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Final pathology exam review
Terms in this set (299)
What are the retroperitoneal borders?
Lateral- transversalis fascia
Posterior- posterior abd wall muscles/spine
Anterior-posterior parietal peritoneum
What structures are within the retroperitoneum?
suprarenal (adrenal) glands
What is the function of lymph nodes?
-Filter the lymph of debris and organisms
-form lymphocytes and antibodies to fight infection
Is this sono appearance a normal or abnormal lymph node?
Hypoechoic solid area w/ hyperechoic hilum, smooth margins, oval shape, internal vascular flow (at hilum), less than 1cm short axis
What pathology is the enlargement of abdominal lymph nodes?
In the abdomen, where are lymph nodes typically located?
mesentery, renal hilum, along the aorta
What sonographic "sign" is seen when enlarged lymph nodes are seen compressing/surrounding the great vessels?
If a lymph node appears enlarged with smooth walls and oval shape should infection or malignancy be suspected?
f a lymph node appears enlarged with irregular margins and round shape should infection or malignancy be suspected?
What is the generalized term for swelling of glands?
What is the generalized term for swelling of lymph nodes?
What is the term for cancer that begins in lymphocytes (lymph nodes)?
What might a retroperitoneal mass disrupt/appear as?
-may deform IVC or bladder
-May obstruct urinary tract/biliary system
-may cause anterior displacement of kidneys, IVC, aorta, and mesenteric vessels
What pathology is a fluid collection containing lymph from an injured lymph vessel (associated w/ organ transplant/lymph node removal)?
What term is used for a collection of pus/infection?
What is another name for retroperitoneal fibrosis?
What pathology is the chronic inflammatory process in which fibrotic tissue surrounds the large blood vessels in the lumbar region?
retroperitoneal fibrosis/ormond's disease
What is the etiology or Ormond's disease?
What factors are associated with retroperitoneal hemorrhage?
trauma, tumor, aneurysm, cyst
How will a new/acute hemorrhage appear?
How will a chronic/old hemorrhage appear?
more echogenic over time, may have internal debris and become ore complex as it resolves
What is the most common location of a retroperitoneal hematoma?
within the psoas muscles
What is the name of a cystic area filled with urine? Often adjacent or within the urinary tract
What is another name for a germ cell tumor?
What pathology is a neoplasm composed of different types of tissues that do not typically occur together or even at the site of the tumor?
What is the most common primary retroperitoneal tumor?
What group of tumors develop within connective tissues of the retroperitoneum?
What are the 4 mesenchymal tumors?
What is the third most common malignant tumor in soft tissue?
What pathology presents as a sarcoma containing fibrous connective tissue?
What neoplasm presents as a sarcoma containing large spindle cells of smooth muscle?
What neoplasm is a highly malignant tumor derived from striated muscle?
What age group is rhabdomyosarcoma most common in?
children younger than 10
The most common primary malignancies that spread to the retroperitoneum are from_________?
-previously resected urologic/gynecologic tumor
What sono findings are associated with retroperitoneal metastatic spread?
ascites, possible lymph node extension, retroperitoneal tumor
What other organ should be checked for metastases when metastatic spread is found in the retroperitoneum?
Are adrenal glands intra- or retroperitoneal?
What structure controls hormone release form the adrenal glands?
What hormone does the anterior pituitary secrete to control the adrenals?
adrenocorticotropic hormone (ACTH)
What fascia encloses the adrenal glands?
What two parts are each adrenal glad composed of? Which is the inner and which is the outer?
cortex (outer) and medulla (inner)
What are the 3 zones of the adrenal cortex?
zona glomerulosa, zona fasciculata, zona reticularis
What % of space does the adrenal medulla and cortex each occupy?
-medulla: inner 10%
-cortex: outer 90%
What does the adrenal cortex secrete?
What does the adrenal medulla secrete?
epinephrine and norepinephrine
What is aldosterone responsible for?
regulating blood pressure
controlling the amount of sodium and water in the body
What function does cortisol have?
controls the body's use of fat, carbs, and protein
What is another name for the adrenal glands?
