatinine
a chemical waste molecule that is generated from muscle metabolism and excreted in urine
cystitis
an inflammation of the urinary bladder
detrusor muscle
the muscle that controls the appropriate emptying of the urinary bladder
dysuria
painful or difficult urination
emphysematous pyelonephritis
the formation of air within the kidney parenchyma secondary to bacterial infiltration
exophytic
growing outward
Gerota fascia
the fibrous envelope of tissue that surrounds the kidney and adrenal gland
glomerulonephritis
an infection of the kidney glomeruli
gross hematuria
blood within the urine that is visible by the naked eye
hematuria
blood within the urine
homeostasis
maintenance of normal body physiology
hydronephrosis
the dilation of the renal collecting system resulting from the obstruction of the flow of urine from the kidney to the bladder
hydroureter
distension of the ureter with fluid due to obstruction
hyperkalemia
abnormally high levels of potassium in the blood
hypernephroma or renal cell carcinoma
carcinoma of the kidney
hypovolemia
decreased blood volume
lactate dehydrogenase
an enzyme found within the blood that may be used to monitor renal function
lymphocele
a collection of lymphatic fluid
malaise
a feeling of uneasiness
medullary nephrocalcinosis
the accumulation of calcium within the medulla of the renal parenchyma
medullary sponge kidney
a congenital disorder characterized by the accumulation of calcium within abnormally dilated collecting ducts located within the medulla
megacystitis
an abnormally enlarged urinary bladder
megaureter
an enlarged ureter; can be congenital or acquired
multicystic dysplastic kidney disease
a renal disease thought to be caused by an early renal obstruction; leads to the development of multiple noncommunicating cysts of varying sizes in the renal fossa
mural nodules
a small mass located on the wall of a structure
nephroblastoma
the most common solid malignant pediatric abdominal mass
nephrocalcinosis
an accumulation of calcium within the renal parenchyma
nephrolithiasis
the urinary stones located within the kidney
nephron
the functional unit of the kidney
nephrotic syndrome
a kidney disorder caused by damage to the glomeruli, which results in excess amounts of protein in the urine and the swelling of the ankles, face, and feet due to accumulation of excess water
neurogenic bladder
a bladder that is poorly functioning secondary to any type of neurological disorder
nocturia
frequent urination at night
nuclear cystogram
a nuclear medicine examination of the urinary bladder and ureters
oliguria
a scant or decreased urine output
oncocytoma
a benign renal tumor that is often found in men in their 60s
papillary projections
a small protrusion of tissue
perinephric abscess
an abscess that surrounds the kidney
posterior urethral valves
irregular thin membranes of tissue located within the male posterior urethra that do not allow urine to exit the urethra
proteinuria
protein within the uria
prune belly syndrome
a syndrome that is a consequence of the abdominal wall musculature being stretched by an extremely enlarged urinary bladder
pyonephrosis
the condition of having pus within the collecting system of the kidney
pyuria
pus within the urine
renal artery stenosis
the narrowing of the renal artery
renal cell adenoma
a benign renal mass
renal colic
a sharp pain in the lower back that radiates into the groin and is typically associated with the passage of a urinary stone through the ureter
renal cortex
the outer part of the renal parenchyma that is responsible for filtration
renal/aorta ratio
a ratio calculated by dividing the highest renal artery velocity by the highest aortic velocity obtained at the level of the renal arteries
renal medulla
the inner part of the parenchyma that is responsible for absorption
renal pyramids
cone-shaped structures located within the renal medulla that contains part of the nephron
renal sinus
the portion of the kidney containing the minor calices, major calices, renal pelvis, and infundibula
retroperitoneal fibrosis
a disease characterized by the buildup of fibrous tissue within the retroperitoneum; this mass may involve the abdominal aorta, IVC, ureters, sacrum
staghorn calculus
a large urinary stone that completely fills and takes the shape of the renal pelvis
