URR 64

Question 1

fibrous band that connects the two rectus abdominis muscles

Answer 1

linea alba

Question 2

The ___ muscles form the lateral sides of the anterior abdominal wall

Answer 2

oblique

Question 3

The ____ muscle is most superior and lies anterior to the internal oblique muscle.

Answer 3

external oblique

Question 4

The ___ muscles lie anterior to the transversus abdominis/transversalis muscle

Answer 4

internal oblique

Question 5

vertical fibrous band at the lateral edge of the rectus sheath

Answer 5

linea semilunaris

Question 6

The linea sumilunaris is also known as the

Answer 6

spigelian fascia

Question 7

____ lies deep to abdominal wall muscles and lines entire abdominal wal

Answer 7

Transversalis fascia

Question 8

The transversalis facia is separated from parietal peritoneum by a layer of ____

Answer 8

extraperitoneal fat

Question 9

Ultrasound evaluation of the abdominal wall should include application of the ___ and imaging the patient in a ___ position

Answer 9

valsalva maneuver
standing

Question 10

blood collection between the layers of the rectus sheath

Answer 10

rectus sheath hematoma

Question 11

A rectus sheath hematoma is a common complication seen with:

Answer 11

antiocoagulant therapy

Question 12

a horizontal line that demarcates the lower limit of the posterior layer of the rectus sheath

Answer 12

arcuate line

Question 13

The posterior rectus sheath ends at the level of the:

Answer 13

arcuate line

Question 14

The arcuate line is usually located between the ___ and the ___

Answer 14

umbilicus
symphysis pubis

Question 15

location where the inferior epigastric vessels perforate the rectus abdominis muscles

Answer 15

arcuate line

Question 16

most common cause of rectus sheath formation

Answer 16

injury to the inferior epigastric artery

Question 17

____ the arcuate line, hematomas are confined within the sheath

Answer 17

above

Question 18

___ the arcuate line, the blood is not confined within the sheath and can extend into the ____

Answer 18

Below
Space of Retzius

Question 19

The ___ stops the hematoma from extending across the midline above the arcuate line

Answer 19

linea alba

Question 20

Sonographic appearance of rectus sheath hematoma

Answer 20

varies with blood/thrombus age

usually fills the space of the space it occupies

good through transmission with early hematomas

Question 21

increased distance between the rectus abdominis muscles caused by weakness in the anterior abdominal wall

Answer 21

diastasis recti

Question 22

The ___ is normally a narrow fibrous band in the midline abdomen that separates the two rectus abdominis muscles

Answer 22

linea alba

Question 23

____ and ____ cause diastasis recti

Answer 23

muscle weakness
thinning/stretching of the linea alba

Question 24

The distance between the two rectus abdominis muscles can increases with ___, ___, and in ___

Answer 24

pregnancy
obesity
newborns

Question 25

Diastasis recti can be differentiated from a ventral hernia because:

Answer 25

there is no fascial defect

Question 26

presents as a midline bulge that increases with increased abdominal pressure

Answer 26

diastastis recti

Question 27

fatty tumor localized within abdominal wall; usually hypoechoic to isoechoic with surrounding tissues; soft, compressible, moveable; usually removed for cosmetic purposes

Answer 27

abdominal wall lipoma

Question 28

benign neoplasm; usually found in the abdominal wall but can be intra- or extraabdominal; homogeneous, isoechoic to hypoechoic mass

Answer 28

desmoid tumors

Question 29

Desmoid tumors are most commonly seen in ___ age __-__ years

Answer 29

women 25 40

Question 30

Desmoid tumors are associated with __ and ___

Answer 30

pregnancy previous abdominal surgery

Question 31

Endometriomas are associated with ___ or ___

Answer 31

cesarean section laparotamies

Question 32

Endometriomas are commonly mistaken for:

Answer 32

incisional hernia

Question 33

It is important to determine if an endometrioma has invaded the ____

Answer 33

abdominal fascia

Question 34

Parts of a hernia sac

Answer 34

neck body fundus contents

Question 35

The neck of the hernia is in the ___

Answer 35

orifice

Question 36

A _, __, or ___ neck of hernia increases the risk of strangulation

Answer 36

narrow rigid angled

Question 37

The ___ is the widest part of the hernia sac

Answer 37

body

Question 38

The ___ is the area furthest away from the hernia

Answer 38

fundus

Question 39

Most hernias contain ___ or ____, but ___ can also protrude into the sac

Answer 39

intraperitoneal fat extraperitoneal fat bowel

Question 40

patients with one hernia, usually have ___

Answer 40

multiple

Question 41

hernias that are not reducible

Answer 41

incarcerated hernias

Question 42

contain incarcerated bowel loops that have become mechanically obstructed

Answer 42

obstructed hernias

Question 43

hernias that contain incarcerated contents with compromised vascularity

Answer 43

strangulated hernias

Question 44

most significant complication of a hernia

Answer 44

strangulation

Question 45

Strangulation of a hernia can cause:

Answer 45

bowel infarction

Question 46

Signs of strangulation of a hernia

Answer 46

hyperechoic fat thickened hernia sac fluid in the sac thickened bowel loops in the sac

Question 47

Items that must be reported for a hernia evaluation

Answer 47

dynamic maneuvers used in exam presence or absence of hernia hernia size hernia contents reducibility of hernia tender vs nontender during exam

Question 48

one of the most common surgical procedures in the US

Answer 48

herniorrhaphy

Question 49

Hernia repair is usually done using a ___

Answer 49

mesh material

Question 50

Must recurrent hernias form from:

