Abd ALL levels! Flashcards
1
Q
portal system brings blood to _____ from ______
A
liver; GI
2
Q
portal system supplies
A
70-80% of blood to liver
3
Q
hepatic artery supplies
A
20-30 % of blood
4
Q
MPV formed by
A
SMV and SV
5
Q
MPV is post to ______ of pancreas
A
neck
6
Q
SMV is on the ______ side of the SMA
A
right
7
Q
portal confluence
A
junction of SMV and PV, origin of MPV
8
Q
SV lies ______ to SA
A
inferior
9
Q
SV, SA lie…
A
post surface of pancreas body and tail
10
Q
IMV joins…
A
SV, post to panc body
11
Q
iliac veins lie ______ to iliac arteries
A
POSTERIOR
12
Q
left portal vein branches
A
medial, lateral
13
Q
right portal vein branches
A
anterior, posterior
14
Q
MPV is _____ to ___ and ___ at porta hepatis
A
posterior, hepatic artery proper, CBD, CHD
15
Q
MPV is __ to IVC
A
anterior
16
Q
MPV is ___ to duodenum
A
posterior
17
Q
Portal veins run, Hepatic veins
A
intrasegmental, intersegmental
18
Q
Hepatocyte function
A
bile production
19
Q
fixed portion of GB
A
neck
20
Q
MLF runs from
A
GB neck to RPV superiorly
21
Q
Mobile portion of GB
A
fundus
22
Q
3 normal variants of GB
A
Phrygian cap, Junctional fold, Hartmann pouch
23
Q
Phrygian cap
A
fold in GB fundus
24
Q
Junctional fold
A
fold at junction of neck and body
25
Hartmann's pouch
posterior pouch near GB neck
26
Intrahepatic ductules follow
portal veins
27
R + L hepatic ducts join to form
CHD
28
CHD
anterior to MPV
29
CHD terminates at
junction of CD
30
Cystic duct
drains GB
31
spiral valves of Heister
mucosal folds providing structural support to CD
32
CBD formed by
junction of CHD and CD
33
portal triad
MPV, HA, CBD
34
CBD enters panc head
posteriorly
35
Ampulla of Vater
junction of pancreatic duct and CBD
| opening into duodenum
36
Sphincter of Oddi
controls flow of bile into duodenum
37
pancreas has no..
capsule
38
panc is predominantly _____peritoneal except for
retroperitoneal, except for portion of tail
39
what % of panc is exo/endocrine
99% exocrine - digestion
| 1% endocrine- insulin, glucagon
40
panc exo secretions?
lipase, amylase
41
panc endo secretions?
insulin, glucagon
42
panc endo cells?
Islet of Lagerhans
43
panc exo cells?
acini cells
44
panc head is surrounded by
duodenum
45
what is post to panc head?
IVC
46
GDA in panc head
anterolateral
47
CBD in panc head
posterolateral
48
uncinate process
posteromedial extension of panc head
| curls around SMV
49
what is post to panc neck?
SMV
50
what is post to panc body?
aorta, SMA, LRV, spine, SV, LRA
51
most superior portion of the panc?
tail
52
SA vs SV
```
SA = superior surface of tail
SV = posterior (inf?)
```
53
main pancreatic duct
Duct of Wirsung
54
Duct of Wirsung diameter?
2 mm
55
Accessory panceatic duct
Duct of Santorini
56
kidney length
9-12 cm
57
kidney spine level
T12 - L4
58
kidneys lie in the _____ space
retroperitoneal
59
kidney UP lies ____ and _____ to LP
posterior, medial
60
kidney parenchyma is made up of
cortex and medulla
61
renal cortex contains
nephrons, columns of Bertin
62
renal medulla is made up of
renal pyramids
63
kidney parenchyma outer to inner
cortex, medulla, sinus
64
renal sinus is in the ___ aspect
medial
65
renal sinus contains
calyces - major + minor, renal pelvis, vessels, fat,
66
renal pelvis contains
ureter, vessels
67
ureter lies ____ to vessels (TRV)
posterior
68
renal vein is ______ to renal artery
anterior
69
Gerota's fascia
capsule covering kidney and adrenal gland, outermost
70
Renal normal variants
Dromedary hump, Hypertrophied Column of Bertin, Parenchymal junctional defect, horseshoe kidney, ectopic kidney
71
Dromedary hump
lateral aspect, cortex, more common on LK
72
ureters travel through the...
retroperitoneum
73
ureters enter bladder at ___ aspect, called ___
posterior, trigone
74
ureters lie ___ to iliac artery
anterior
75
UPJ
renal pelvis and ureter, proximal
| ureteropelvic junction
76
UVJ
junction between lower ureters and bladder
77
three narrowings of ureters
UPJ, UVJ, crossing over iliacs
78
which is more superior - UPJ, or UVJ
UPJ - at renal hilum
| UVJ - at bladder entrance
79
4 layers of bladder wall
mucosa, submucosa, muscularis, serosa
80
trigone
base of bladder
81
bladder outlet
urethra
82
adrenal glands are in which space?
retroperitoneum
83
spleen lies in which space?
intraperitoneal
84
most common splenic variant
spenule
85
GI lining layers
mucosa, submucosa, muscularis, serosa
86
esophagus postion relative to ao?
anterior, left
87
GE junction SAG
ant to aorta
post to LLL
inf to diaphragm
88
4 parts of duodenum
superior/bulb, descending, transverse, ascending
89
which part of duodenum is intraperitoneal?
superior/bulb/ first
90
marking of large intestine?
haustra
91
Segments of large bowel?
cecum (appendix), colon, sigmoid, rectum, anus
92
appendix is attached to?
cecum
93
4 sections of colon
ascending, trv, descending, sigmoid
94
which parts of colon are retroperitoneal
ascending, descending
95
peritoneum
serous membrane
96
parietal peritoneum
outer
97
visceral peritoneum
inner
98
peritoneal organs
liver, GB, spleen, stomach, ovaries, duodenum part 1, transverse colon
99
peritoneal folds
mesenteries, omentum
100
mesenteries
connect small + large bowel to posterior abd wall
101
lesser omentum
stomach to liver
102
lesser sac
omental bursa, contained within greater omentum
103
sigmoid mesocolon
sigmoid colon to post abd wall
104
greater space
ant to greater omentum (within parietal peritoneum)
105
mesentery
loops of small bowel to post abd wall
106
falciform ligament
liver (sup surface) to diaphragm
107
mesenteries
mesentery and mesocolon
108
mesocolon
trv, sigmoid colon to post abd wall
109
greater omentum
apron-like fold,
| greater curvature of stomach to trv colon
110
lesser omentum
gastrohepatic ligament
| lesser curvature of stomach + 1st part of duodenum tp liver
111
greater sac
surrounds small bowel
| surrounds lesser sac
112
lesser sac
omental bursa
113
opening between sacs
neck, epiploic foramen, foramen of Winslow, omental foramen
114
supracolic compartment
above transverse colon
| subphrenic, subhepatic spaces
115
infracolic compartment
below transverse colon
| paracolic gutters, pelvic reflections
116
subphrenic
falciform ligament (liver to diaphragm) - divides left and right
117
subhepatic
Morison's pouch
118
perirenal space
contains perirenal fat, surrounds kidney + adrenal
119
hepatic veins drain into IVC ___ to CT?
superior
120
contained in left intersegmental fissure
LHV, LPV, lig teres
121
caudate lobe relation in space?
ant to IVC, post to ligamentum venosum (is its ant border)
122
HA supplies ___ of blood to liver
20-30%
123
portal venous system supplies ___ of blood to liver
70-80%
124
IMV drains into
SV
125
MPV formed by
SMV, SV
126
CBD formed by
CHD, CD
127
CBD lies ___ to MPV
ANT
128
IVC lies ___ to head of panc
post
129
neck of panc is ant to ___?
SMV (SAG- long axis of SMV, TRV- short axis confluence)
130
body of panc ant to___?
