MIDTERM

Question 1

When you are looking at a CT scan it is as if you are looking

Answer 1

From the feet up to the head

Question 2

On a CT, you will see a “hat” on top of each kidney. This is called the

Answer 2

Adrenal gland

Question 3

A gallbladder stone will appear echogenic on ultrasound, but will not be echogenic on CT.
TRUE OR FALSE

Answer 3

False

Question 4

The aorta bifurcates into __ at the level of the _

Lt and Rt External Iliac arteries, groin

Lt and Rt Common Iliac arteries, umbilicus

Lt and Rt Internal Iliac arteries, groin

A and C

Answer 4

Lt and Rt Common Iliac arteries, umbilicus

Question 5

All of the following are anterior branches of the aorta, EXCEPT:

SMA
IMA
Celiac Trunk
Renal arteries

Question 6

The seagle sign is displayed is in which of the following orientations?

Answer 6

transverse

Question 7

Portal T is which branch of the MPV

Answer 7

left

Question 8

Which blood vessel courses anterior to the aorta and posterior to the SMA?
SMV
RRV
IMV
LRV

Answer 8

LRV

Question 9

Which blood vessel courses more anteriorly, renal arteries or renal veins?
veins
arteries

Answer 9

veins

Question 10

All of the following are lower extremity arteries except:
superficial femoral artery
deep femoral artery
greater saphenous artery
popliteal artery

Answer 10

greater saphenous artery

Question 11

The liver occupies a major portion of the:
left hypchondrium
epigastrium
righ hypochondrium
hypogastrium

Answer 11

righ hypochondrium

Question 12

The IVC and its visible branches are primarily evaluated to detect
enlargement
the location of the hepatic veins
liver disease !
intraluminal thrombosis or tumor invasion

Answer 12

intraluminal thrombosis or tumor invasion

Question 13

All of the following are ligaments of the liver EXCEPT:
coronary ligaments
triangular ligaments
bare area
falciform

Answer 13

bare area

Question 14

On the left anteriorly, the legamentum teres divides the
anterior from the posterior left lobe
medial from the lateral left lobe
lateral from the distal left lobe
medial from the lateral right lobe

Answer 14

medial from the lateral left lobe

Question 15

The caudate lobe is bordered posteriorly by the _______ and anteriorly by the _______.
aorta, left portal vein
IVC, right hepatic vein
IVC , left portal vein
Aorta, left hepatic vein

Answer 15

IVC , left portal vein

Question 16

The main portal vein enters the ________________and divides into left and right portal branches

portal triad
portal hilum
the liver triad
porta hepatis

Answer 16

porta hepatis

Question 17

The main lobar fissure is seen as an echogenic line connecting the ________________ to the _________.

liver, kidney
gallbladder, right portal vein
gallbladder left portal vein
gallbladder, liver

Answer 17

gallbladder, right portal vein

Question 18

The portal triad consist of
GB, HV, PV
CBD, Pancreas, PV
CBD, HA, PV
pancreas, IVC, CBD

Answer 18

CBD, HA, PV

Question 19

The common hepatic duct is _________ to the portal vein.
lateral
posterior
medial
anterior

Answer 19

anterior

Question 20

All of the following are divisions of the gallbladder EXCEPT!
cystic duct
fundus
body
neck

Answer 20

cystic duct

Question 21

Which of the following is not a probe position for a Gallbladder Fast Exam
High/Lateral view
low/lateral view
subcostal view

Answer 21

low/lateral view

Question 22

The right and left hepatic ducts emerge from the right lobe of the liver in the porta hepatis and unite to form the:
common hepatic duct
cystic duct
common bile duct
common pancreatic duct

Answer 22

common hepatic duct

Question 23

The hepatic duct is joined by the _____ to form the _____.
pancreatic duct; cystic duct
cystic duct; common bile duct
common bile duct; cystic duct
right hepatic duct; common bile duct

Answer 23

cystic duct; common bile duct

Question 24

The distal duct lies _____ with the anterior wall of the inferior vena cava (IVC).
parallel
perpendicular
lateral
horizontal

Answer 24

parallel

Question 25

The cystic duct connects the _____ of the gallbladder with the common hepatic duct to form the _____. fundus; common hepatic duct (CHD) fundus; common bile duct (CBD) neck; CBD body; CHD

Answer 25

neck; CBD

Question 26

The function of the gallbladder is: storage for extra cholesterol storage for enzymes reservoir for bile reservoir for biliary salts

Answer 26

reservoir for bile

Question 27

The bright linear echo within the liver connecting the gallbladder and the right or main portal vein is the: right lobar fissure main lobar fissure ligamentum teres left lobar fissure

Answer 27

main lobar fissure

Question 28

The _____ branch of the hepatic artery can be seen between the common duct and the portal vein as a small circular structure. left middle right lateral

Answer 28

right

Question 29

The common bile duct is joined by the main pancreatic duct. Together they open through the _____ into the duodenal wall.

Answer 29

ampulla of Vater

Question 30

The walls of the portal vein are _____ when compared to the liver parenchyma?