tardus-parvus
the combination of a slow systolic upstroke and a decreased systolic velocity
trabeculae
muscular bundles
transitional cell carcinoma
a malignant tumor of the urinary tract that is often found within the urinary bladder or within the renal pelvis
trigone of the urinary bladder
the area within the urinary bladder where the two ureteral orifices and urethral orifice are located
tuberous sclerosis
a systemic disorder that leads to the development of tumors within various organs
tubo-ovarian abscess
a pelvic abscess involving the uterine tubes and ovaries that is often caused by PID
twinkle sign
an artifact noted as an increased color Doppler signal posterior to a kidney stone
urachus
a tubular structure that is a remnant of embryonic development, which extends from the umbilicus to the apex of the bladder
ureterocele
an abnormality in which the distal ureter projects into the urinary bladder
ureteropelvic junction
the junction of the ureter and renal pelvis
ureterovesicular junction
the junction of the ureter and urinary bladder
urethritis
an inflammation of the urethra
urinoma
a localized collection of urine
vesicoureteral reflux
the retrograde flow of urine from the urinary bladder into the ureter
voiding cystourethrogram
a radiographic examination that involves the assessment of the urinary bladder and distal ureter for urinary reflux and other abnormalities
von Hippel-Lindau syndrome
an inherited disorder characterized by tumors of the central nervous system and the development of cysts within the kidneys, renal cell carcinoma, and pheochromocytomas
xanthogranulomatous pyelonephritis
a rare chronic form of pyelonephritis that is typically the result of a chronic obstructive process
acute pyelonephritis, UTI
what does bacteruria indicate?
UTI
what does pyuria indicate?
acute and chronic pyelonephritis, renal cell carcinoma, infarction, trauma, kidney stones
what does hematuria indicate?
masses, glomerulonephritis, infection, nephrotic syndrome, acute or chronic pyelonephritis, urinary calculi
what does proteinuria indicate?
kidney stones
what does an abnormal urine pH indicate?
renal failure or pyelonephritis
what does low specific gravity indicate?
dehydration
what does high specific gravity indicate?
UTI
what does an elevated white blood cell count in urine indicate?
elevated BUN and creatinine, oliguria, hypertension, leukocytosis, hematuria, edema, hypovolemia
what are the clinical findings of acute renal failure?
normal kidneys, may appear more echogenic
what are the sonographic findings of acute renal failure?
diabetes mellitus, malaise, elevated BUN and creatinine, fatigue, hypertension, hyperkalemia
what are the clinical findings of chronic renal failure?
small, echogenic kidneys, loss of normal corticomedullary differentation, renal cysts
what are the sonographic findings of chronic renal failure?
asymptomatic
what are the clinical findings of simple renal cysts?
3rd or 4th decade of life, decreased renal function, UTI, renal calculi, flank pain, hematuria, abdominal mass
what are the clinical findings of Autosomal Dominant polycystic kidney disease?
bilateral enlarged kidneys, numerous cortical renal cysts
what are the sonographic findings of Autosomal Dominant polycystic kidney disease?
clinical findings of renal failure
what are the clinical findings of Autosomal Recessive polycystic kidney disease?
bilateral enlarged echogenic kidneys, loss of corticomedullary differentation
what are the sonographic findings of Autosomal Recessive polycystic kidney disease?
asymptomatic
what are the clinical findings of multicystic dysplastic renal disease?
unilateral cysts, hypertrophy of contralateral kidney
what are the sonographic findings of multicystic dysplastic renal disease?
clinical findings of chronic renal failure, history of hemodialysis
what are the clinical findings of acquired renal cystic disease?
kidneys are small first, then enlarge with numerous small cysts
what are the sonographic findings of acquired renal cystic disease?
symptoms of brain/eye tumors
what are the clinical findings of von Hippel-Lindau syndrome?
multiple renal cysts, pancreatic cysts, pheochromocytoma
what are the sonographic findings of on Hippel-Lindau syndrome?