SV, AO, SMA, SPINE, LRV
131
ampulla of Vater opens into
descending, 2nd part of duodenum
132
_____ controls flow of bile
Sphincter of Oddi
133
accessory panc duct
duct of Santorini
134
RRV is ___ to RRA
anterior
135
adrenals sit ___ , ____ to kidney
medial, superior
136
appendix courses _____ , ______ from cecum
inferior, medially
137
TRV colon is _____peritoneal
INTRA
138
which retroperitoneal space communicates across ML
anterior pararenal space
139
pelvic diaphragm muscles
levator ani, coccygeus
140
dartos tunica
divides scrotum into 2 sacs
141
cremaster muscle
raises and lowers testes from body
142
tunica vaginalis
outermost covering of testicle
143
tunica albuginea
capsule adhering to testes, divides into lobules
144
rete testis is a part of the
mediastinum
145
epididymis head aka
globus major
146
epididymis tail aka
globus minor
147
largest zone of prostate
peripheral
148
most common site of prostate cancers
peripheral
149
smallest zone of prostate
transitional
150
base of prostate
superior
151
apex of prostate
inferior
152
pampiniform plexus
drains testes, into gonadal vein
153
ejaculatory duct goes through which zone
central
154
seminal vessicles sit ___ to prostate
superior
155
adductor canal
hunter's canal (knee)
156
longest vein in the body
GSV
157
aortic arch branches
1. innominate/brachiocephalic
2. LCCA
3. left subclavian
158
3 membranes of meninges
dura mater, arachnoid, pia mater
159
dural sinuses purpose
circulate CSF, venous blood system
160
3 dural folds
falx cerebri, falx cerebelli, tentorium cerebelli
161
space containing CSF
subarachnoid space
162
structure separating lateral ventricles
septum pellucidum
163
foramen of Munro
connects lateral and 3rd ventricles
164
connects 3rd and 4th ventricles
cerebral aqueduct
165
connects 4th ventricle to spinal canal
foramen of Magendie
166
produces CSF
choroid plexus
167
cistern
widened subarachnoid space
168
outer edge of cerebrum is ___ matter, inner is ___
grey, white
169
bridges cerebral hemispheres
corpus callosum
170
longitudonal fissure
falx cerebri
171
sylvian fissure
lateral fissure
172
anchors spinal cord to coccyx
filum terminale
173
2 enlargements of spinal cord
nerve attachments- arms, legs
174
strands of nerve roots at en of spinal canal
cauda equina
175
narrowed tip of spinal cord
conus medullaris
176
lowest point of conus medullaris
L2
177
3 portions of brainstem
midbrain, pons, medulla
178
corpus callosum is ____ matter
white
179
gyri
folds
180
sulci
grooves
181
white matter
myelinated
182
grey matter
unmyelinated
183
thalamus
grey matter
184
surrounds cerebral aqueduct
midbrain
185
ant wall of 4th ventricle
pons
186
posterior wall of 4th ventricle
cerebellum
187
lateral openings of 4th ventricle
foramen of Luschka
188
cauda equina
nerve bundle inf to conus medularis
189
SCM lie ___ to thyroid
lateral + anterior
190
throat
pharynx
191
voice box
larynx
192
esophagus lies ___ to trachea
post
193
RCCA is branch of
innominate/ brachiocephalic
194
1st branch of subclavian a.
vertebral a's
195
carotid sheath contains
CCA, IJV, vagus nerve
196
right lung has __ lobes, left has ___
3, 2
197
carina
point of bifurcation of trachea
198
mediastinum contains
heart, pericardial sac, great vessels, trachea, esophagus, thymus, nerves, lymphatics
199
azygous vein
right side, collateral
200
hemiazygous vein
left side
201
aortic hiatus level
T12
202
spermatic cord contains
vas deferens, testicular artery, pampiniform plexus (veins)
203
splenic flexure
descending colon
204
hepatic flexure
ascending colon
205
axillary vein is formed by
basilic and brachial veins
206
renal pyramids drain directly into
minor calyces
207
pyramids per kidney
8-18
208
trachea bifurcates at
T5
209
pons connects
cerebrum to cerebellum
210
CIA are ___ to CIV
anterior
211
LRV runs...
post to SMA, and to Ao
212
RRA runs...
post to IVC
213
CIA origin level
L4
214
renal arteries lie ___ to renal veins
posterior
215
common hepatic a. branches into
GDA, HA proper
216
left gonadal vein empties into
left renal vein
217
panc body lies ant to
aorta
218
part of stomach directly ant to body of panc
pyloric antrum
219
connected to 4th part of duodenum
jejunum
220
folds within stomach
rugae
221
desc duodenum is ___ to panc head
lateral
222
CBD empties into ____ part of duodenum
2nd, descending
223
chyme
product of food breakdown in stomach
224
peritoneum connects medial stomach to liver
lesser omentum
225
lesser sac
omental bursa
226
epiploic foramen
foramen of winslow
227
3 retroperitoneal spaces
anterior and posterior pararenal spaces, perirenal space
228
liver bare area boundaries
coronary and triangular ligaments
229
liver capsule
Glisson's capsule
230
MPV lies ___ to IVC
anterior
231
LPV branches
lateral, medial
232
RPV branches
ant, post
233
___ dumps into SV
IMV
234
this divides left and right subphrenic space
falciform ligament
235
area of liver NOT in contact with diaphragm
inferior
236
quadrate lobe
left medial lobe
237
accessory spleen
splenule
238
muscle directly post to kidney
quadratus lumborum
239
ureters travel ___ to psoas
anterior
240
kidneys lie at what vertebral level
T12 - L4
241
psoas is medial to ____ and lateral to ____
kidney; spine
242
trigone is located at the
base
243
renal fascia
Gerota's fascia
244
____ lies directly ant to LK
panc tail
245
SV is post to ____ of panc
body
246
SA is ___ to SV
superior
247
MLF connects ...?
GB neck to RPV (in SAG)
248
outpouching at neck of GB
Hartmann's pouch
249
CBD lies ____ to MPV
anterior
250
CBD joins panc duct at
ampulla of Vater
251
directly post to head of panc?
IVC
252
panc is post to
antrum of stomach
253
posteromedial appendage of panc head
uncinate process
254
SMA is ___ to panc ____
post ; body
255
lesser sac is __ to panc
anterior
256
CBD is ____ to HA
lateral
257
SA runs along ____ aspect of panc body/tail
SA
258
dilated ectatic renal collecting tubules
medullary sponge kidney
259
adult polycystic disease is associated with
Berry aneurysms, renal failure. Usually normal LFT's
260
which organ is most likely to have a simple cyst
kidneys (50% of over 50 yrs)
261
associated with unilateral renal agenesis?
prostatic utricle cyst
262
renal cystic disease of lymphatic origin?
parapelvic cyst
263
parapelvic cyst
tubular atrophy, cysts at CM junction
264
causes an increase in serum creatinine levels
ADPKD
265
primary liver neoplasm linked to arsenic exposure
hemagiosarcoma
266
mucinous cystadenocarcinoma
cystic -1% - pancreatic
267
can mimic panc head adenocarcinoma
focal pancreatitis
268
hyperechoic well-defined cortical renal mass
AML
269
renal neoplasm occuring in renal collecting system
TCC
270
TCC
renal pelvis, ureters, bladder
271
common site of mets from lung CA
adrenal
272
renal parenchyma tumour
RCC
273
asymmetrical bladder wall thickening, right hydro, dilated right ureter -??
TCC
274
primary malignancy of adrenal medulla
pheochromocytoma
275
primary malignancy of adrenal cortex
adenocarcinoma
276
most common CA of GI tract?
adenocarcinoma
277
most common benign tumour of liver
hemangioma
278
most common primary that metastasizes to spleen
malignant melanoma
279
how to know GB polyp is benign?
