URR 68 Flashcards by Billie Harney

What are intraluminal extensions/folds that increase surface area for absorption in the jejunum?
a. valvulae conniventes
b. hausta
c. diverticulum
d. gastroesophageal junction

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What vitamin is produced by the colon?
a. D
b. K
c. B12
d. A

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The wall of a normal distended bowel segment will demonstrate __ layers and measure ___mm thick.
a. 4, <4
b. 3, <3
c. 5, <3
d. 2, <3

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Which of the following is a hormone that stimulates the digestive system?
a. gastrin
b. secretin
c. cholecystokinin
d. all the above

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Hematocrit levels can be tested to evaluate suspected ___, while white blood cell levels can be tested to evaluate suspected ___.
a. GI bleed, infection
b. diverticulitis, anemia
c. carcinoma, sarcoma
d. infection, anemia

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Graded compression and deep breathing can be used:
a. to slow peristalsis
b. to displace gas out of the field of view
c. to correct intussusception
d. to correct pyloric stenosis

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The celiac axis branches into:
a. hepatic, renal, and left gastric arteries
b. hepatic, splenic, and left gastric arteries
c. gastric, colic, and splenic arteries
d. splenic, renal, and gonadal arteries

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The seagull sign refers to the:
A. sma
B. ima
c. celiac axis
d. renal arteries

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What causes stenosis in median arcuate ligament syndrome?
a. soft plaque
b. inflamed vessel walls
c. thrombus
d. compression

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Evaluation of what artery is typically performed before and after eating?
a. SMA
b. Renal
c. gastric
d. aorta

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If you locate the renal artery origins in the transverse plane and slide inferiorly, what vessel can be seen coursing anterior to the aorta?
a. IMA
b. SMA
c. Celiac axis
d. gonadal artery

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Which of the following indicates mesenteric ischemia?
a. dilated IMA
b. retrograde flow in the hepatic artery
c. portal venous gas
d. all the above

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The olive, doughnut, and cervix signs are indications of:
a. mesenteric stenosis
b. intussusception
c. pyloric stenosis
d. bezoar

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Patients evaluated for pyloric stenosis are typically __ in age and evaluated with ultrasound with the patient in the ___ position.
a. 2-10 weeks, right lateral decubitus
b. 3-4 months, prone
c. less than 1 month, supine
d. less than 6 months, left lateral decubitus

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Which of the following measurements should be obtained when evaluating a patient for suspected pyloric stenosis?
a. muscle thickness
b. channel length
c. cross section thickness
d. all the above

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Which of the following is evaluated on patients with suspected inflammatory bowel disease?
a. BUN and creatinine
b. PT and INR
c. Fecal testing
d. urinalysis

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Creeping fat and the pseudokidney sign findings associated with:
a. appendicitis
b. Pyloric stenosis
c. Crohn disease
d. all the above

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Acute RLQ pain is commonly associated with ___, while acute LLQ pain is commonly associated with ___.
a. appendicitis, diverticulitis
b. diverticulitis, Crohn disease
c. colitis, diverticulitis
d. diverticulitis, Crohn disease

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Which of the following correctly describes ulcerative colitis?
a. associated with Marfan Syndrome
b. usually affects the jejunum
c. causes portal venous gas
d. all the above

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The normal appendix is identified posterior to the ____ and anterior to the ___.
a. right kidney, terminal ileum
b. terminal ileum, iliac vessels
c. iliac vessels, rectus abdominis
d. left kidney, iliac vessels

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The McBurney sign is associated with ___, while the Murphy sign is associated with ___.
a. diverticulitis, appendicitis
b. appendicitis, Crohn disease
c. Crohn disease, hepatitis
d. appendicitis, cholecystitis

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The appendix can be obstructed by:
a. fecalith
b. coprolith
c. stercolith
d. all the above

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What is the primary purpose for using graded compression during an ultrasound evaluation of the gastrointestinal tract?
a. to cause peristalsis
b. to dislodge an obstruction
c. to evaluate intraluminal thrombus formation
d. all the above

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If the appendix is obstructed by a fecalith, a ___ typically forms.
a. mucocele
b. abscess
c. phlegmon
d. cyst

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Epiploic appendagitis is most likely to be mistaken sonographically for ___. a. pyloric stenosi b. intussusception c. appendicitis d. Crohn disease

How can you differentiate Epiploic Appendagitis from appendicitis? a. apply color Doppler b. Document the gut wall signature c. ask the patient to perform the Valsalva maneuver d. apply graded compression

Which GI tract abnormality presents as anemia, dehydration, red currant jelly stool, and leukocytosis? a. pyloric stenosis b. appendicitis c. diverticulitis d. intussusception

How is midgut malrotation diagnosed? a. documenting the position of the aorta and IVC b. Documenting the position of the SMA and SMV c. Documenting the position of the gallbladder and liver d. documenting the position of the right and left kidneys

____ and ___ increase the risk of development dysplasia of the hip.

oligohydramnios breech position

___ are more commonly affected with developmental hip dysplasia.

females

The ___, ___, and ___ form the hip socket.

ilium ischium pubis bone

____ is located laterally where the hip socket bones meet.

acetabulum

___ is very cartaliginous at birth, allows penetration of US beam

femoral head

Ossification of the femoral head begins as early as __ months of age, starts ___ and moves ___

2 centrally peripherally

It is important to evaluate infant hips between __ and __ weeks of age

4 6

If the infant hips are evaluated too early, the hips are lax due to ___ with birth.

hormonal stimulation

If the infant hips are evaluated too late, ___

the femoral head will be too ossified to evaluate with ultrasound

Radiography for infant hip evaluation must be used if the patient is older than __ months because of femoral head ossification

Symptoms of developmental hip dysplasia

hip click of physical exam limited abduction prominent trochanter short femur skin fold assymetry

What kind of transducer is used to evaluate infant hips?