What arteries supply the adrenal glands?
-suprarenal branch of inferior phrenic
-suprarenal branch of aorta
-suprarenal branch of renal arteries
What vein is the drainage of the adrenals?
Where do the left and right suprarenal veins drain?
right- directly into IVC
left- into the left renal vein
What adrenal pathology is the hypofunction of the adrenal cortex?
What hormone is insufficiently secreted in Addison disease?
What are some symptoms of Addison disease?
hypotension, weakness/fatigue, loss of appetite, weight loss, hyperpigmentation
What pathology is the excessive secretion of cortisol by the adrenal cortex?
What pathology presents with truncal obesity, thin arms/legs, hypertension, hirsutism, hyperglycemia, and severe fatigue?
What pathology is the result of excessive secretion of aldosterone by the adrenal cortex?
What adrenal pathology ahs the symptoms of excessive thirst, excessive urination, high sodium, and high potassium?
What is the most common primary adrenal tumor?
What does "non-functional" neoplasm mean?
does not change hormone secretion
What does "functional" neoplasm mean?
affects secretion of hormones
What adrenal pathology presents with uncontrollable HTN, headaches, tachycardia, tremors, anxiety, and excessive sweating?
What part of the adrenal gland does pheochromocytomas arise?
What is the name of accessory adrenal tissue found in the testis, epididymis, ovaries, and inguinal canal?
Where does metastasis to the adrenal glands originate?
lungs, breast, colon, kidney, melanoma
What is the most common: adrenal malignancy in childhood and cancer in infants
What structure is the third most common for metastatic spread?
What is the second most common primary retroperitoneal tumor?
What is the most common cause of conn's syndrome?
What pathology is the bilateral hemorrhage of the adrenal glands?
Where does the aorta originate?
Is the aorta intra or retroperitoneal?
Where does the thoracic aorta become the abdominal aorta?
as it passes through the aortic hiatus of the diaphragm
What are the three layers of the aorta wall?
What layer of the aorta is responsible for vasoconstriction?
What is the function of the aorta?
supply blood to the abdominal organs, pelvis, and lower extremities
What is the first anterior branch off the aorta?
What three arteries branch off the celiac axis?
common hepatic artery
left gastric artery
What does the common hepatic artery branch into?
GDA and proper hepatic artery
What is the second anterior branch of the aorta?
What does the SMA supply blood to?
small intestines, colon, pancreas
What is the third main visceral branches of the aorta?
What aorta branches arise from the aorta just below the renal arteries?
What does the IMA supply blood to?
transverse colon, descending colon, rectum
Where does the aorta bifurcate?
At the level of the umbilicus
What factors may inhibit visualization of the aorta?
As it travels through the body, the aorta will be located more _________?
What measurement should the aorta not exceed?
2.5cm in diameter
When are the common iliac arteries considered enlarged?
When they exceed 2cm diameter
What is the focal or diffuse dilation of a vessel referred to as?
How does an aneurysm occur?
the weakening in a vessel wall
An aneurysm that involves all three layers of the vessel wall is a __________ aneurysm
When the diameter of the aorta exceeds ____________ and AAA is present
What is the most common shape of AAA?
What is the most common cause of AAA?
What % of AAA are infrarenal?
When is surgery considered for AAA?
When it is >5cm
Aneurysms caused by infection are termed ____________ aneurysms
What pathology is a defect in the intimal wall of the aorta, causing it to separate from the other layers?
What pathology is a contained rupture of a blood vessel that is most likely to secondary to the disruption of one or more layers of the vessel?
What pathology is the diffuse dilation of the aorta?
What are the two main treatment options for pseudoaneurysms?
Where does the IVC originate?
the convergence of the 2 common iliac veins
Where does the IVC terminate?
What are the 4 sections of the IVC?
hepatic, prerenal, renal, postrenal
What is the primary function of the IVC?
return deoxygenated blood to the heart from the lower extremities, pelvis, and abdominal organs
What is the most superior branch(s) of the IVC?