< 10 mm
280
which prostate zone most common adenocarcinoma
peripheral
281
benign nodal (LN) presentation
echogenic hilum, bean shaped
282
malignant nodal (LN) presentation
taller than wide, loss of hilum
283
disease associated with AAA
Atherosclerosis
284
most critical AAA complication
rupture
285
most common IVC pathology
thrombosis
286
cavernous transformation of portal veins
portal hypertension
287
occlusion of hepatic veins
Budd-Chiari
288
indirect sign of TIPS malfunction
recurrence of ascites
289
most common AAA complication
stenosis
290
most common primary tumour of IVC
leiomyosarcoma
291
secondary ca affecting IVC
RCC
292
most sensitive indicator of biliary obstruction
ALP (alk phos)
293
metabolic disorder of the liver
Glycogen storage disease
294
stone impacted in CD, compressing CHD
Mirizzi syndrome
295
Mirizzi syndrome cause
continous bouts of cholecystitis
296
cholecystitis
inflammation of GB
297
stone located in bile ducts
choledocholithiasis
298
icterus
jaundice
299
cause decreased echogenicity in pancreas
acute inflammation
300
cause increased echogenicity in pancreas
obesity, diabetes, CF
301
UPJ
at renal pelvis, ureter leaving kidney
302
UVJ
ureter entering bladder, inf
303
most common cause of acute renal failure
ATN, acute tubular necrosis
304
splenomagaly, tortuous vessels at splenic hilum
portal HTN
305
moderate splenomegaly
AIDS, infection, portal HTN
306
hypersecretion of cortisol due to adrenal hyperplasia
Cushing's syndrome
307
most common cause of increased cortisol secretion
adrenal hyperplasia
308
Cushing's disease
due to pituitary problem
309
increased cortisol secretion can be caused by
adrenal hyperplasia (#1), adrenal adenoma, carcinoma
310
commonly associated with ureterocele
duplicated collecting system
311
congenital adrenal hyperplasia
autosomal recessive
| overproduction of ACTH
312
primary adrenal insufficiency
Addison's disease
313
3 metabolic diseases of adrenal gland
Conn's, Cushing's, Addison's
314
ureterocele
ureter inserts ectopically into bladder wall
315
UPJ obstruction will cause
renal pelviectasis, normal ureter
316
incomplete fusion during fetal dev
junctional parenchymal defect
317
most common cause of urinary obstruction in male infant
posterior urethral valves
318
posterior urethral valves
bladder outlet obstruction, bilateral hydro, distended bladder and posterior urethra
319
palpation of hypertrophic pyloric stenosis
olive
320
CF pancreas
atrophic, echogenic
321
saccular dilatation of CBD
choledochal cyst type 1
322
subcapsular hematoma
crescent shaped hypo area conforming to spleen contour
323
ruptured capsule with splenic trauma
FF in Morison's pouch
324
loculated fluid collection
mass effect, rounded margins BAD
325
most common cause of hemobilia
liver biopsy
326
lab values with unilateral renal trauma
microscopic hematuria
327
Spigellian hernia
lateral abd wall, spontaneous
328
liver abn commonly occuring with AIDS
pneumocystitis carinii
329
cholecystitis with air in GB wall
ephysematous cholecystitis
330
Spleen histoplasmosis findings
scattered echogenic foci throughout parenchyma
331
spleen of AIDS patients
moderate splenomegaly
332
Crohn's disease affects the
terminal ileum and colon
333
Crohn's disease sonographically
thickened bowel wall
334
bowel pathology linked to antibiotic therapy
pseudomembranous colitis
335
most common cause of acute pancreatitis
EtOH abuse
336
cause of acute appendicitis
blocked lumen
337
appearance of acute pyelonephritis
renal enlargement, loss of CM junction, change in echotexture
338
causes of acute pancreatitis
biliary calculi, trauma, choledochal cyst
339
acute pancreatitis sonographic appearance
hypoechoic, enlarged
340
BPH occurs in which zone
transitional
341
causes area of focal inflamed peritoneal fat
diverticulitis
342
diffuse acute pyelonephritis lab values
elevated WBCs (leukocytes)
343
consolidation
inflammation of lung tissue
344
3 bones comprising the hip bone
ischium, ilium, pubis
345
ovaries are ____ to broad ligament
posterior
346
levator ani muscles
ileococcygeus, pubococcygeus
347
round ligament
maintains forward bend (anteversion) of UT
348
most dependent space in pelvis
pouch of Douglas, posterior cul-de-sac
349
pelvic space filled with extraperitoneal fat
space of Retzius
350
longest portion of fallopian tube
ampulla
351
ovum found within the
follicle
352
posterior to broad ligament
adnexae
353
fallopian tube
oviduct
354
fibrous capsule covering the testes
tunica albuginea (inner, creates lobules)
355
layer of peritoneum lining scrotal sac
tunica vaginalis (outer)
356
epididymal head
globus major
357
epididymal tail
globus minor
358
efferent ducts in mediastinum
rete testis
359
epi head located ___ to testes
superior
360
epi body located ___ to testes
posterior
361
superior aspect of prostate
base
362
prostate is ___ to bladder
inferior
363
ejaculatory duct connects
seminal vesicles to vas deferens
364
network draining testicles
pampiniform plexus
365
largest zone of prostate
peripheral
366
lesser sac is ___ to aorta
anterior
367
GDA is __________ in panc head
anterolateral
368
cystic artery
supplies GB, CBD, hepatic ducts
369
which CT branch is largest
splenic artery
370
SA travels ___ to pancreas
posterior and superior
371
SMA is ____ to panc ____
posterior; body
372
RRA is ___ to ___
post; IVC
373
IMA courses
inf, left
374
CIA start at
L4
375
CIA lie ___ and ___ to ___
anterior, lateral, CIV
376
aorta is considered aneurysmal at this size
3.0 cm
377
CIV unite at what level
L5
378
IVC considered dilated at
3.7 cm
379
LRV courses
under SMA, ant to ao
380
left gonadal vein drains
into LRV
381
MPV formed by
union of SV and SMV
382
IMV drains into
SV
383
SV runs
post, inf to panc body and tail
384
confluence is ___ to panc ____
post; neck
385
SMV origin
root of mesentery
386
SMV lies to the ___ of the SMA
right
387
MPV suupplies _____ of 02 to liver cells
50-60 %
388
long axis of RPV viewed in
TRANSVERSE
389
portal vein walls are _______ than hepatic veins
hyperechoic, do not collapse
390
IVC spectral
pulsatile, phasic, bidirectional
391
HV flow
phasic, pulsatile, away from liver - hepatofugal
392
RA flow
low resistance, always forward flow
393
PV flow
phasic, continous, hepatopedal
394
aortic hiatus
T12
395
CHA sits ___ to MPV
anterior
396
1st and 2nd branches off CHA
right gastric artery, GDA
397
SMA sits ____ to uncinate process of pancreas
anterior
398
normal IVC diameter
2.5 -3.7 cm
399
Hep v's run ____; portal v's run ____
intersegmentally; intra
400
on inspiration the IVC will
collapse
401
in TRV, the SV runs ____ to the aorta a SMA
ANTERIOR
402
at renal hilum RRV lies ___ to RRA
anterior
403
IVC lies ____ to liver
posterior
404
CL/RT ratio
< 0.65
405
liver length
= 15.5 cm
406
right and left lobes of liver are separated by
MLF
407
quadrate lobe
medial left lobe
408
caudate lobe blood supply
right and left lobes
409
posterior landmark for caudate lobe
IVC
410
anterior landmark for caudate lobe
ligamentum venosum
411
inferior landmark for caudate lobe
MPV
412
Couinaud's seg 1
caudate lobe
413
Couinaud's seg 2
left lateral sup
414
Couinaud's seg 3
left lateral inf
415
Couinaud's seg 4
left medial (4a, 4b- sup, inf)
416
Couinaud's seg 5
right ant INF
417
Couinaud's seg 6
right post INF
418
Couinaud's seg 7
right post SUP
419
Couinaud's seg 8
right ant SUP
420
COUINAUD'S sup landmark
Hep veins
421
COUINAUD'S inf landmark
portal veins, lig teres (inf left)
422
MHV separates
left and right lobes
423
LHV separates
2 and 4; 2 = left lateral sup, 4 = left medial
424
RHV separates
7, 8 ; 8= right ant sup; 7= right post sup
425
hepatogastric ligament
part of lesser omentum
| runs in fissure for lig venosum
426
GB fossa
POST INF right lobe
427
hepatoduodenal ligament contains
portal triad (MPV, CHA, CBD)
428
hepatoduodenal ligament
fold of lesser omentum
| ant boundary of epiploic foramen
429
falciform ligament
umbilicus to liver
sup liver to diaphragm
fetal umbilical vein
430
ligamentum teres (round ligament)
atrophied umbilical vein