epilepsy, skin lesions on the face
what are the clinical findings of Tuberous Sclerosis?
bilateral renal cysts, bilateral angiomyolipomas
what are the sonographic findings of Tuberous Sclerosis?
flank pain, bacteriuria, pyuria, leukocytosis, dysuria, urinary frequency
what are the clinical findings of acute pyelonephritis?
normal, renal enlargement, altered echotexture, compression of renal sinus
what are the sonographic findings of acute pyelonephritis?
pyuria, bacteruria, fever, flank pain, leukocytosis
what are the clinical findings of pyonephrosis?
hydronephrosis, pus and debris in collecting system
what are the sonographic findings of pyonephrosis?
symptoms of pyelonephritis, high fever, flank pain, leukocytosis
what are the clinical findings of renal abscesses?
complex mass with shadowing
what are the sonographic findings of renal abscesses?
diabetes mellitus, immunocompromised patient, fever, flank pain, leukocytosis
what are the clinical findings of emphysematous pyelonephritis?
gas or air within the renal parenchyma, dirty shadowing
what are the sonographic findigns of emphysematous pyelonephritis?
flank pain, bacteruria, pyuria, leukocytosis, dysuria, urinary frequency
what are the clinical findings of chronic pyelonephritis?
small, echogenic kidneys with lobulated borders
what are the sonographic findings of chronic pyelonephritis?
immunocompromised, diabetes mellitus, IV drug abuse, catheters, flank pain, fever, chills
what are the clinical findings of renal fungal disease?
fungal balls (hyperechoic, nonshadowing mobile structures)
what are the sonographic findings of renal fungal disease?
recent throat infection, smoky urine, hematuria, proteinuria, fever, hypertension, azotemia
what are the clinical findings of glomerulonephritis?
enlarged kidneys, prominent renal pyramids
what are the sonographic findings of acute glomerulonephritis?
small, echogenic kidneys
what are the sonographic findings of chronic glomerulonephritis?
caliectasis
dilation of the calices
pelviectasis
dilation of the renal pelvis
pelvocaliectasis
dilation of the calices and renal pelvis
adrenal adenoma
benign solid mass located within the adrenal glands
adrenal cysts
benign simple cysts located within the adrenal glands
adrenocorticotropic hormone
hormone secreted by the anterior pituitary gland which controls the release of hormones by the adrenal gland
Conn syndrome
a syndrome caused by a functioning tumor within the adrenal cortex that produces excess amounts of aldosterone
Conn syndrome
syndrome in which patients have hypertension, excessive thirst, excessive urination, low levels of potassium in the blood
Cushing syndrome
a syndrome that results from a pituitary or adrenal tumor that causes overproduction of cortisol by the adrenal glands
Cushing syndrome
syndrome in which patients suffer from obesity, thinning arms and legs, hypertension, hyperglycemia, and severe fatigue
endocrine glands
glands that release their hormones directly into the bloodstream
Gerota fascia
the fibrous envelope of tissue that surrounds the kidney and adrenal gland
hirsutism
excessive hair growth in women in areas where hair growth is normally negligible
hypernatremia
high levels of sodium in the blood
hypokalemia
low levels of potassium in the blood
suprarenal glands
another name for the adrenal glands
tachycardia
abnormally rapid heart rate
aldosterone
what adrenal hormone is responsible for regulating blood pressure by controlling the amounts of sodium and water in the body?
androgens
what adrenal hormone has minimal impact on development of male characteristics
cortisol
what adrenal hormone is responsible for glucose metabolism, blood pressure regulation, immune function, inflammatory response?
aldosterone, androgen, cortisol
what are the 3 hormones of the adrenal cortex?
epinephrine and norepinephrine
what are the hormones of the adrenal medulla?
epinephrine
what hormone accelerates heart rate, increasing blood pressure, opens airways in the lungs, narrows blood vessels in the skin and intestine to increase blood flow to major muscle groups
norepinephrine
what hormone accelerates heart rate, increases blood pressure, contracts blood vessels
obesity, thinning arms and legs, hypertension, hirsutism, hyperglycemia, severe fatigue
what are the clinical indications of Cushing syndrome?