What pathology is described as the occlusion of the hepatic veins and possible the IVC?
What is the second branch(s) of the IVC below the hepatics?
What vessel runs anterior to the aorta and posterior to the SMA?
left renal vein
What vessel courses posterior to the IVC?
right renal artery
Where do the right and left gonadal vein drain?
right- directly into the IVC
left- into the left renal vein
What should the diameter of the IVC never exceed?
Deep inspiration will cause the IVC to ___________ and expiration will cause the IVC to __________
_____________________ is used to trap emboli that could be traveling up though the IVC
What vessels create the portal vein?
SMV, splenic vein, IMV
What pathology is the abnormal connection between arteries and veins?
arteriovenous fistula (malformation)
What are the possible causes of AV fistula?
congenital, surgery, malignancy, trauma, biopsy
What is the name for normal flow in the portal vein
What is the name for abnormal flow in the portal vein
How does the PV branch in the liver
right and left
right into ant and post
left into medial and lat
___________ peritoneum surrounds the abdominal wall
______________ peritoneum surrounds the organs
What is another name for the lesser sac?
How is the greater sac connected to the lesser sac?
foramen of Winslow
What is the location of the lesser sac?
anterior to pancreas
posterior to stomach
between diaphragm and trv colon
What is another name for Morrison's pouch?
What structure prevents the hepatorenal recess from communicating with the subphrenic space?
What potential space allows fluid to move between the pelvis and abdomen?
Which paracolic gutter is deep and which is shallow?
What structure divides the right and left subphrenic space?
What space is posterior to the bladder and anterior to the rectum?
What space is posterior to the uterus and anterior to the rectum?
What space is anterior to the uterus and posterior to the bladder?
What space is anterior to the bladder and posterior to the symphysis pubis?
What is another name for the retropubic space?
space of Retzuis
What term is the drainage of abdominal fluid?
What term is the drainage of thoracic fluid?
What are the two main clinical findings form an abscess?
What is the most common sono appearance of an abscess?
What pathology is inflammation of the peritoneum?
What type of abscess is typically and extrahepatic lobulated collection of bile?
What is the term for an abscess that forms within the renal parenchyma?
Where would a perinephric abscess be?
around the kidney
What is the term for the double fold of peritoneal tissue that suspends the small intestine and large intestine from the posterior abd wall?
What is the double fold of peritoneum that spreads inferiorly like an apron?
What is the double layer of peritoneum that extends from the liver to the lesser curvature of the stomach?
What amount of omental masses are malignant?
Where are malignant solid masses usually found in the peritoneum?
near the root of the mesentery
Where are benign solid tumors usually found in the peritoneum?
in the periphery near the bowel
What is the name of the remnant channel between the bladder and umbilicus where urine initially drains?
When does the urachus usually seal off?
12 weeks gestation
What are the most common sites for peritoneal metastases?
ovaries, stomach, colon
What pathology exhibits a uniformly thick, hypoechoic, band-shaped structure that follows the convexity of the anterior and lateral abd wall, creating an omental band?
lymphoma of mesentary/omentun
What pathology occurs most often in middle ages men as a result of exposure to asbestos?
What is the term for the accumulation of serous fluid in the peritoneal cavity?
What pathology is a rupture in the muscle or under the sheath?
rectus sheath hematoma
What is the most common areas of weakness for an abdominal hernia?
Is a hernia lateral the epigastric vessels direct or indirect?
Is a hernia medial to the epigastric vessels direct or indirect?
What capsule covers the liver?
What are the borders of the caudate lobe?
What % of blood does the main portal vein supply to the liver? and how much does the hepatic artery supply?
Are the portal veins intra or intersegmental?
Are the hepatic veins intra or intersegmental?
Enlargement of the hepatic veins and IVC is seen with_________?
right sided heart failure
What 3 vessels make up the portal triad?
MPV, CBD, HA
What is the name of the tongue like extension of the right lobe of the liver?
What is the normal measurement of the liver?
What size is hepatomegaly suspected?
What is another name for fatty liver disease?