| in left lobe inf
431
defines bare area
coronary ligaments
432
remnant of fetal ductus venosum
ligamentum venosum
433
MHV travels within
MLF
434
functional unit of liver
lobule
435
lobule consists of
hepatocytes, central hep v., sinusoids, Kupffer cells, bile canuliculi, portal triads (portal arteriole, portal vein, bile duct)
436
Kupffer cells are in the
sinusoids
437
hepatocytes
two layered columns, converge to central vein, arranged radially, in contact with sinuoid blood
438
sinusoid
a highly permeable blood capillary
439
sinusoid blood composition
80% portal venous
| 20% hepatic arterial
440
Kupffer cells are a part of, function
reticuloendothelial system (immune), ingest & destroy foreign materials
441
bile pathway
released from hepatocyte, into bile canuliculi, towards larger bile duct at edge of lobule, into r/l hepatic ducts, converge into CHD at porta hepatis, CD inserts, becomes CBD, drains into duodenum (via ampulla of Vater, sphincter of Oddi
442
liver functions
1. bile formation, secretion
2. hemopoeisis, produces plasma proteins, antibodies (eg albumin)
3. gluconeogenesis
4. storage - vit A., D, B12, glycogen, iron, ferritin, amino acids
5. blood reservoir
6. heat production
7. detox - alcohol, drugs
8. lymph formation- 1/3 to 1/2 of body's lymph
443
unconjugated bilirubin
indirect, fat soluble, toxic to tissues
444
conjugated bilirubin
direct, water soluble, safe, non-toxic, excreted by kidneys
445
ALT
SGPT, alanine aminotransferase
| specific indicator for hepatocellular damage
446
increased ALT
hepatitis, cirrhosis, tumours, hepatotoxicity (exposure to toxins), acute hepatitis, non-malignant obstruction
447
AST
SGOT, aspartate aminotransferase
| indicate muscle damage, not liver specific (also heart- MI)
448
increased AST
hepatitis, MI, cirrhosis, metastatic carcinoma of liver
449
ALP
alk phos
| not liver specific (also bone), seeps into blood when liver cells damaged
450
increased ALP
pregnancy, bone disease, biliary obstruction, cancer
451
increased ALP with normal ALT, AST
bile duct disease
452
LDH
hepatitis, cirrhosis, obstructive jaundice, mono
453
GGT
gamma glutamyl transpeptidase
liver disease, EtOH abuse,
non-specific
454
AFP
alpha-feto protein
455
increased AFP
HCC, testicular (germ cell) ca
456
bilirubin
product of hemoglobin breakdown
| pigment in bile
457
increased total bilirubin
hepatocellular disease
458
increased unconjugated bilirubin
hepatocellular disease, hemolytic anemia
459
increased conjugated bilirubin
extrahepatic bile duct obstruction
460
prothrombin time
clotting factor, depends on vit K levels, prolonged in non-functioning or scarred liver
461
normal INR
1
462
abnormal INR
> 1.2
463
PTT
partial prothrombin time, measures clotting time
464
serum protein
ablumin, gamma globulins
465
albumin
produced by liver, maintains osmotic balance, decreased levels in liver dysfunction
466
normal CBD diameter
4 mm
467
post cholecystectomy CBD diameter
up to 10 mm
468
CBD enters ____ part of duodenum
2nd, descending
469
cystic duct contains
spiral valves of Heister - mucosal folds for structural support
470
most dependent portion of GB in LLD
fundus
471
most dependent portion of GB in SUPINE
NECK
472
normal GB wall thickness
3 mm or less
473
GB function
bile reservoir
474
RA sinuses
Rokitanksy-Aschoff, folds on inner border of GB wall
475
bile secretion hormone
CCK, cholecystokinin
476
CCK is released by
duodenum
477
CCK acts by
GB to contract, sphincter of Oddi to relax
478
bile function
breakdown fat, cholesterol, fatty acid absorption
479
cystic artery is a branch off the
HA proper
480
cystic vein drains into
portal vein
481
HIDA scan
nuc med - function of GB
482
ERCP
endoscopic retrograde cholangiopancreatography
| contrast into bile ducts and panc duct
483
smallest division of biliary tree
bile canuliculi
484
CHD formed by
right and left intrahepatic bile ducts
485
CBD formed by
CHD and CD
486
normal CBD diameter
<= 4mm, + 1 mm for every decade after 50
487
narrowest portion of extrahepatic biliary tract
intraduodenal - 4t
488
where are valves of Heister
CD
489
intrahepatic bile duct diameter
< 2mm
490
junctional fold
neck of GB
491
Hartmann's pouch
neck
492
panc lies in which space
retroperitoneal
493
panc lies ___ to lesser sac
posterior
494
panc head landmark
ant to IVC, inf to MPV (SAG)
495
panc neck landmark
ant to SMV, portal confluence, inf to CHA
496
panc body landmark
ant to aorta, SMA, LRV, SV
497
panc tail landmark
SA - sup post border
| SV- post inf border
498
main panc duct
duct of Wirsung
499
accessory panc duct
duct of Santorini
500
80 % of panc tissue
exocrine -acini cells
501
panc enzymes
amylase, lipase, trypsin, chymotrypsin, carboxypeoptidase, protease, NaHCO3
502
panc hormones - exocrine
secretin- NaHCO3
| CCK
503
panc hormones - endocrine
glucagon, insulin, somatostatin
504
alpha cells produce
glucagon
505
beta cells produce
insulin
506
delta cells produce
somatostatin
507
somatostatin function
inhibits both insulin and glucagon production
508
panc blood supply
suprapancreatic artery
509
panc lies posterior to what 3 structures
LLL, lesser sac, stomach
510
panc size _____ with age
decreases
511
panc head lies ____ to MPV
inferior
512
functional unit of liver
lobule
513
_____ unite to form hepatic veins
central veins (in lobule)
514
2 layers of peritoneum
visceral, parietal
515
right subhepatic space
Morison's pouch
516
lesser sac
omental bursa
517
structures posterior to epiploic foramen
pancreas, IVC
518
structures superior to epiploic foramen
caudate lobe
519
structures anterior to epiploic foramen
stomach
520
inframesocolic compartment does not communicate with pelvic cavity
right medial - blocked by root of mesentery
521
which ligament preents left lateral gutter from communicating with left supramesocolic area
left phrenocolic ligament
522
3 spaces in retroperitoneum
anterior pararenal space, perirenal space, posterior pararenal space
523
ant & post bounaries of anterior pararenal space
```
ant = parietal peritoneum,
post = Gerota's fascia (renal)
```
524
major structures in the anterior pararenal space
pancreas, asc + desc colon, duodenum
525
major structures in the perirenal space
kidneys, great vessels, adrenals, ureters
526
major structures in the posterior pararenal space
fat
527
pronephros
4th week, non-functioning
528
mesonephros
late 4th week, becomes mesonephric duct
529
mesonephric duct
Wolffian duct
530
in males, the wolffian duct becomes
epididymis, vas deferens, ejaculatory duct
531
in females the wolffian duct becomes
recedes, becomes Mullerian duct - uterus and vagina
532
metanephros
permanent kidney, end of 5th wk
533
metanephros function begins at
8 wks
534
wolffian duct/Wolffian duct becomes
ureters
535
urinary bladder develops from
urogenital sinus
536
kidneys and ureters reside in which retroperitoneal space
perirenal space
537
UP of kidneys lie___ to LP
medial, posterior
538
ureters lie ___ to iliac vessels
anterior
539
ptosis
kidney falls when fascia tears
540
renal cortex contains
nephrons, column of Bertin
541
functional unit of kidneys
nephron
542
each renal column contains
interlobar artery and vein
543
interlobar vessels run
between columns
544
renal medulla
pyramids
545
renal sinus contains
minor and major calyces, renal pelvis, vessels, nerves
546
from ant -post in renal hilum
renal vein
renal artery
ureter
547
3 narrowings of ureters
UPJ, UVJ, crossing over iliacs
548
bladder neck
urethral orifice, constant shape and position
549
median umbilical ligament attachment
apex of bladder
550
apex of bladder
most sup and ant portion
551
4 layers of bladder wall
mucosa, submucosa, detrusor muscle, serosa
552
normal bladder wall thickness- distended
3 mm
553
normal bladder wall thickness- non-distended
6 mm
554
urethra is longer in
males
555
urethral segments in males
prostatic, membranous, penile
556
muscles posterior to kidneys
psoas (posteromedial), quadratus lumborum
557
female ANT to POST
ovary, ureter, IIA, IIV
558
potential space ant to bladder
space of Retzius
