URR 65

Question 1

An indirect inguinal hernia is due to ____, ___ or ___

Answer 1

fetal migration of testis, spermatic cord, or round ligament penetration of the pelvic floor

Question 2

Indirect inguinal hernias are associated with abnormal movement of fat, bowel, or both through the ___ and the ___

Answer 2

deep inguinal ring
inguinal canal

Question 3

In an indirect inguinal hernia, the neck lies superior and lateral the:

Answer 3

inferior epigastric artery origin

Question 4

In an indirect inguinal hernia, the ___ is oriented horizontally and expands inferior and medial, passing superficial to the IEA origin.

Answer 4

fundus

Question 5

In an indirect inguinal hernia, the inguinal hernia sac lies anterior and lateral to the ___ in males and the __ in females

Answer 5

spermatic cord
round ligament

Question 6

Sliding inguinal hernia

Answer 6

wide neck, usually reproducible

Question 7

Nonsliding hernia

Answer 7

narrow neck, usually non reproducible

Question 8

In a direct inguinal hernia, intra-abdominal structures move anteriorly through the ____ at the ____

Answer 8

aponeuroses
Hesselbach triangle

Question 9

layers of fibrous tissue that connect sheet-like muscles needing a wider area of attachment

Answer 9

aponeuroses

Question 10

The Hesselbach triangle is bordered inferiorly by the ___, medially by the _____, and superolaterally by the ___

Answer 10

inguinal ligament

lateral aspect of the rectus abdominis muscle

inferior epigastric artery

Question 11

In a direct inguinal hernia, the ___ lies inferior and medial to the ____ origin

Answer 11

inferior epigastric artery

Question 12

In a direct inguinal hernia, the inguinal sac lies posterior and medial to the ____ in males and the ___ in females

Answer 12

spermatic cord
round ligament

Question 13

rare inguinal hernia that contains the appendix

Answer 13

amyand hernia

Question 14

delayed complication of abdominal surgery; occurs in first few months after surgery

Answer 14

incisional hernia

Question 15

Incisional hernia are most common with ___ than with ___ incisions

Answer 15

vertical
transverse

Question 16

___, ___, and ___ patients have an increased risk on an incisional hernia

Answer 16

elderly
obese
malnourished

Question 17

Incisional hernias are associated with _____

Answer 17

transverse rectus abdominis myocuteaneous flap breast reconstruction surgery

Question 18

occur in areas where vessels penetrate the abdominal wall

Answer 18

femoral hernia

Question 19

A femoral hernia is located:

Answer 19

below the inguinal ligament

Question 20

In a femoral hernia, abnormal intraabdominal contents move inferiorly through the ____

Answer 20

femoral canal

Question 21

Femoral hernias are more common in ___

Answer 21

women

Question 22

Femoral hernias are more common on the ___ side.

Answer 22

right

Question 23

With a femoral hernia, the hernia sac usually lies medial to the ___

Answer 23

common femoral vein

Question 24

The most common use of chest sonography is to evaluate a:

Answer 24

radiopaque hemithorax

Question 25

___ and ___ are the most common causes for pleural effusion

Answer 25

congestive heart failure malignancy

Question 26

___, ___, and ____ are the most common locations for ascites in a supine patient.

Answer 26

paracolic gutters Morrison pouch pouch of Douglas

Question 27

___ and ___ are the most common causes for ascites

Answer 27

cirrhosis malignancy

Question 28

____ is the most common site of retroperitoneal infection

Answer 28

anterior pararenal space

Question 29

____ are the most common retroperitoneal mass

Answer 29

liposarcomas

Question 30

The most common reason for missing a ventral hernia is that the examination for abdominal pain was performed with:

Answer 30

low frequency transducer with deep focus

Question 31

___ are the most common ventral hernia

Answer 31

umbilical hernias

Question 32

____ are commonly mistaken for an incisional hernia

Answer 32

abdominal wall endometriomas

Question 33

___ is the most common type of groin hernia and most common in males

Answer 33

indirect inguinal hernia

Question 34

M-mode is commonly used to evaluate a patient for: a. thymus enlargement b. pneumothorax c. pneumonia d. lung sequestration

Answer 34

b

Question 35

In pediatric patients, the thymus offers an acoustic window to evaluate: a. the SCV b. the aorta c. the pulmonary artery d. all the above

Answer 35

d

Question 36

What causes the diaphragm to appear highly echogenic on ultrasound evaluation? a. refraction b. diffraction c. specular reflection d. impedance