hypertension, excessive thirst, excessive urination, high levels of sodium, low levels of potassium
what are the clinical indication of Conn syndrome?
sign and symptoms of Cushing or Conn syndrome; may be asymptomatic
what are the clinical findings of adrenal adenomas?
solid, hypoechoic mass in the area of the adrenal gland
what are the sonographic findings of adrenal adenomas?
uncontrollable hypertension, headaches, tachycardia, tremors, anxiety, excessive sweating
what are the clinical findings of pheochromocytomas?
large, hyperechoic mass in the area of the adrenal gland
what are the sonographic findings of pheochromocytomas?
palpable abdominal mass, abdominal pain, bone pain
what are the clinical findings of neuroblastoma?
large, heterogeneous mass containing areas of calcification and hemorrhage; metastasis often present at the time of discovery
what are the sonographic findings of neuroblastoma?
abdominal mass, acute drop in hematocrit and blood pressue
what are the clinical findings of adrenal hemorrhage?
heterogeneous mass in the area of the adrenal gland
what are the sonographic findings of adrenal hemorrhage?
atherosclerosis
a disease characterized by the accumulation of plaque within the walls of arteries
false aneurysm
a contained rupture of a blood vessel that is most likely secondary to the disruption of one or more layers of that vessel's walls
false lumen
the residual channel of a vessel created by the accumulation of a clot within that vessel
fusiform
shaped like a spindle; wider in the middle and tapering toward the ends
intimal flap
observation of the intimal layer of a vessel as a result of a dissection
high resistance flow
the flow pattern that results from small arteries or arterioles that are contracted, which produces an increase in the resistance to blood flow to the structure that is being supplied
low resistance flow
the flow pattern characterized by persistent forward flow throughout the cardiac cycle
Marfan syndrome
a disorder of the connective tissue characterized by tall stature and aortic and mitral valve insufficiency
mycotic aneurysms
aneurysms caused by infection
saccular aneurysms
a saclike dilation of a blood vessel
small bowel ischemia
a condition resulting in interruption or reduction of the blood supply to the small intestines
true aneurysm
the enlargement of a vessel that involves all three layers of the wall
true lumen
the true channel within a vessel
acute appendicitis
inflammation of the appendix
adenocarcinoma
cancer originating in glandular tissue
appendicolith
a dense, calcified stone within the appendix
autoimmune disorder
a disorder in which the immune system attacks normal tissue
bezoars
masses of various ingested material that may cause an intestinal obstruction
Crohn disease
an autoimmune disease characterized by periods of inflammation of the gastrointestinal tract
duodenal bulb
the proximal portion of the duodenum closest to the stomach
fecalith
a stone that consists of feces
gastroesophageal reflux
an abnormality in which fluid is allowed to reflux out of the stomach back into the esophagus
hypertrophic pyloric stenosis
a defect in the relaxation of the pyloric sphincter that leads to the enlargement of the pyloric muscles and closure of the pyloric sphincter
intussusception
the telescoping of one segment of bowel into another; most often the proximal segment of the bowel inserts into the distal segment
intussusceptum
the proximal segment of the bowel with intussusception
intussuscipiens
the distal segment of the bowel with intussusception
lactobezoar
a bezoar that consists of powdered milk
malrotation of the midgut
a situation in which the small bowel mesentery rotates around the SMA
McBurney point
a point halfway between the anterior superior iliac spine and the umbilicus; the area of pain and rebound tenderness in patients suffering from acute appendicitis
mechanical obstruction
a situation in which bowel is physically blocked by something
Meckel diverticulum
a common congenital outpouching of the wall of the small intestine
melanoma
a malignant form of cancer found most often on the skin
nonbilious
not containing bile
nonmechanical obstruction