What type of fatty infiltration is categorized by areas of normal liver within a fatty liver?
focal fatty sparing
What type of fatty infiltration is categorized by regions of fatty deposits in an otherwise normal liver?
focal fatty infiltration
What pathology may be triggered by Epstein-Barr virus?
How is Hep A spread?
How is Hep B spread?
blood and body fluids
Does chronic or acute hepatitis appear with the starry night sign?
When is hepatitis considered chronic?
When it extends beyond 6 months
What is the most common cause of cirrhosis?
What is the term for the elevation of blood pressure in the portal system?
What is the most common cause of portal HTN?
What does TIPS stand for?
transjugular intrahepatic portosystemic shunt
What does a TIPS procedure do?
the placement of a shunt between the PV (right) and hepatic vein (right) to shunt blood and reduce portal systemic pressure
What is the term for a clot in the PV?
portal vein thrombosis
What pathology is an infectious cystic disease common in sheep herding communities?
What is another name for echinococcal cyst?
What cystic liver disease presents with a cyst within a cyst?
What hepatic pathology is caused by parasites in the liver?
What hepatic pathology is the result of a fungal infection?
What hepatic pathology is the result of bacteria?
What patients are most likely to get hepatic candidiasis?
What is the most common benign liver tumor?
What is the second most common benign liver tumor?
focal nodular hyperplasia (FNH)
What liver neoplasm is known as the "stealth lesion" and appears with a central scar?
focal nodular hyperplasia
What benign liver neoplasm is associated with the use of oral contraceptives?
What is the most common primary liver cancer?
Hepatocellular carcinoma (HCC)
What is the name of the mass associated with HCC?
What elevated lab value is an indicator for HCC?
What is the most common organ for metastatic disease to manifest?
What is the most common organism causing infection in patient with AIDS?
What are the most common primary site of metastasis to the liver?
lung, breast, colon
What is the most common benign childhood liver tumor?
What is the most common malignant pediatric liver tumor?
Where is the GB located?
posterior to the rt lobe of the liver in the GB fossa
What is the main function of the GB?
store and concentrate bile
What are the three layers of the GB?
What are the three sections of the GB?
neck, body, fundus
What is the most dependent part of the GB?
What artery is the arterial supply to the GB?
What hormone stimulates the GB to contract?
What is the most common variant of the GB?
What GB pathology results from the twisting off of blood supply?
GB torsion/GB volvulus
What is the normal size of the GB?
What is the normal GB wall thickness?
What are the classical clinical symptoms of GB pathology?
intolerance to fatty foods
positive Murphy sign
What is the most common disease of the GB?
What are the 5 Fs of cholelithiasis?
female, fat, forty, fair, fertile
What sonographic sign is seen with cholelithiasis?
WES (wall echo shadow)
What is GB sludge most often associated with?
What is another name for a sludge ball?
What is the term for the GB filling with sludge and becoming isoechoic to the liver?
hepatization of the GB
What pathology is associated with a strawberry GB?
What pathology occurs when the GB walls contain rokitansky-aschoff sinuses that contain cholesterol crystals?
What is the most common cause of acute cholecystitis?
gallstone stuck in the cystic duct or GB neck
What pathology is caused by gas forming infection invading the GB wall, lumen, or both?
When is the GB hydropic?
when it measures >5cm
What is the term for an enlarged GB caused by a pancreatic head mass?
What pathology results from the calcification of the Gb wall?
What is the most common cancer of the biliary tract?
What is the most common metastatic disease to the GB?
What is the function of the biliary tree?
provide a conduit for bile to drain from the liver into the small intestine
What structure in the cystic duct prevents collapse and distension?
spiral valves of heister
What is the normal diameter of the CBD?
What is the most common level of obstruction in the biliary tree?
What is the most common causes of CBD obstruction?
choledocholithiasis, chronic pancreatitis, acute pancreatitis, pancreatic carcinoma
What is a common clinical sign of biliary obstruction?
What is the most common cause of obstructive jaundice?
gallstones in the CBD
What pathology is due to a large stone impacted in the cystic duct causing extrinsic compression of the CHD?