5-7.5 MHz linear transducer

All scanning of the infant hips is done from the ___ or ___ aspect of the joint

lateral posterolateral

The infant hip examination is performed with and without stressing the ___

hip joint

Image labels for infant hip evaluation

scan plane neutral or flexed stress or no stress

The normal hip should always be seated in the acetabulum when __, __, and __

rest flexed stressed

"ball in spoon" appearance

coronal view of infant hips

used to measure alpha and beta angles

coronal view of infant hips

The coronal view of the infant hips demonstrates:

femoral head within acetabulum

Three lines are drawn on coronal image of infant hips for measurements

1. aligned with iliac bone and courses through femoral head 2. extends from the iliac bone along the labrum and the medial aspect of the femoral head 3. extends from the bony edge of the acetabulum to the lateral aspect of the femoral head

The alpha angle is measure between lines __ and __

1 2

The alpha angle is formed by the ___ to the ____

acetabular roof vertical cortex of the iliac bone

The normal alpha angle value is:

greater than or equal to 60 degrees

An alpha angle less than 60 degrees suggests ___, ___, or ___

dysplasia subluxation dislocation

The beta angle is measured between lines __ and __

1 3

The beta angle is formed between the ___ and ___

vertical cortex of the iliac bone triangular labral fibrocartilage (echogenic triangle)

The beta angle is not universally used to assess ___

dysplasia

Performed by rotating probe 90 degrees to coronal view

transverse view

The transverse view of the infant hips is usually obtained with:

hip in flexed position

In the transverse view, demonstrates "__" shape formed by femoral shaft and ischium as they surround the femoral head

Loss of the "U" shape indicates:

hip dislocation

attempt to push the femoral head out of the hip socket posteriorly; attempt to see if the hip can be dislocated

Barlow maneuver

attempt to reduce an acutely dislocated hip

Ortolani maneuver

Positive Ortolani maneuver

palpable "clunk" sound with manipulation

visual shortening of the femur(s) when the hip(s) and knee(s) are flexed; asymmetric folds of the skin around the thigh at the hip area may be noted

Allis or Galeazzi sign

Gradual migration of the femoral head from the acetabulum because the joint capsule is loose

developmental dysplasia of the hip

femoral head moves partially out of the acetabulum

subluxation

femoral head moves completely out of the acetabulum

dislocation

Developmental dysplasia is more common in ___

first born child

Risk factors for developmental dysplasia of the hip

oligohydramnios breech delivery family history foot deformities abnormal clinical exam

based on the position of the femoral head related to the acetabulum; uses alpha and beta angles

Graf Classification

Alpha angle less than __ degrees suggests abnormal findings

Alpha angle <__ degrees indicates dislocation

another technique used to assess for DDH; not as accurate as alpha angle assessment; evaluation of how well the femoral head sits posteriorly within the acetabulum

femoral head coverage

Average femoral head coverage

55%

Pediatric hip evaluation is performed for signs of ___ or ___

effusion inflammation

Symptoms of abnormal pediatric hips

refusal to walk/stand limping hip pain fever

When performing a pediatric hip evaluation us a ___ probe in an ___ plane on the __ hip.

linear oblique anterior

Normal pediatric hip capsule is _-_ mm thick; should be symmetric between hips

2 5

Common cause of hip pain in children

transient arthritis

may present with a history or recent respiratory infection, no fever at the onset of the hip pain; treated with anti-inflammatory meds

transient arthritis

In septic arthritis, ___ causes __

bacterial infection inflammation

Symptoms of septic arthritis

fever increased WBC count hip pain

Septic arthritis is considered a medical emergency to prevent ___

long term joint damage

Septic arthritis requires us guided ____ for fluid evaluation and is treated with ____

arthrocentesis IV antibiotics

composed of dense connective tissue that contains collagen fibers

tendons

connective sheath that wraps around each tendon

peritenon

____ protects some tendons by maintain flat contact with the bone

Fibrous sheath

____ protects some tendons with a double layer of tissue with a small amount of synovial fluid between the layers

Synovial sheath

small fluid filled pockets that facilitate tendon movement

synovial bursae

What kind of transducer should be used to evaluate tendons?

7.5 MHz-20 MHz linear array transducer

___, ___, and ___ (trapezoid FOV) are used to evaluate the length of the tendon.

panoramic view extended field of view beam steering

All tendons should be evaluated ___ and with ____.

at rest multiple maneuvers

___ views are used for most accurate measurement of tendon thickness

transverse

___ is used to reduce speckle and improve boundary visualization

spatial compounding

Sonographic appearance of tendons

medium echogenicity with a fibrillar echotexture hyperechoic to surrounding musculature

In comparison to tendons, ___ demonstrate a thinner, more compact fibrillar echotexture

ligaments

__ demonstrate hypoechoic tissue with echogenic fascial lines within and around the tissue

muscle

Nerves are ___ to tendons and ___ to muscle

hypoechoic hyperechoic

falsely hypoechoic areas of tendon; occurs when transducer is not completely parallel to the tendon

anisotropy artifact

reduced by rocking the transducer to make the face of the transducer more parallel to the tendon

anisotropy artifact

Curved tendons can be straightened by:

muscular contraction

URR 68 Flashcards

(100 cards)