a situation in which bowel is blocked because of the lack of normal peristalsis of a bowel segment or segments AKA paralytic ileus
olive sign
when the pyloric sphincter muscle is enlarged and palpable on physical examination of the abdomen
phytobezoars
a bezoar that consists of vegetable matter
pylorospasm
a temporary spasm and thickening of the pyloric sphincter that can replicate the sonographic appearance of pyloric stenosis
rebound tenderness
pain encountered after the removal of pressure
red currant jelly stool
feces that contains a mixture of mucus and blood; a common clinical finding in patients with intussuseption
trichobezoars
a bezoar that consists of matted hair
vermiform appendix
a blind-ended tube that is connected to the cecum of the colon
volvulus
a situation in which a loop of bowel twists upon itself
cystic adenomatoid malformation
a mass consisting of abnormal bronchial and lung tissue the develops within the fetal chest
hemophiliac
an inherited bleeding disorder that inhibits the control of blood clotting
lung consolidation
the replacement of normal air-filled alveoli with fluid, inflammation, blood, or neoplastic cells
pneumothorax
free air within the chest outside of the lungs that can lead to lung collapse
pulmonary sequestration
a separate mass of nonfunctioning lung tissue with its own blood supply
retroperitoneal fibrosis
a disease characterized by the buildup of fibrous tissue within the retroperitoneum; this mass may involve the aorta, IVC, ureters, and sacrum
retroperitoneal hematoma
a bloody tumor located within the retroperitoneum
retroperitoneal lymphadenopathy
the enlargement of the abdominal lymph nodes located within the abdomen
hematuria, renal colic, oliguria
what are the clinical findings of urolithiasis?
echogenic focus with shadowing, twinkle sign posterior to stone, possible hydronephrosis
what are the sonographic findings of urolithiasis?
hypercalcemia, hyperparathyroidism, UTI, history of urinary calculi
what are the clinical findings of nephrocalcinosis?
echogenic renal pyramids, echogenic foci within the cortex
what are the sonographic findings of nephrocalcinosis?
asymptomatic, hematuria
what are the clinical findings of renal adenomas?
hyperechoic, vascular mass with internal calcifications
what are the sonographic findings of renal adenomas?
asymptomatic
what are the clinical findings of oncocytoma?
varying echogenicity, may have central scar
what are the sonographic findings of oncocytomas?
asymptomatic
what are the clinical findings of angiomyolipoma?
solid, hyperechoic mass
what are the sonographic findings of angiomyolipomas?
asymptomatic
what are the clinical findings of renal hemangiomas?
small, hyperechoic mass
what are the sonographic findings of renal hemangiomas?
asymptomatic
what are the clinical findings of renal lipoma?
hyperechoic mass
what are the sonographic findings of renal lipoma?
anorexia, flank pain, gross hematuria, hypertension, palpable mass, smoker, weight loss
what are the clinical findings of renal cell carcinoma?
hypoechoic or isoechoic solid mass in the kidney
what are the sonographic findings of renal cell carcinoma?
hematuria, pain
what are the clinical findings of transitional cell carcinoma of the kidney
hypoechoic or isoechoic mass within the renal sinus
what are the sonographic findings of transitional cell carcinoma of the kidney?
lung or breast
what are the common primary cancers of renal metastasis?
hematuria, fever, weight loss
what are the clinical findings of metastasis of the kidney?
bilateral hypoechoic or hyperechoic masses
what are the sonographic findings of metastasis of the kidney?
smoking, hypertension, high cholesterol, diabetes
what are the clinical findings of renal artery stenosis?
thickening and calcification of the renal artery, renal/aorta ratio >3.5, tardus parvus
what are the sonographic findings of renal artery stenosis?
pain, hematuria
what are the clinical findings of renal vein thrombosis?
heterogeneous renal echotexture, enlarged renal vein, absent renal vein Doppler signals
what are the sonographic findings of renal vein thrombosis?
pulsatile abdominal mass, abdominal bruit, back pain, abdominal pain, lower extremity pain
what are the clinical findings of AAA?
