Study guide test 3

Question 1

What are the three layers of the breast?

Answer 1

subcutaneous layer

mammary (glandular) layer-functional portion

retromammary layer

Question 2

functional portion of the breast consists of how may lobes?

Answer 2

15-20 lobes

Question 3

What is the fibrous skeletal muscle that maintains the breast?

Answer 3

Cooper’s ligaments

Question 4

As a woman ages, glandular breast tissue is replaced with what?

Answer 4

fatty tissue

Question 5

Describe what Cooper’s ligaments look like under US?

Answer 5

echogenic and are dispersed in a linear pattern

Question 6

Describe sonographic appearance of the retromammary layer:

Answer 6

similar in ehcogenicity and echotexture to the subcutaneous layer

hypoechoic

Question 7

What are the most important signs to make sure a lesion is cystic?

Answer 7

anechoic

show smooth inner margins with an imperceptible capsule

posterior acoustic enhancement

Question 8

If a patient has clinical findings of lumpy, bumpy, painful, and tender breasts during their cycle, what do they have?

Answer 8

fibrocystic condition

Question 9

What are the characteristics of a papilloma?

Answer 9

small, multiple, multicenteric

consist of simple proliferations of duct epithelium projecting outward into a dilated lumen from one or more focal points

Question 10

What is the most common solid, benign tumor of the breast?

Answer 10

fibroadenoma

Question 11

What are the sonographic characteristics of a fibroadenoma?

Answer 11

smooth, rounded margins

low-level homogeneous internal echoes

may demonstrate intermediate posterior enhancement

Question 12

Lymphatic drainage from the breast generally flows to what lymph nodes?

Answer 12

first or “sentinel” lymph node along axillary node chain

Question 13

What is the most common malignant neoplasm of the breast?

Answer 13

Invasive ductal carcinoma

Question 14

Describe the characteristics of breast carcinoma:

Answer 14

arise from the epithelium, in the ductal and glandular tissue, and usually has tentacles

ductal or lobular

invasive or noninvasive

Question 15

What does skin dimpling suggest?

Answer 15

cancer

Question 16

Most common clinical sign of breast cancer is?

Question 17

Primary purpose of breast screening:

Answer 17

detection and diagnosis of breast cancer in its earliest and most curable stage

Question 18

Know the clock face:

Answer 18

breast is viewed as a clock face

Question 19

Normal extension of breast tissue into the axillary region

Answer 19

tail of Spence

Question 20

According to the ACS, all women should begin annual mammogram screening at what age?

Answer 20

40

Question 21

Which artery is responsible for supplying more than 1/2 of the breast?

Answer 21

anterior perforating branches of the internal mammary artery

Question 22

What is the condition when a male has breasts?

Answer 22

gynecomastia

Question 23

Appearance of breast cancer on US:

Answer 23

indistinct, fuzzy, spiculated

grow through tissue without compressing adjacent tissue and may cause retraction of the nipple or dimpling of the skin

sharp, angular microlobulations

taller than wide

hypoechoic, weak internal echoes, clustered microcalcifications

strong attenuating

firmly fixed

rigid, noncompressible

hypervascular; feeder vessel may be identified

Question 24

US is often a benefit for what procedures?

Answer 24

cyst aspiration

fine needle aspiration cytology (FNAC)

drainage procedures

preoperative needle (wire) localization

large-core needle biopsy

sentinel node biopsy

Question 25

If family hostory of breast cancer, when should you have a mammogram? ## Footnote

Answer 25

30 ## Footnote

Question 26

If you have a family history of breast cancer and are younger than 30 and/or pregnant, what is the modality of choice?

Answer 26

ultrasound

Question 27

What other modalities are used besides US for the breast?

Answer 27

mammography-provides a sensitive method of screening for breast cancer MRI- used along with US to provide additional characterization and further interrogation of breast lesions

Question 28

If you see a smooth mass on a mammogram and they want correlating images on US, what do you think you're going to see?

Answer 28

aneochic cyst with posterior acoustic enhancement

Question 29

What are the advantages of breast US over mammography?

Answer 29

can differentiate structures within uniformly dense breast tissue can visualize tissue adjacent to implants

Question 30

What is the diameter of a varicocele?

Answer 30

more than 2mm in diameter

Question 31

What is the fibrous capsule surrounding the testicle?

Answer 31

tunica albuginea

Question 32

Normal measurements of the testicle:

Answer 32

3-5cm length 2-4cm width 3cm height

Question 33

Sonographic characteristics of a testicle:

Answer 33

smooth, medium gray structures with a fine echo texture

Question 34

What is the linear strip that is echogenic that runs through the testis?

Answer 34

mediastinum

Question 35

Normal location of the epididymis:

Answer 35

begins superiorly and then courses posterolateral to the testis

Question 36

What are the facts about undescended testes?

Answer 36

10 times more likely to be affected by torsion 2.5-8 times more likely to develop cancer 80% testis found in inguinal canal more common in premature babies bilateral in 10-25% of cases can prohibit spermatogenesis and result in infertility

Question 37

The most common cause of acute scrotal pain in an adolescent:

Answer 37

torsion

Question 38

Some common causes for hydroceles:

Answer 38

epididymo-orchitis torsion trauma development of a neoplasm

Question 39

Know about varicoceles

Answer 39

abnormal dilatation of the veins of the pampiniform plexus caused by incompetent venous valves within spermatic vein-called primary varicoceles more common on the left secondary varicoceles-caused by increased pressure on spermatic vein (result of renal hydronephrosis, abdominal mass, liver cirrhosis) abdominal malignancy invading left renal vein may cause varicocele with noncompressible veins

Question 40

What part of the epididymis is the spermatocele located?

Answer 40

head of epididymis

Question 41

Common cause for scrotal pain in adults:

Answer 41

epididymo-orchitis

Question 42

What almost always transpires secondary to epididymitis?

Answer 42

orchitis

Question 43

What is tubular ectasia?

Answer 43

uncommon, benign condition associated with the presence of a spermatocele, an epididymal or testicular cyst, or other epididymal obstruction

Question 44

What is a seminoma and what does it look like on US?

Answer 44

most common type of germ cell tumor homogeneous, hypoechoic masses with a smooth border

Question 45

Epididymo-orchitis most commonly results from what?

Answer 45

spread of a lower urinary tract infection via the spermatic cord

Question 46

A clinical history of vasectomy is associated with what?

Answer 46

spermatoceles

Question 47

What is the primary source of blood supply to the testicle?

Answer 47

right and left testicular arteries

Question 48

Intratesticular cysts have an association with what?

Answer 48

extratesticular spermatoceles

Question 49

What is microlithiasis of the testis is associated with what?

Answer 49

testicular malignancy

Question 50

How frequently is a follow up for patients with microlithiasis recommended?

Answer 50

annually

Question 51

Attached at the superior pole of the testis between the epididymis and testis is what structure?

Answer 51

appendix

Question 52

Hydrocele develops between what layers of the scrotum?

Answer 52

between the visceral and parietal layers of the tunica vaginalis

Question 53

What is the location of the rete testis?

Answer 53

where the tubules converge at the apex of each lobule in the mediastinum

Question 54

What is the echogenicity difference between the testes and epididymis?

Answer 54

epididymis appears as isoechoic or hypoechoic-compared with the testis (echotexture is coarser)