Answer 36

c

Question 37

In cases of pneumothorax, what sign is identified on ultrasound evaluation? a. Gliding sign b. seashore sign c. barcode sign d. all the above

Answer 37

c

Question 38

Transudate pleural effusion is related to: a. congestive heart failure b. malignancy c. lupus d. tuberculosis

Answer 38

a

Question 39

Exudate pleural effusion is related to: a. congestive heart failure b. renal failure c. malignancy d. liver failure

Answer 39

c

Question 40

Which of the following are signs of pleural effusion? a. diaphragm sign b. displaced crus sign c. bare area sign d. all the above

Answer 40

d

Question 41

Lactate dehydrogenase concentration can be used to differentiate: a. ascites from pleural effusion b. transudate from exudate effusion c. seroma from hematoma d. lymphocele from seroma

Answer 41

b

Question 42

US is used to evaluate the ___ for hernia formation. a. anterior parietal peritoneum b. posterior parietal peritoneum c. posterior visceral peritoneum d. omental bursa

Answer 42

a

Question 43

The __ is called the foramen of Winslow and the ___ is called the Morison pouch. a. right suprahepatic (subphrenic) space, right subhepatic space b. left anterior suprahepatic (subphrenic) space, left subhepatic space c. right subhepatic space, hepatorenal space d. hepatorenal space, paracolic gutters

Answer 43

c

Question 44

Liver disease causes a reduction in __ levels which are associated with ascites formation. a. lactate dehydrogenase b. BUN c. Creatinine d. Albumin

Answer 44

d

Question 45

Ascites with debris and septations is associated with: a. malignancy b. infection c. internal bleeding d. all the above

Answer 45

d

Question 46

The retroperitoneum is located between the: a. psoas and quadratus lumborum muscles b. parietal peritoneum and transversalis fascia c. rectus abdominis muscles and linea alba d. diaphragm and mesentery

Answer 46

b

Question 47

___ is a malignant fatty mass of the retroperitoneum, while ___ is a malignant retroperitoneal mass of the muscle tissues a. myxoma, mesothelioma b. liposarcoma, rhabdomyosarcoma c. fibrosarcoma, leiomysarcoma d. lipoma, fibroma

Answer 47

b

Question 48

Which of the following is a sign of an abnormal lymph node:? a. ovoid shape b. no visible hilum c. No posterior enhancement d. all the above

Answer 48

b

Question 49

An enlarged, rounded lymph node with loss of hilar definition = suspicious for __. An enlarged, oval lymph node with normal hilar characteristics = suspicious for __. a. infection, inflammation b. inflammation, infection c. malignancy, infection d. lymphoma, leukemia

Answer 49

c

Question 50

Which of the following can cause hydronephrosis, pedal edema, and scrotal swelling in a male patient? a. Ormond disease b. Marfan Syndrome c. Ehlers-Danlos syndrome d. Crohn disease

Answer 50

a

Question 51

Rectus abdominis muscle originates at the __ and extends to the ___. a. iliac crest, lateral ribs b. sternal notch, iliac crest c. symphysis pubis, xiphoid process d. symphysis pubis, sternum

Answer 51

c

Question 52

Which of the following are required when evaluating a patient with a suspected anterior wall hernia? a. ask them to perform the valsalva maneuver b. scan them standing up c. obtain comparison views of the unaffected sides d. all the above

Answer 52

d

Question 53

Injury to the ___ is the most common cause of hematoma formation in the anterior abdominal wall. a. aorta b. umbilical vein c. inferior epigastric artery d. azygos vein

Answer 53

c

Question 54

Stretching of the linea alba pregnancy results in what chronic issue? a. hematoma formation b. diastasis recti c. femoral hernia d. spigelian hernia

Answer 54

b

Question 55

How can you differentiate diastasis recti from a ventral hernia? a. the size of the fascial defect b. the location of the fascial defect c. the presence of a fascial defect d. the presence of a hematoma at the defect

Answer 55

c

Question 56

A narrow, rigid, or angled hernia neck increases the risk of: a. hemorrhage b. infection c. reduction d. strangulation

Answer 56

d

Question 57

An incarcerated hernia cannot be: a. reduced b. strangulated c. identified on ultrasound d. evaluated with doppler

Answer 57

a

Question 58

When reporting findings from an ultrasound evaluation for a hernia, which of the following must be included? a. dynamic maneuvers used in the exam b. hernia contents c. reducibility of hernia d. all the above