Answer 30

Hyperechoic

Question 31

“Shotgun sign” seen in the liver parenchyma is indicative of: Hepatic veins Portal hypertension AAA Dilated biliary ducts

Answer 31

Dilated biliary ducts

Question 32

What vein brings oxygen enriched blood to the liver?

Answer 32

Portal vein

Question 33

Within the liver, which is one of the ligaments that divides the right lobe from the left lobe. Main lobar fissure Right portal vein Common bile duct Right hepatic vein

Answer 33

Main lobar fissure

Question 34

A contracted gallbladder packed with stones will give the ______ sign. Mickey Mouse Seagull WES GES

Answer 34

WES

Question 35

On ultrasound, a gallstone appears hypoechoic with posterior shadowing hyperechoic with posterior enhancement hypoechoic with posterior enhancement hyperechoic with posterior shadowing

Answer 35

hyperechoic with posterior shadowing

Question 36

A benign growth the protudes from the wall of the gallbladder is called a

Answer 36

polyp

Question 37

A patient presents to the ER with acute RUQ pain. Upon examination, you find that the gallbladder wall measures 4mm and there are stones within the gallbladder, and some fluid is seen anterior to the gallbladder. The most likely diagnosis would be: acute pancreatitis with cholelithiasis nephrolithiasis acute cholecystitis with cholelithiasis Choledocholithiasis

Answer 37

acute cholecystitis with cholelithiasis

Question 38

Causes of gallbladder wall thickening include everything EXCEPT: hepatitis liver failure renal failure ! deep vein thrombosis

Answer 38

deep vein thrombosis

Question 39

Low level, nonshadowing echoes in the dependent portion of the gallbladder can be described as

Answer 39

biliary sludge

Question 40

The gallbladder is located on the ___ of the liver

Answer 40

posterior and inferior portion of the right lobe

Question 41

The left and right hepatic ducts join at approximately the level of

Answer 41

porta hepatis

Question 42

The cystic duct connects the gallbladder to the

Answer 42

common hepatic duct

Question 43

The overall length of the gallbladder is

Answer 43

highly variable

Question 44

Bile enters the intestinal tract at the

Answer 44

ampulla of vater

Question 45

The ______________ supplies blood to the gallbladder and liver cystic artery aorta proper hepatic artery common bile duct

Answer 45

proper hepatic artery

Question 46

The intrahepatic ducts run alongside of the: hepatic veins and the hepatic arteries hepatic veins and cystic duct hepatic veins and the celiac trunk portal vein and hepatic arteries

Answer 46

portal vein and hepatic arteries

Question 47

The three landmarks that may be helpful in locating the gallbladder on a longitudinal image are portal vein, ligamentum venosum and the right kidney portal vein, main lobar fissure and the right kidney hepatic artery, main lobar fissure and the right kidney common bile duct, ligamentum venosum and the right kidney

Answer 47

portal vein, main lobar fissure and the right kidney

Question 48

The hepatic duct is joined by the _____ to form the _____. pancreatic duct; cystic duct cystic duct; common bile duct common bile duct; cystic duct right hepatic duct; common bile duct

Answer 48

cystic duct; common bile duct

Question 49

The head of the pancreas lies in the:

Answer 49

lap of the duodenum

Question 50

The head of the pancreas is inferior to the: right lobe of liver caudate lobe of liver right lateral fissure of liver left lateral fissure of liver

Answer 50

caudate lobe of liver

Question 51

The _____ is the anterolateral border of the pancreatic head

Answer 51

gastroduodenal artery

Question 52

The tail of the pancreas is found: posterior to the left kidney, near the splenic hilum anterior to the left kidney, near the splenic hilum posterior to the right kidney, near the liver hilum anterior to the right kidney, near the liver hilum

Answer 52

anterior to the left kidney, near the splenic hilum

Question 53

The primary pancreatic duct is the:

Answer 53

duct of Wirsung

Question 54

The duct of Santorini is a

Answer 54

accessory duct to the pancreas

Question 55

The splenic artery is considered to be what type of boarder of the pancreas

Answer 55

superior

Question 56

The pancreas is reflective in its sonographic appearance because of : islets of Langerhans Cooper's ligaments small glands or acini fat between the lobules

Answer 56

fat between the lobules

Question 57

Approximately 2% of the pancreatic gland is endocrine. TRUE OR FALSE

Answer 57

false

Question 58

The largest component of pancreatic juice is hydrochloric acid. TRUE OR FALSE

Answer 58

FALSE

Question 59

The _______________ is a posteromedial projection of the pancreas head.

Answer 59

uncinate process

Question 60

Pancreatic juice from the acini cells are drained by ______________.

Answer 60

intercalated ducts

Question 61

Transverse scanning plane images best demonstrate the __________ section of the pancreas.

Answer 61

Head

Question 62

Sagittal scanning plane images best demonstrate the __________ section of the pancreas.

Answer 62

body

Question 63

A normal pancreatic duct variant that enters the duodenum is called the __________.