559
RRA is _____ than LRA
longer
560
renal arteries pathway
interlobar - between pyramids
arcuate - at base of pyramids
interlobular - into renal cortex
afferent arterioles -glomerulus of nephron
561
neonatal kidneys
more echogenic than liver, thin cortex, lobulated, large pyramids, little sinus fat
562
renal variants occur
during fetal development
563
dromedary hump occurs more often
on the left kidney
564
hypertrophied column of Bertin should not measure more than
3 cm
565
fetal lobulation occurs in ___ of adults
51%
566
this renal variant occurs more in the RK
junctional parenchymal defect
567
junctional parenchymal defect
wedge shaped hyperchoic defect, anterior superior cortex, incomplete embryological fusion, can be confused with scarring
568
2 types of nephrons
juxtamedullary - deep
| cortical - superficial
569
renal corpuscle
glomerulus, Bowman's capsule
570
renal tubule
PCT, DCT, loop of Henle, collecting duct
571
kidney functions
blood volume, concentration, blood pH
572
kidneys remove toxins through
osmosis and active transport
573
3 processes of urine formation
glomerular filtration, tubular reabsorption, tubular secretion
574
glomerular filtration occurs in
afferent arteriole, bowman's capsule, PCT, efferent arteriole
575
tubular reabsorption occurs in
PCT
576
tubular secretion occurs in
DCT
577
normal blood pH
7.35- 7.45
578
ADH secreted by
posterior pituitary
579
ADH acts on
collecting ducts
580
aldosterone secreted by
adrenal cortex
581
aldosterone acts on
PCT
582
aldosterone affected by
renin-angiotensin system
583
renin secreted by
juxtaglomerular apparatus
584
renin released by
kidneys
585
renin stimulates
angiotensin formation
586
angiotensin stimulates
release of aldosterone
587
renin responds to
decrease in blood pressure
588
serum creatinine
directly related to glomerular filtration rate, more sensitive than BUN
589
increased serum creatinine
renal failure, chronic nephritis, urinary tract obstruction
590
BUN
blood urea nitrogen
591
increased BUN
renal dysfunction, dehydration, increased protein metabolism
592
decreased BUN
severe hepatic damage, malnutrition, over hydration
593
serum electrolytes
Cl, K, Na, HCO3
594
increased serum electrolytes
acute renal failure, glomerulonephritis, renal tubular acidosis
595
decreased serum electrolytes
chronic and acute renal failure
596
urine tests
RBC, WBC, pyuria, proteinuria, pH, specific gravity
597
prostate poduces
PSA- prostate specific antigen
598
largest zone of prostate
peripheral
599
site of most prostatic cancers
peripheral
600
peripheral zone accounts for ___ of prostate tissue
70%
601
BPH does not affect this zone
peripheral zone
602
transition zone accounts for ___ of prostate
5%
603
site of BPH
transition zone
604
this zone accounts for 25 % of prostate
central zone
605
located at base of prostate
central zone
606
zone resistant to diseases
central zone
607
1 % of prostate
periurethral glands
608
periurethral glands
internal prostatic sphincter
609
non glandular area of prostate
fibromuscular stroma
610
ejaculatory duct made up of
SV and vas deferens
611
PSA indicates
BPH, infection, carcinoma
612
normal PSA
< 4 ng/mL
613
renal collecting system is located in
renal sinus
614
of pyramids per kidney
8-18
615
lobar artery
segmental artery
616
renal corpuscle
glomerulus, Bowman's capsule
617
aldosterone secreted by
adrenal cortex
618
blood enters glomerulus via
afferent arteriole
619
blood leaves glomerulus via
efferent arteriole
620
renal tubule comprised of
PCT, DCT, loop of Henle, collecting duct
621
can be mistaken for renal artery
crura of diaphragm
622
first step in urine formation
filtration
623
what substance does not enter Bowman's capsule
RBCs
624
lab tests to measure nitrogenous wastes in urine
BUN, creatinine
625
loop of Henle, renal corpuscle, column of Bertin are all part of
renal parenchyma
626
where does tubular secretion occur
DCT
627
where does reabsorption occur
collecting duct
628
substance produced in kidneys
renin
629
adrenal cortex develops from
mesoderm
630
adrenal medulla develops from
neural crest cells
631
3 zones of adrenal cortex
glomerulosa, fasiculata, reticularis
632
glomerulosa secretes
mineralocorticoids eg)aldosterone
633
fasiculata secretes
glucocortiocoids
634
reticularis secretes
sex hormones, androgens
635
shape of adrenal glands
X, Y, Z
636
outermost adrenal cortex layer
glomerulosa
637
middle adrenal cortex layer
fasiculata
638
innermost adrenal cortex layer
reticularis
639
adrenal cortex makes up
90% of gland
640
hypothalamus secrets ____ that acts on ant pit
ACTHRF
641
ACTHRF acts on
anterior pituitary
642
anterior pituitary secretes
ACTH
643
zona fasiculata secretes
cortisone, hydrocortisone
644
adrenal medulla secretes
(nor)epinephrine
645
catecholamine
sympathetic nervous system, adrenaline
646
spleen is a part of the __system
RE
647
RE system comprised of
brain, blood, spleen, liver, thymus, bone marrow, lymph nodes
648
splenic function
hematopoiesis
649
leukocytosis
increased in # of WBCs
650
leukopenia
decrease in # of WBCs
651
humoral immune response
antibodies- gamma globulins, committed lymphocytes
652
cell mediated response
lymphocyte produces antitoxin, attaches to antigen, both die
653
spleen is _____peritoneal
intra
654
size of spleen
not > 12 cm
655
severe splenomegaly
> 18 cm
656
red pulp
splenic sinuses, venous component, phagocytic cells line sinusoids
657
white pulp
islands of lymphatic tissue = lymphocytes + macrophages, site of immunological activity, production of antibodies
658
sleen function
filter blood, blood reservoir, erythropoiesis
659
accessory spleen
splenule
660
3 types of extracellular fluid
plasma, interstitial, lymph
661
lymphatic system has no
pump
662
2 node areas in retroperitoneum
para-aortic, iliac + hypogastric
663
lymphatic tissues
tonsils, thymus, spleen
664
Peyer's patch
lymph node on intestines
665
right lymphatic duct drains
RUQ
666
left lymphatic duct drains
other 3/4 of body
667
lymph functions
phagocytosis, immunity, tissue drainage, excretion, adsorption, circulation of fat digestion products
668
normal lymph node size
< 1 cm
669
parts of the stomach
cardia, fundus, body, lesser + greater curve, pylorus
670
small boel
duodenum, jejunum, ileum
671
first part of duodenum is _____peritoneal
intra
672
jejunum becomes intraperitoneal at
ligament of Treitz
673
longest portion of small bowel
ileum
674
ileum and jejunum are anchored by
mesentery, to post abd wall
675
hepatic flexure is in the
ascending colon
676
splenic flexure is in the
descending colon
677
intraperitoneal portion of colon
transverse
678
asc + desc colon are _____ peritoneal
retro
679
4 gut layers
mucosa, submucosa, muscularis propria, serosa
680
folds in stomach
rugae
681
circular folds in small bowel
valvulae conniventes
682
large bowel markings
haustra
683
distended gut wall thickness
3 mm
684
non-distended gut wall thickness
5 mm
685
gut signature
bulls eye appearance
686
GI hormones
gastrin (stomach), CCK (duodenum), secretin (duodenum)
687
symmetric thickening
inflammation
688
asymmetric thickening
malignancy
689
abd wall layers
epidermis, subcutaneous layer, muscle
690
factors affecting fat echogenicity
water content
691
rectus adbominis
paired ML ant abd
692
linea alba
fibrous band, aponeuroses, echogenic
693
arcuate ine
umbilicus to symphysis - rectus sheath passes in front of rectus muscle
694
external oblique
outer layer, run inf + medial
695
internal oblique
90 degrees to external, runs sup and lat, deep to external (middle layer)
696
transversus adbominis
deepest layer, horizontal
697
deep inguinal ring
internal -superior end of canal
698
superficial inguinal ring
inferior end,
699
superficial inguinal ring contains
men- spermatic cord; women - round ligament of UT
700
normal diaphragm thickness
= 5 mm
701
a true cyst has
an epithelial wall
702
acquired cyst
NO epithelial wall
703
neoplastic disease defn
abnormal tissue growth - cells proliferate at a faster rate
704
etiologies of neoplastic disease