Diameter of abdominal aorta measure >3cm, thrombus within the lumen of the aorta
what are the sonographic findings of AAA?
intense chest pain, hypertension, abdominal pain, lower back pain, neurologic systems
what are the clinical findings of an aortic dissection?
intimal flap may be noted within the aortic lumen
what are the sonographic findings of an aortic dissection?
decreased hematocrit, hypotension, pulsatile abdominal mass, abdominal bruit, back pain, abdominal pain, lower extremity pain
what are the clinical findings of an aortic rupture?
abdominal aneurysm with an adjacent hematoma
what are the sonographic findings of an aortic rupture?
recent catherterization, surgical procedure, or trauma; pulsatile mass in the area of the puncture location
what are the clinical findings of a pseudoaneurysm?
perivascular hematoma containing swirling blood an has a neck connecting it to the vessel
what are the sonographic findings of a pseudoaneurysm?
brachial cleft cysts
benign congenital neck cysts found most often near the angle of the mandible
cervical lymphadenopathy
enlargement of the cervical lymph nodes
cold nodules
the hypofunctioning thyroid nodules seen on a nuclear medicine study that have a malignant potential
colloid
the fluid produced by the thyroid that contains thyroid hormones
goiter
an enlarged, hyperplastic thyroid gland
Graves disease
the most common cause of hyperthyroidism that produces bulging eyes, heat intolerance, nervousness, weight loss, hair loss
Hashimoto thyroiditis
the most common cause of hypothyroidism in the United States
hot nodules
the hyperfunctioning thyroid nodules seen on a nuclear medicine study that are almost always benign
hyperthyroidism
a condition that results from the overproduction of thyroid hormones
hypothyroidism
the condition that results from the underproduction of thyroid hormones
papillary carcinoma
the most common form of thyroid cancer
pyramidal lobe
a normal variant of the thyroid gland in which there is a superior extension of the isthmus
scintigraphy
nuclear medicine in which a radiopharmaceutical is used to examine the thyroid gland
thyroglossal duct cysts
benign congenital cysts located within the midline of the neck superior to the thyroid gland and near the hyoid bone
thyroid inferno
the sonographic appearance of hypervascularity demonstrated with color Doppler imaging of the thyroid gland
thyroglossal duct
the embryonic duct that is located from the base of the tongue to the midportion of the anterior neck
anterior to each lobe
what is the location of the strap muscles?
lateral to each lobe
what is the location of the sternocleidomastoid muscles?
posterior to each lobe
what is the location of the longus colli muscles?
lateral to each lobe
what is the location of the carotid artery in relation to the thyroid?
left side posterior to the trachea and thyroid
what is the location of the esophagus in relation to the thyroid?
aids in the metabolism of fats, proteins, and carbohydrates
what is the function of thyroxine (T4)?
aids in the metabolism of fats, proteins, and carbohydrates
what is the function of triiodothyronine (T3)?
removing calcium from the blood for storage in the bones
what is the function of calcitonin?
heterogeneous echotexture, may contain multiple nodules with cystic and solid components
what is the sonographic findings of a goiter?
bulging eyes, heat intolerance, nervousness, weight loss, hair loss
what are the clinical findings of graves disease?
enlarged gland, heterogeneous or diffusely hypoechoic echotexture, thyroid inferno
what are the sonographic findings of graves disease?
depression, increased cold sensitivity, elevated blood cholesterol levels, slight weight gain may occur
what are the clinical findings of hashimoto thyroiditis?
mild enlargement of the thyroid gland, heterogeneous echotexture, hypervascular gland
what are the sonographic findings of hashimoto thyroiditis?
elevated serum calcium, elevated PTH
what are the clinical findings of a parathyroid adenoma?
hypoechoic mass adjacent to the thyroid
what are the sonographic findings of a parathyroid adenoma?