Answer 63

Duct of Santorini

Question 64

The muscle that surrounds the ampula through which the main pancreatic duct enters the duodenum is called the ______________.

Answer 64

Sphincter of Oddi

Question 65

The hormone that causes cells to release glucose into the bloodstream is called __________.

Answer 65

glucagon

Question 66

The hormone that causes cells to take up glucose from the bloodstream is __________.

Answer 66

insulin

Question 67

Which of the following statements about the spleen is FALSE? A prominent bulge along along the medial surface of the spleen can be seen in normal patients. The normal-sized spleen should not extend caudal to the mid portion of the left kidney. The spleen is a retroperitoneal organ. the sonographic texture of the normal spleen is homogeneous.

Answer 67

The spleen is a retroperitoneal organ.

Question 68

The best sonographic window to image the left hemidiaphragm is the

Answer 68

spleen

Question 69

The normal sonographic texture of the spleen is: homogeneous with internal echoes equal to or less echogenic than those of the liver hypoechoic isoechoic but more echogenic than the liver hyperechoic

Answer 69

homogeneous with internal echoes equal to or less echogenic than those of the liver

Question 70

Which statement describes the correct anatomic location of structures adjacent to the spleen? the diaphragm is anterior, lateral and inferior to the spleen the fundus of the stomach and lesser sac are medial and posterior to the splenic hilum the left kidney lies inferior and medial to the spleen the right adrenal and kidney lie superior to the spleen

Answer 70

the left kidney lies inferior and medial to the spleen

Question 71

When accessory spleens are present, they usually are located: at the inferior margin of the spleen on the posterior aspect of the spleen near the hilum of the spleen near the kidney

Answer 71

near the hilum of the spleen

Question 72

With splenomegaly, the left kidney may be displaced:

Answer 72

inferiorly

Question 73

A spleen that has migrated from its normal location is termed: accessory spleen wandering or ectopic spleen splenectomy splenomegaly

Answer 73

wandering or ectopic spleen

Question 74

In the adult, splenomegaly is diagnosed when the length of the spleen exceeds

Answer 74

13 cm

Question 75

The splenic artery is a branch of which of the following vascular structures?

Answer 75

celiac trunk/axis

Question 76

When compared to the liver, the echogenicity of the normal parenchyma is described as hypoechoic hyperechoic isoechoic hypoechoic or isoechoic

Answer 76

hypoechoic or isoechoic

Question 77

The splenic artery arises from which artery

Answer 77

celiac artery

Question 78

Which artery is a branch of the splenic artery? Left gastric artery Short gastric artery Right gastroepiploic artery Inferior mesenteric artery

Answer 78

Short gastric artery

Question 79

The average volume of the adult spleen is about

Answer 79

200mL (60-200)

Question 80

The echogenicity of the spleen can be described as what level of echoes high medium low

Answer 80

medium-level echoes

Question 81

The echogenicity of the splenic calcifications can be described as what level of echoes

Answer 81

high level echoes

Question 82

The spleen is a retroperitoneal organ. TRUE OR FALSE

Answer 82

FALSE intraperitoneal

Question 83

What is the thickest layer in an artery? And in a vein?

Answer 83

Artery: tunica media Vein: tunica adventitia

Question 84

Aorta long

Answer 84

- tubular - pulsatile - anechoic lumen - echogenic walls - anterior to spine

Question 85

When is the aorta considered the abdominal aorta?

Answer 85

after it reaches the aortic hiatus on the diaphragm

Question 86

What happens to the aorta as it becomes more distal?

Answer 86

it tapers and becomes more anterior distally

Question 87

The celiac axis bifurcates into what

Answer 87

splenic artery, common hepatic artery, left gastric artery

Question 88

what are some indications to scan SMA

Answer 88

- pain after eating - weight loss - "fear of food" - diarrhea - nausea and vomitting

Question 89

why do we scan the SMA

Answer 89

make sure no blockages or something compressing it check for narrowing or a mass

Question 90

Can the SMA be seen with reasonable consistency on ultrasound

Answer 90

TRUE

Question 91

Can the IMA be seen with reasonable consistency on ultrasound

Answer 91

FALSE

Question 92

Where does the portal vein form in terms of pancreas

Answer 92

forms near head of panc and posterior to neck

Question 93

What vessel serves as an intersegmental boundary between the medial and lateral lobes of the liver

Answer 93

left portal vein

Question 94

Where are the hepatic veins best visualized

Answer 94

superior section of liver

Question 95

What vessels are located superior to hepatic veins

Answer 95

inferior phrenic veins

Question 96

Where do the renal veins empty into

Answer 96

Into IVC immediately inferior to the level of the renal arteries

Question 97

What are the functions of the liver

Answer 97

- blood reservoir - detoxifies harmful substances - filter blood - makes bile - synthesizes blood proteins and heparin

Question 98

What enters and exits the liver

Answer 98

Portal vein and hepatic arteries enter the liver Hepatic ducts exit the liver

Question 99

Space between the liver and kidney where fluid can collect

Answer 99

Morrisons pouch