Answer 50

edges of mesh

Question 51

The edges of the mesh should be evaluated with ___

Answer 51

dynamic maneuvers

Question 52

caused by chronically increased intraabdominal pressure or connective tissue weakness

Answer 52

abdominal wall or ventral hernia

Question 53

Weakness in abdominal muscle layers allows protrusion of:

Answer 53

intestines

Question 54

___ can cause intestine to continuously enter and exit wall defect

Answer 54

peristalsis

Question 55

____ can assist in visualization of a ventral hernia

Answer 55

valsalva maneuver

Question 56

____ can be performed to assess tenderness and reducibility of the hernia

Answer 56

compression techniques

Question 57

anterior abdominal wall hernias that penetrate through the linea alba

Answer 57

linea alba hernias

Question 58

thick layer of aponeurosis that separates the rectus abdominis muscles

Answer 58

linea alba

Question 59

weakening of the linea alba without hernia; anterior bulging of linea alba

Answer 59

diastasis recti

Question 60

hernias superior to umbilicus are called

Answer 60

epigastric hernia

Question 61

hernias inferior to the umbilicus are called

Answer 61

hypogastric

Question 62

The most common reason for missing an epigastric linea alba hernia

Answer 62

exam was done for abdominal pain so was performed with low frequency transducer with deep focus

Question 63

___ hernias usually have a narrow neck, are not reducible with increased risk for strangulation

Answer 63

epigastric

Question 64

___ hernias are usually found within a few centimeters of the umbilicus

Answer 64

Hypogastric

Question 65

___ hernias have narrow necks, are usually not reducible, and are at an increased risk for strangulation

Answer 65

hypogastric

Question 66

most common type of ventral hernia

Answer 66

umbilical hernias

Question 67

Nearly all spigelian hernias occur inferior to the ___, where the spigelian fascia is penetrated by the ____ vessels

Answer 67

arcuate line inferior epigastric

Question 68

Spigelian hernias are associated with conditions that:

Answer 68

increase abdominal pressure

Question 69

A spigelian hernia has a __ neck and __ fundus

Answer 69

narrow broad

Question 70

complex mass within the anterolateral aspect of the abdominal wall, could contain fluid or bowels loops; usually mushroom or anvil shaped

Answer 70

spigelian hernia

Question 71

the region of the ilioguinal crease at the junction of the abdomen and the thigh and the adjacent areas immediately above and below

Answer 71

groin

Question 72

A ___ transducer is optimal for a groin ultrasound

Answer 72

high frequency linear >12 MHz

Question 73

In obese patients, a lower-frequency transducer may be needed, usually a ____

Answer 73

7-9 MHz curved array

Question 74

____ in the groin is helpful to assess inflammation and viability of bowel segments protruding through the opening

Answer 74

Color Doppler

Question 75

Dynamic maneuvers in the groin

Answer 75

quiet breathing valsalva maneuver compression maneuver upright position

Question 76

Quiet breathing during a groin exam for a hernia demonstrates ___

Answer 76

bowel peristalsis

Question 77

Performed with the patient supine so that the herniated contents move anteriorly when the strain is applied

Answer 77

Valsalva maneuver

Question 78

A hernia should ___ in size with the valsalva maneuver strain

Answer 78

increase

Question 79

If the hernia does not increase in size with strain, _____ should be suspected

Answer 79

incarceration/strangulation

Question 80

used to assess reducibility and tenderness in patients who have sonographically identifiable hernias

Answer 80

compression maneuver

Question 81

A hernia can be ____ reducible, ___ reducible, or ___

Answer 81

completely partially nonreducible

Question 82

A hernia with a broad fundus and narrow neck is usually ____

Answer 82

nonreducible

Question 83

A hernia with a broad neck and a more narrow fundus is usually ____

Answer 83

reducible

Question 84

Always evaluate the patient in the ___ and ___ position for reducibility

Answer 84

supine upright

Question 85

Delayed imaging in the ___ position may be helpful in demonstrating pooling of any related peritoneal fluid

Answer 85

upright

Question 86

The key landmark in distinguishing among the direct, indirect, and spigelian hernias

Answer 86

inferior epigastric artery

Question 87

The inferior epigastric artery originates at the ___

Answer 87

external iliac artery

Question 88

The inferior epigastric artery courses superomedially across the ____ and the ___

Answer 88

spigelian fascia semilunar line

Question 89

Distally, the inferior epigastric artery courses along the midposterior aspect of the _____

Answer 89

rectus abdominis muscle

Question 90

When attempting to find the inferior epigastric artery, use the transverse plane and scan about halfway between the ____ and the ___

Answer 90

umbilicus pubic symphysis

Question 91

The inferior epigastric artery can be identified along the midposterior surface of the _____ and anterior to the ___

Answer 91

rectus abdominis peritoneum

Question 92

herniated structures medial to the inferior epigastric artery

Answer 92

direct inguinal hernia

Question 93

herniated structures lateral to the inferior epigastric artery

Answer 93

indirect inguinal hernia

Question 94

herniated structures located just lateral to when the spigelian fascia is penetrated by the inferior epigastric artery

Answer 94

spigelian hernias

Question 95

The inguinal ligament extends from the _____ to the ____

Answer 95

anterior superior iliac spine pubic tubercle

Question 96

The inguinal canal runs between the ___ and the ____, superficial to the ___

Answer 96

external oblique transversalis fascia inguinal ligament

Question 97

Weakness in ___ muscles allows pelvic contents to drop into ____

Answer 97

scrotal area

Question 98

The hernia sac is composed of:

Answer 98

peritoneum

Question 99

most common type of groin hernia

Answer 99

indirect inguinal hernia

Question 100

Indirect inguinal hernias are more common in ___

Answer 100

males