>1cm, rounded shape, loss of the echogenic hilum, calcifications
what are the sonographic findings of abnormal lymph nodes?
alpha-fetoprotein
a protein produced by the fetal yolk sac, fetal gastrointestinal tract, and the fetal liver; may also be produced by some malignant tumors
appendix epididymis
the testicular appendage located at the head of the epididymis
appendix testis
the testicular appendage located between the head of the epididymis and the superior pole of the testis
appendix vas
the testicular appendage located between the body and tail of the epididymis
"bell-clapper" deformity
the condition in which the patient lacks the normal posterior fixation of the testis and epididymis to the scrotal wall
benign prostatic hypertrophy
the benign enlargement of the prostate gland
"blue dot" sign
the appearance of a torsed testicular appendage that can be observed as a blue dot just under the skin surface
bulbourethral gland
gland that secretes preejaculate fluid that lubricates the penile urethra prior to ejaculation
chlamydia
a STD that can lead to inflammatory disease in both sexes
Cowper gland
what is another name for the bulbourethral gland?
cremaster muscle
the muscle that raises the testicle
cryptorchidism
the condition of having an undescended testis or testicles
ductus vas deferens
the tube that connects the epididymis to the seminal vesicles
epididymal cyst
a cyst located anywhere along the length of the epididymis
epididymis
a coiled structure that is attached to the testicle and the posterior scrotal wall that is responsible for storing sperm
epididymitis
inflammation of all or part of the epididymis
epididymoorchitis
inflammation of the epididymis and testis
germ cell tumor
a type of neoplasm derived from germ cells of the gonads; may be found outside of the reproductive tract
hematocele
a collection of blood within the scrotum
human chorionic gonadotropin
hormone produced by the trophoblastic cells of the early placenta; may also by used as a tumor marker in nongravid patients and males
hydrocele
a fluid collection within the scrotum; most often found between the 2 laters of the tunica vaginalis
idiopathic
from an unknown origin
inguinal canal
an opening in the lower anterior abdominal wall
inguinal hernia
the protrusion of bowel or abdominal contents into the inguinal canal
Klinefelter syndrome
a condition in which a male has an extra X chromosome; characteristic features include small testicles, infertility, gynecomastia, long legs, and abnormally low intelligence
median raphe
the structure that separates the scrotum into two compartments externally
mediastinum testis
the structure that is formed by the tunica albuginea and contains the rete testis
orchiopexy
the surgery that moves an undescended testis into the scrotum
orchitis
inflammation of the testis or testicles
pampiniform plexus
the group of veins in the scrotum
peripheral zone
the largest zone of the prostate and most common location for prostatic cancer
prostate-specific antigen
a protein produced by the prostate gland
prostatitis
inflammation of the prostate gland
pyocele
a pus collection within the scrotum
rete testis
a network of tubules that carry sperm from the seminiferous tubules to the epididymis
scrotal pearl
an extratesticular calculi
semen
a fluid that contains secretions from the testicles, seminal vesicles, and prostate gland
seminal vesicles
small glands located superior to the prostate gland and posterior to the base of the bladder, which secrete an alkaline-based fluid
seminiferous tubules
the location of spermatogenesis within the testicles
seminoma
the most common malignant neoplasm of the testicles
spermatic cord
the structure that travels through the inguinal canal and contains blood vessels, nerves, lymph nodes, and the cremaster muscle
spermatocele
a common cyst found often in the head of the epididymis that is composed of nonviable sperm, fat, cellular debris, and lymphocytes
spermatogenesis
the creation of sperm
testicular torsion
a condition that results from the arterial blood supply to the testicle being cut off secondary to the twisting of the testicular axis
transitional zone
the prostatic zone that is the most common site for benign prostatic hypertrophy
tunica albuginea
the dense connective tissue that is closely applied to each testicle
tunica albuginea cyst
cysts located within the tunica albuginea surrounding the testis
tunica dartos
the structure that separates the scrotum into two separate compartments internally