Answer 58

d

Question 59

The most common reason for missing an epigastric linea alba hernia is that the examination for abdominal pain was performed: a. with a low frequency transducer with deep focus b. without harmonic imaging c. with spatial compounding deactivated d. without applying color Doppler

Answer 59

a

Question 60

What is the key landmark in distinguishing among the direct, indirect, and spigelian hernias? a. linea alba b. iliac arteries c. inferior epigastric artery d. umbilicus

Answer 60

c

Question 61

If the hernia does not increase in size with Valsalva strain, __ should be suspected. a. strangulation b. incarceration c. ischemia d. all the above

Answer 61

d

Question 62

extends from the pharynx to the cardiac orifice of the stomach

Answer 62

esophagus

Question 63

The ___ technique is used to identify the esophagus in the neck

Answer 63

swallowing

Question 64

point where the esophagus passes through the diaphragm and joins the stomach

Answer 64

esophagogastric junction

Question 65

Identified in the longitudinal view anterior to the aorta and posterior to the left lobe of the liver

Answer 65

esophagogastric junction

Question 66

3 segments of the stomach

Answer 66

body fundus pylorus

Question 67

The stomach secretes ___, ___, and ___ for digestion.

Answer 67

pepsinogen bicarbonate hydrochloric acid

Question 68

The contents of the stomach cause variation in the sonographic appearance but the ____ is constant

Answer 68

gut wall signature

Question 69

The small bowel is ___peritoneal except for the 2nd-4th portions of duodenum which are ___peritoneal

Answer 69

intra retro

Question 70

The small bowel is responsible for ____

Answer 70

nutrient absorption

Question 71

C shaped first portion of the small bowel

Answer 71

duodenum

Question 72

The small bowel is divided into 4 sections, ____ sections usually seen on US

Answer 72

first two

Question 73

The duodenum ends at the ___

Answer 73

jejunum

Question 74

The Ampulla of Vater is located in the ___ segment of the small bowel

Answer 74

second

Question 75

The ___ secretes mucus to protect the small bowel from acid

Answer 75

ampulla of vater

Question 76

second portion of small bowel

Answer 76

jejunum

Question 77

The ___ demonstrates a stepladder configuration

Answer 77

Jejunum

Question 78

intraluminal extensions/folds that increase surface area for absorption

Answer 78

valvulae conniventes

Question 79

Valvulae conniventes are abundant in ___ small bowel, but decreased in number in ___ small bowel loops.

Answer 79

proximal distal

Question 80

Valvulae conniventes are more abundant in the ___ than in the distal ___

Answer 80

jejunum ileum

Question 81

The jejunum has a feathery appearance on ultrasound due to the ____

Answer 81

valvulae conniventes

Question 82

terminates at the cecum portion of the colon in the RLQ

Answer 82

ileum

Question 83

The ____ controls flow from small to large bowel

Answer 83

ileocecal

Question 84

Bacteria in the colon produce ____ that plays a role in blood cotting

Answer 84

Vitamin K

Question 85

begins with the cecum portion that connects to the ileum of the small intestine and extends to hepatic flexure

Answer 85

ascending colon

Question 86

The appendix most commonly attaches to the ___

Answer 86

cecum

Question 87

begins at the hepatic flexure and ends at the splenic flexure

Answer 87

transverse colon

Question 88

from splenic flexure to sigmoid

Answer 88

descending colon

Question 89

terminal segment of colon

Answer 89

sigmoid colon

Question 90

accessory glands of the digestive tract

Answer 90

salivary glands pancreas liver

Question 91

The ANATOMIC gut wall layers

Answer 91

Mucosa Submucosa muscularis serosa

Question 92

epithelial line of gut wall (and lumen); echogenic

Answer 92

superficial mucosa

Question 93

gut wall layer that consists of loose connective tissue and muscularis mucosa; hypoechoic

Answer 93

deep mucosa

Question 94

gut wall layer echogenic; in between the deep mucosa and the muscularis propia

Answer 94

submucosa

Question 95

gut wall layer made of inner circular fibers and outer longitudinal fibers; hypoechoic

Answer 95

muscularis propia

Question 96

outside layer of gut wall; echogenic

Answer 96

serosa or adventitia

Question 97

Sonographically, you should see __ layers of the gut wall

Answer 97

5

Question 98

Normal wall thickness in distended bowel <__

Answer 98

3mm

Question 99

Normal wall thickness in non-distended bowel < __

Answer 99

5mm

Question 100

____ of the colon may be identified as a series of echogenic lobulations some refer to as the keyboard sign

Answer 100

Haustra