genetic, infection, lifestyle, env
705
infectious disease defn
due to a microorganism
706
congenital disorder
present at or before birth
707
most common type of aortic aneurysm
fusiforms
708
aneurysm linked to trauma or infection
saccular aneurysm
709
75 -90% of all cystic lesions in pancreas
pseudocyst
710
pseudocyst is most often a complication of
pancreatitis
711
most common malignancy of panc
adenocarcinoma
712
pancreatic adenocarcinoma assoc with
smoking, alcohol, diabetes
713
lab values of pancreatic adenocarcinoma
elevated lipase
714
most common benign liver tumour
hemangioma
715
hemangioma may increase due to
estrogen
716
"stealth lesion" in liver
focal nodular hyperplasia
717
benign adenoma is linked to
oral contraceptives
718
fatty infiltration
steatosis
719
steatosis linked to
alcohol abuse, obesity
720
cirrhosis
fibrosis and nodular changes
721
most common primary malignant tumour in liver
HCC
722
HCC lab values
increased AFP
723
most common malignant tumour in liver
metastatic disease
724
GB adenoma
polyp
725
GB cholesterol polyp
choesterolosis
726
comet tail artifact is associated with GB
adenomyomatosis
727
cholelithiasis
GB stones
728
most common GB disease
cholelithiasis
729
painless jaundice
neoplastic, choledochal cysts
730
painful jaundice
acute obstruction, biliary tree infection
731
choledocholithiasis
stone in biliary tree
732
urolithiasis
stones in urinary sustem
733
nephrolithiasis
stone in renal collecting system
734
nephrocalcinosis
calcs in renal parenchyma
735
RCC is more common in
males, 50-70 yrs
736
acquired cysts are due to
trauma, infection
737
multiple cysts or within one organ indicate
true cysts
738
simple cyst criteria
round/oval, strong back wall, anechoic, posterior enhancement
739
septations within a cyst indicate
malignancy, hemorrhage, infection
740
cyst calcs indicate
malignancy
741
____ increases occurrence of cysts
age
742
multiple cysts indicate
genetic abnormality
743
ADPKD
autosomal dominant polycystic kidney disease
744
most common hereditary renal disorder
ADPKD
745
ADPKD is assoc w
berry aneurysm
746
ALL cases of ARPKD are associated with
hepatic fibrosis
747
sonographic features of ARPKD
enlarged, echogenic kidneys, loss of CM differentiation
748
renal cysts lymphatic in origin
parapelvic cysts
749
dilated collecting tubules
medullary sponge kidney
750
the result of progressive renal tubular atrophy
medullary cystic disease
751
obstruction of ureter in utero results in
multicystic dysplastic kidney MCDK
752
fusiform dilation of CBD
choledochal cyst
753
choledochal cysts are associated with
cholangiocarcinoma
754
most common type of choledochal cyst
type 1, diffuse dilatation of extrahepatic ducts
755
dilation of intrahepatic biliary tree
Caroli's disease
756
Caroli's disease is associated with
ARPKD and medullary sponge disease
757
Caroli's disease results in
stasis, stones, cholangitis, sepsis
758
cholangitis
inflammation of bile duct
759
the pancreas in a patient with CF will look
echogenic, atrophic (small), small cysts
760
adhesion trapped ovarian fluid is a
peritoneal inclusion cyst
761
cyst with double- layered wall
GI duplication cyst
762
GI duplication cyst layers
inner = mucosal (bright); outer = muscular (hypo)
763
prostatic cyst in transitional zone
degenerative prostatic cyst
764
prostatic cysts associated with infertility and hematospermia
congenital prostatic cysts
765
prostatic cyst associated with unilateral renal agenesis
utricle cyst
766
teardrop shaped, thick walled cyst with no spermatozoa
mullerian duct cyst
767
prostatic cyst containing spermatozoa, assoc. w infertility
ED cyst
768
prostatic cyst assoc w ipsilateral renal agenesis
seminal vesicle cyst
769
epidermoid primary congenital cysts occur in
spleen
770
cyst of lymphatic/ mesenteric origin
mesenteric cyst
771
cystic kidney disease most common in children
multicystic dysplastic kidney MCDK
772
sono. app of multicystic dysplastic kidney MCDK
small, malformed, multiple cysts, no normal architecture
773
hyperplastic lesion containing normal liver tissue
focal nodular hyperplasia (FNH)
774
FNH is more common in
women
775
stealth lesion
FNH
776
hot sulphur colloid scan
FNH
777
liver lesion linked to oral contraceptives, type 1 GSD
adenomas
778
von Gierke's disease
GSD
779
cold sulphur colloid scan
adenoma
780
benign neoplasm of spleen
cavernous hemangioma
781
splenic hamartoma is made of
lymphoid tissue
782
rare splenic lymphatic malformation
lymphangioma
783
multi-loculated cystic mass in spleen
cystic lymphangiomyomatosis
784
GB adenoma
polyp, pedunculated
785
accumulation of cholesterol in GB wall
cholesterolosis
786
strawberry GB
cholesterolosis
787
adenomyomatosis is most common in GB
fundus
788
exaggeration of RA sinuses
adenomyomatosis
789
artefact assoc w adenomyomatosis
comet tail
790
pancreatic neoplasm that can be benign or malignant
islet cell tumour
791
85 % of islet cell tumours are
functioning
792
15 % of islet cell tumours are
non-functioning
793
angiomyolipoma
renal hamartoma
794
AMLs are assoc with
tuberous sclerosis
795
AML's are more common in
females
796
renal adenoma size
, 3 cm
797
renal oncocytoma size
> 3 cm
798
adrenal adenoma arise from
adrenal cortex
799
hyperfunctioning adrenal adenomas cause
Cushing's, Conn's disease
800
adrenal neoplasm arising from zona fasiculata
myelolipoma
801
what artefact will adrenal myelolipoma show
propagation speed artefact
802
hyperfunctioning tumour of adrenal medulla
pheochromocytoma
803
which side is more common for pheochromocytoma
right
804
pheochromocytoma is assoc w
tuberous sclerosis, MEN syndrome
805
benign adbd wall tumour
desmoid tumour
806
desmoid tumour arises from
connective tissue
807
sono features of lipoma
soft, compressible, mobile, echogenic
808
connective tissue malignancy
sarcoma
809
epithelial tissue malignancy
adenocarcinoma
810
HCC affects ____ more commonly
males
811
3 forms of HCC
focal solitary, multiple, diffuse infiltration
812
HCC risk factors
cirrhosis, hep b +C, metabolic disorders, toxic metabolites
813
HCC lab values
elevated ALP, ALT, AST, AFP
814
liver malignancy related to arsenic and PVC exposure
hemangiosarcoma
815
malignant vascular liver tumour
epitheloid hemangioendthelioma
816
epitheloid hemangioendthelioma causes
Glisson's capsule to retract
817
most common primary liver malignancy in children
hepatoblastoma
818
hepatoblastoma is assoc w
Beckwith-Wiedemann syndrome
819
hepatoblastoma lab values
increased AFP
820
cancer of lymph tissue
lymphoma
821
Hodgkins lymphoma affect what age group
younger, males
822
cancerous growth of B cells and T cells
non-Hodgkins
823
non-Hodgkins lymphoma affect what age group
older
824
fever, night sweats
non-Hodgkins
825
sono sign of lymphoma
floating aorta, sandwich sign, mantle sign
826
malignant appearance of LN
round/oval, eccentric cortical widening, taller than wide, absetn hilum
827
splenic malignancy with mets to liver
hemangiosarcoma
828
GB carcinoma aka
adenocarcinoma
829
GB carcinoma assoc w
galsstones
830
adenocarcinoma of bile ducts
cholangiocarcinoma
831
3 forms of cholangiocarcinoma
intrahepatic, distal, hilar- Klatskin's
832
most common forms of cholangiocarcinoma
Klatskin's tumour
833
Klatskin's tumour sit of origin
at bifurcation of right and left common heaptic duct
834
sono appearance of Klatskin's tumour
CBD normal, dilated intrahepatic ducts, bulging of duct walls, slid mass at liver hilum
835
most common malignancy of pancreas
adenocarcinoma
836
pancreatic adenocarcinoma assoc w
smoking, alcohol abuse, diabetes
837
adenocarcinoma affects
panc head
838
lab values for adenocarcinoma
elevated lipase
839
clinical signs of adenocarcinoma
painless jaundice, n&v
840
adenocarcinoma indirect signs
dilated pancreatic duct, bile duct dilation, double duct sign, dilated GB (Courvoisier's GB)
841
Courvoisier's GB
an enlarged, often palpable gallbladder in a patient with carcinoma of the head of the pancreas. It is associated with jaundice due to obstruction of the common bile duct.