What is the term for inflammation of the biliary ducts?
At what size should bile duct walls be suspected for cholangitis?
What is the term for air in the biliary tree?
What is the most common manifestation of cholangiocarcinoma?
What is the term used for primary biliary tree cancer?
Where are Klatskin tumors located?
the junction of the right and left hepatic ducts
What pathology is a congenital condition described as narrowing/obliteration of the biliary tree?
What pathology is a congenital disorder characterized by segmental dilation of intrahepatic ducts?
What is the term for a cystic dilation of the biliary tree?
Is the pancreas intra or retroperitoneal?
What cells carry out the exocrine functions of the pancreas?
What is the name of the main pancreatic duct?
duct of Wirsung
What do the following enzymes act on?
What cells carry out the endocrine function of the pancreas?
islets of langerhans
What is the name of the accessory pancreatic duct?
Duct of Santorini
What hormones do the following produce?
What action do the following have?
glucose - glycogen
glycogen - glucose
blood sugar regulation
blood sugar regulation
What are the 2 main challenges when scanning the GB?
gas and body habitus
What should the measurement of the main pancreatic duct not exceed?
What are the anterior and posterior vessels in the pancreatic head?
What are the normal pancreas measurements?
What is the most common congenital variant of the pancreas?
What congenital anomaly occurs when there is an abnormal fusion of the pancreatic ducts, resulting in the duct of wirsung only draining the head?
What congenital anomaly occurs when the ventral part of the pancreas encases the duodenum
What enzyme stays elevated longer in cases of acute pancreatitis and which is elevated first?
What is the term for inflammation of the pancreas secondary to leakage of pancreatic enzymes from the acinar cells into the parenchyma?
What is one of the most common locations for a pancreatic pseudocyst?
What pathology is caused by multiple bouts of acute pancreatitis?
What is the most common primary pancreatic malignancy?
Pancreatic cancer is the ____________ most common cause of cancer-related death
what is the most common location in the pancreas for adenocarcinoma?
What is removed in a Whipple procedure?
pancreatic head, GB, some bile ducts, proximal duodenum
Is a serous cystadenoma macro or microcystic?
Is an mucinous cystadenoma macro or microcystic?
What is another name for mucinous cystadenoma?
What are the two functional tumors of the pancreas?
insulinoma and gastrinoma
Which is more common, insulinoma or gastrinoma?
What syndrome do functional gastrinomas produce that causes excessive secretion of acid by the stomach leading to peptic ulcers?
Zollinger Ellison syndrome
Is the spleen intra or retroperitoneal?
What is the main function of the spleen?
filter peripheral blood
What does the spleen produce in a fetus and what does it produce in adults?
adults- lymphocytes and monocytes
Where does pitting and culling occur?
What is the term for the removal of nuclei from old RBCs without damaging the cell?
What is the term for the removal of abnormal RBCs?
What vessels are the arterial supply and venous drainage of the spleen?
splenic artery and splenic vein
Does the spleen increase or decrease in size with age?
What is polysplenia associated with?
bilateral left sidedness
What is asplenia associated with?
bilateral right sidedness
What is the most common abnormality of the spleen?
What is the most common cause of splenomegaly?
What is the most common cause of massive splenomegaly?
what splenic pathology will appear as a hypoechoic wedge shaped mass in the periphery of the spleen?
What is the most common benign spleen tumor?
What pathology appears as small foci within the spleen?
granulomatous disease (granulomas)
What are the two most common causes of granulomas?
histoplasmosis and tuberculosis
What benign spleen neoplasm is associated with Beckwith-Weidmann syndrome and tuberculosis?
What is the most common malignancy of the spleen?
Which lymphoma has Reed-Sternberg cells?
What splenic pathology is a benign congenital malformation of the lymphatic system?
splenic (cystic) lymphangioma
What inherited blood disorder has crescent shaped RBCs?
sickle cell anemia
What is the term for the wasting away of spleen tissue as a result of multiple sickle cell crises?
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