842
malignancy in panc tail
mucinous cystadenocarcinoma
843
hyperechoic layers of gut
lumen, submucosa, serosa (outermost)
844
hypoechoic layers of gut
mucosa, muscularis
845
sonographic pattern of thickened gut
bulls eye or pseudo kidney
846
benign conditions of gut wall thickening
long segment, symmetric, layers preserved
847
malignant conditions of gut wall thickening
short segment, asymmetric thickening, layers destroyed
848
most common malignant tumour of GI tract
adenocarcinoma
849
increased incidence of GI tract adenocarcinoma with
Crohn's
850
#3 most common cancer for men and women
colon
851
RCC
hypernephroma (adenocarcinoma)
852
most common renal tumour in adults
adenocarcinoma (RCC)
853
triad of RCC
flank pain, gross hematuria, palpable renal mass
854
RCC is assoc w
tuberous sclerosis
855
RCC complications
IVC, RV invasion, para-aortic nodes, contralateral kidney invasion
856
nephroblastoma
Wim's tumour
857
most common malignant renal tumour in children
Wim's tumour/ nephroblastoma
858
Wim's tumour/ nephroblastoma can be confused with
neuroblastoma (primary tumour of adrenal gland)
859
malignancy of epithelial lining of collecting system
TCC
860
TCC occurs more often in
men
861
TCC could be mistaken for
blood clot, fungal balls, slouged papillae
862
2 procedures necessary to diagnose TCC of bladder
cytoscopy, biopsy
863
TCC in ureter may have
hydro above level of mass
864
rare but aggressive bladder ca
squamous cell carcinoma
865
squamous cell carcinoma is assoc w
chronic UTI's, stones, stricture
866
most common cancer in men
prostate adenocarcinoma
867
risk factors of prostate adenocarcinoma
ag, fatty diet, family history
868
rare adrenal gland malignancy
cortical cancer
869
adrenal cortical cancers are hyperfunctioning in
females
870
cortical cancer are non-functioning in
males
871
Cushing's syndrome is due to
excess cortisol
872
4 signs of excess hormone production
femanization, virilization, precocious puberty,
873
Conn's disease is due to
excess aldosterone
874
hyperfunctioning adrenal cortical cancers look
homogeneous
875
nonfunctioning adrenal cortical cancers look
heterogeneous
876
adrenal tumour in children
neuroblastoma
877
neuroblastoma arises from
adrenal medulla
878
neuroblastoma can be confused with
Wilm's tumour/nephroblastoma
879
peritoneal malignancy associated with asbestos exposure
mesothelioma
880
mesothelioma appearance
omental caking, ascites, peritoneal thickening
881
hypoechoic masses along peritoneum can be from
non-H lymphoma, esp in AIDS patients
882
routes of metastatic spread
blood, lymphatics, direct invasion
883
most common sites for mets
lung, liver, bone, adrenal gland
884
most common malignant tumour of liver
liver mets
885
diffuse metastaic spread to peritoneum
peritoneal carcinomatosis
886
gelatinous ascites originating from perforated appendiceal epithelial tumour
pseudomyxoma peritonei
887
starburst appearance is assoc w
pseudomyxoma peritonei
888
morbidity
measure of sickness or disease in an area
889
mortality
measure of deaths in an area
890
proximal aorta flow waveform
moderate resistance
891
distal aorta flow waveform
high resistance
892
renal artery waveform
low resistance
893
SMA pre-prandial waveform
high res
894
SMA post-prandial waveform
low res
895
arteriosclerosis
hardening of arteries
896
atheroma
lipid deposit on intimal layer
897
atherosclerosis
form of arteriosclerosis, large and medium arteries
898
plaque
platelets forming a cap over a fat deposit
899
lipid deposits leads to
fibrosis and calcification
900
atherosclerosis assoc w
HTN, smoking, diabetes
901
most AAA occur
below RA
902
AAA can be caused by
syphilis
903
most common complication of AAA
stenosis
904
AAA assoc findings
iliac artery aneurysm, popliteal aneurysm
905
most urgent complication of AAA
rupture
906
splanchnic/mesenteric artery aneurysm
CT, SMA, IMA
907
most common splanchnic/mesenteric artery aneurysm
SA
908
iliac artery aneurysms are commonly
bilateral
909
IA aneurysm can cause
hydro- compress ureters
910
iliac arteries are post to
ureters
911
mycotic aneurysm
due to bacterial or fungal infection
912
inflammatory aneurysm
dense fibrotic reaction
913
tear of intimal lining of aorta
aortic dissection
914
3 types of aortic dissection
aortic arch + down ao
Marfan's = asc ao only
desc ao after left subclav origin
915
pseudoaneurysm
neck, contained by surrounding tissues
916
pseudoaneurysm causes
trauma, failed graft, post angiogram
917
AV Fistula
abnormal communication between artery and vein
918
AV Fistula can be a complication of
AAA
919
uncontrollabe HTN can be from
RA stenosis
920
most common abnormality of IVC
thrombosis
921
RV thrombosis is assoc w
diabetes, high BP
922
most frequent congenital abn of IVC
duplication, transposition
923
2 types of portal HTN
presinusoidal, intrahepatic
924
2 types of presinusoidal portal HTN
extrahepatic, intrahepatic
925
extrahepatic presinusoidal portal HTN
PV, SV thrombosis
926
varices
collaterals
927
intrahepatic, presinusoidal portal HTN
caused by diseases affecting portal zone. eg) schistosomiasis, cirrhosis
928
5 most common collateral routes
gastroesophageal, paraumbilical, splenorenal/gastrorenal, intestinal, hemorrhoidal
929
PV thrombosis can result in
cavernous transformation - "can of worms"
930
obstruction of HV's, + possible IVC occlusion
Budd-Chiari syndrome
931
causes of Budd-Chiari syndrome
oral contraceptives, coagulation problems, trauma, tumour invasion
932
sudden interruption of blood supply, may lead to necrosis
infarction
933
common cause of focal splenic lesion
splenic infarct
934
splenic infarct caused by
occlusion of SA due to sickle cell anemia
935
diffuse process of hepatocyte dysfunction
hepatocellular disease
936
hepatocellular disease
fatty liver to cirrhosis,size, abnormal LFT's
937
fatty infiltration
steatosis
938
2 most common causes of fatty infiltration
obesity, alcohol
939
altered liver lab values
ALT, AST, ALP, GGT, bilirubin
940
cirrhosis
fibrosis, nodular changes
941
cirrhosis causes
alcohol, viral hepatitis, primary sclerosing cholangitis
942
chronic viral hepatitis causes
micronodular changes
943
macronodular changes cause by
alcohol induced cirrhosis
944
CL/RL ration in cirrhotic liver
> 0.65
945
DECREASED lab values with cirrhosis
serum albumin
946
von Gierke's disease
GSD
947
GSD causes
excess glycogen deposits in hepatocytes
948
transudate fluid
contains little protein or cells, non- inflammatory cause
949
causes of transudate fluid ascites
cirrhosis, CHF
950
exudate fluid
high protein content, blood, pus, chylous
951
causes of exudate fluid ascites
inflammatory process, malignancy
952
sono appearance of causes of exudate fluid ascites
septations, loculations, internal echoes
953
free fluid features
changes with pt position, conforms to organs, acute angle
954
loculated fluid features
rounded margins, no change with movement, mass effect
955
3 most dependent spaces in peritoneal cavity
Morison's pouch, pouch of Douglas/posterior cul de sac, paracolic gutters
956
causes of bile stasis
prolonged fasting, rapid wt loss, TPN, extrahepatic biliary obstruction
957
sludge that mimics polypoid tumour
tumefactive sludge/sludge balls
958
when sludge has same echogenicity as liver
hepatization
959
imaging artifact in GB
pseudo sludge
960
presence of pus in bile
empyema
961
presence of blood in bile
hembilia
962
limey bile
milk of calcium
963
most common disease of the GB
cholelithiasis
964
cholelithiasis
gallstones
965
factors affecting cholelithiasis
bile composition, stasis, infection
966
composition of gallstones
cholesterol, bilirubin, calcium
967
cholelithiasis risk factors
fat, female, 40+, fertile, family hx
968
WES sign
wall, echo, shadow
969
cholelithiasis lab values
ALT, AST, ALP, bilirubin
970
painless jaundice is assoc w
neoplastic conditions, choledochal cysts
971
painful jaundice is assoc w
acute obstruction, infection
972
stones in biliary tree
choledocholithiasis
973
most common cause of choledocholithiasis
secondary - stones pass from GB
974
stones form in ducts due to
inflammation, parasitic infection, Caroli's disease, prior sx
975
most common location for stones in biliary tree
distal CBD at ampulla of Vater (extrahepatic)
976
stones in urinary system
urolithiasis
977
stones in renal collecting system
nephrolithiasis
978
calcs in renal parenchyma
nephrocalcinosis
979
risk factors of nephrolithiasis
hereditary, low water intake, high animal protein diet, urinary stasis
980
3 natural narrowings or ureter
UPJ, UVJ, crossing iliacs
981
stones less than ___ can pass
5 mm
982
artifact assocaited with renal stones
twinkle
983
dilated renal collecting system
hydronephrosis
984
non-obstructive hydronephrosis caused by
reflux, infection, polyuria
985
this can be mistaken for hydro
parapelvic cysts, extra-renal pelvis
986
nephrocalcinosis can be caused by
ischemia, necrosis, hypercalcemia
987
theory of stone progression
Anderson-Carr kidney
988
term describing poorly functioning but unobstructed kidney
medical renal disease
989
sono features of acute medical renal disease
diffuse increase in echogenicity, prominent CM junction, enlarged
990
sono features of chronic medical renal disease
small, echogenic kidneys
991
most common cause of acute reversible renal failure
acute tubular necrosis
992
acute tubular necrosis
debris deposits in renal collecting tubules
993
acute tubular necrosis results from
ischemia, toxicity
994
RI indicating acute tubular necrosis
RI > 0.75
995
ischemic necrosis of cortex with paring of pyramids
acute cortical necrosis
996
acute cortical necrosis can be due to
sepsis, burns, severe dehydration, PIH
997
renal autoimmune reaction
acute glomerulonephritis
998
pt presentation of acute glomerulonephritis
hematuria, HTN, azotemia (N2)
999
systemic metabolic disorder resulting in amyloid deposits in kidneys
amyloidosis
1000
pt presentation of amyloidosis
proteinuria
1001
most common cause of chronic renal failure
diabetes mellitus
1002
complete obstruction of renal collecting system
irreversible damage in 3 wks
1003
partial obstruction of renal collecting system
irreversible damage in 3 months
1004
chronic stage renal failure lab values
creatinine, BUN, uric acid, RBC, WBC in urine
1005
hyperadrenalism
Cushing's syndrome, Conn's disease, MEN,
1006
hyperadrenalism
excess cortisol secretion
1007
causes of hyperadrenalism
adrenal hyperplasia, adenoma, carcinoma, taking too much corticosteroids
1008
hyperadrenalism features
moon face, bufalo hump, truncal obesity, hirsutism, amenorrhea, HTN
1009
Cushing's syndrome
excess cortisol from adrneal gland
1010
Cushing's disease
excess cortisol due to ACTH from pituitary adenoma
1011
Conn's disease
excess aldosterone secretion
1012
Conn's disease presentation
increaced Na+, low K+, HTN, hypoechoic small round mass
1013
MEN
multiple endocrine neoplasi
1014
malignant type of MEN
type 2
1015
MEN causes
excessive hormone production
1016
MEN affects these tissues
adrenal, pancreas, pituitary, parathyroid
1017
MEn type 2 in adrneal
pheochromocytoma
1018
pheochromocytoma
a small vascular tumor of the adrenal medulla, causing irregular secretion of epinephrine and norepinephrine, leading to attacks of raised blood pressure, palpitations, and headache.
1019
hypoadrenalism may cause
adrenal atrophy
1020
hypoadrenalism may be due to
adrenal cortex , hypothalamus or pituitary disorders
1021
3 types of hypoadrenalism
Addison's, TB, Waterhouse-Friedrichsen syndrome
1022
autoimmune hypoadrenalism
Addison's disease
1023
Addison's disease occurs only in
females
1024
autoimmune hypoadrenalism accounts for ___ of all hypoadrenalism cases
80%
1025
TB accounts for ___ of all hypoadrenalism cases
20%
1026
hypoadrenalism due to TB occurs in
males
1027
features of TB hypoadrenalism
emlarged, hyperpigmentation, low BP, muscle weakness, fatigue
1028
in TB hypoadrenalism ___ of the gland is non-functioning
90%
1029
acute hypoadrenalism
Waterhouse-Friedrichsen syndrome
1030
Waterhouse-Friedrichsen syndrome is secondary to
hemorrhage, infection
1031
Waterhouse-Friedrichsen syndrome causes
massive destruction of kidneys
1032
what will you see in a TIPS patient
stent
1033
what does focal fatty infiltration look like
hyperechoic areas, irregular borders
1034
how to distinguish hydro from parapelvic cyst
```
connecting = hydro
separate = cysts
```
1035
this liver disease is assoc w adenoma foramtion
GSD
1036
cirrhosis and CHF produce this type of ascites
transudative fluid
1037
liver cyst with double wall
hyatid cyst
1038
worms in biliary tree
biliary ascariasis
1039
lymphangitis
inflammation of walls of lymphatic vessels
1040
adenitis
inflammation of a gland
1041
adenopathy
enlargement of LN
1042
elephantiasis
enlargement of a limb, due to lymphatic obstruction
1043
elephantiasis is usually due to
nematode - filariasis
1044
bezoars
small stony concretion in stomach of ruminants
1045
lung consolidation
region of lung tissue that has filled with liquid- causing hardening or swelling (induration)
1046
atelectasis
partial or complete lung collapse
1047
pneumothorax
air/gas in pleural cavity, causing lung collapse
1048
infection presentation
fever, pain, leukocytosis
1049
localized collection of pus
abcess
1050
inflammation of liver
hepatitis
1051
hep A transmission
fecal - oral route
1052
99% of acute hep are type
A
1053
Hep B spreads via
blood, body fluid, mucous membrane contact
1054
He c spreads
blood transfusions
1055
hep D
Hep B dependent, IV drug users
1056
(sub)fulminant hepatitis is due to
hep B, toxicity
1057
death occurs if ___ of liver tissue lost
40%
1058
chronic hepatitis
symptoms > 6 months
1059
starry sky appearance is assoc w
acute hepatitis
1060
liver appearance in chronic hepatitis
coarse, hyperechoic, portal HTN, cirrhosis
1061
inflammation, fibrosing of biliary tree
cholangitis
1062
acute/bactrerial cholangitis is due to
choledocholithiasis
1063
left lateral lobe is affected most in
recurrent pyogenic cholangitis
1064
long term effect of recurrent pyogenic cholangitis
biliary cirrhosis, choleangiocarcinoma
1065
lab values assoc w AIDS
increased ALP, normal bilirubin
1066
roundowm infection in biliary tree
biliary ascariasis
1067
acture pancratitis etiology
alcohol abuse, biliary stones
1068
75-90% of all pancreatic lesions are
pseudocysts
1069
Crohn's disease affects
terminla ileum and colon, all layers
1070
ulcerative colitis affects
colon and rectum, mucosal and submucosal layers
1071
necrotizing inflammmation of GI tract
pseudomembranous colitis
1072
pseudomembranous colitis is caused by
C.difficile
1073
acute appendicitis is due to
obstruction of lumen
1074
a normal appendix should measure
<6 mm AP, <3 mm single wal
1075
distention of appendix with mucuous
mucocele
1076
malignant cause of mucocele
primary mucous cystadenocarcinoma
1077
benign cause of mucocele
fecaliths, inflammatory scarring, polyps
1078
diverticulitis more common in young, asian, women
RLQ diverticulitis
1079
RLQ diverticulitis are ____ and _____
congenital, solitary
1080
RLQ diverticulitis involves which layers
all
1081
LLQ diverticulitis is seen in
older patients, low fibre diet
1082
LLQ diverticulitis affects
left colon, sigmoid colon
1083
LLQ diverticulitis affect which layers
mucosa & submucosa
1084
type of bladder diverticula involving all 3 layers
congenital
1085
type of bladder diverticula involving inner 2 layers
acquired, (mucosa, submucosa)
1086
bladder diverticula associated with neurogenic bladder
acquired
1087
bladder diverticula can result in
stasis, stones, infection
1088
early stages of mechanical bowel obstruction
hyperperistalsis
1089
late stages of mechanical bowel obstruction
NO peristalsis
1090
invagination/telescoping of bowel segments
intussusception
1091
intussusception occurs mainly in
children
1092
closed loop obstruction
volvulus
1093
bowel obstruction related to lack of function
paralytic ileus
1094
paralytic ileus is usually due to
general anesthetic
1095
UTI's occur mostly in
women, diabetics, immune compromised
1096
inflamed renal tubules
acute pyelonephritis
1097
acute pyelonephritis is caused by
E. coli
1098
chronic pyelonephritis is caused by
vesicoureteric reflux
1099
pus in renal collecting system
pyonephrosis
1100
pyonephrosis in young adults
UPJ obstruction/ stones
1101
pyonephrosis in elderly
malignant obstruction
1102
Staghorn calculi occur in
Xanthogranulomatous pyelonephritis
1103
most common fungal infection in urinary tract
Candida albicans (yeast)
1104
biliary pathology with dilated intrahepatic ducts, and normal extrahepatic ducts
Klatskin's tumour
1105
panc head is INF to ____ and ANT to ____
PV; IVC
1106
Caroli's disease
intrahepatic duct dilatation, leads to portal HTN, congenital hepatic fibrosis
1107
ADPKD is not associated with
portal HTN
1108
divides inframesocolic compartment into left and right
root of mesentery
1109
INF border of caudate lobe
MPV
1110
echinococcal disease aka
hydatid disease
1111
BPH occurs in
TZ
1112
infectious cystitis can be caused by
prostatitis (men), bladder outlet obstruction
1113
chronic prostatitis caused by
E.coli
1114
transudative pleural effusion is caused by
CHF, cirrhosis
1115
exudative pleural effusion is caused by
infections, neoplasms
1116
severe splenomegaly is due to
leukemia, lymphoma
1117
mild to moderate splenomegaly is due to
portal HTN, infection, AIDS
