ABD Board: Abdominal Vasculature, GI, Abdominal Wall, Non-Cardiac Chest, Retroperitoneum

enlargement of the diameter of the abdominal aorta to greater than 3 cm

Abdominal Aortic Aneurysm

vascular filter placed in the inferior vena cava to prevent emboli

IVC filter

A disorder of the connective tissue characterized by tall stature and aortic and mitral valve insufficiency is

Marfan Syndrome

14. What flow pattern would the postprandial SMA yield in small bowel ischemia? a. high resistance b. low resistance

a. high resistance

8. All of the following are branches of the celiac axis except: a. right gastric artery b. hepatic artery c. splenic artery d. left gastric artery

a. right gastric artery

inflammation of the appendix

acute appendicitis

a dense, calcified stone within the appendix

appendicolith

10. What should the postprandial flow pattern be within the SMA? a. high resistance b. low resistance

b. low resistance

15. An AAA is present when the diameter of the abdominal aorta exceeds: a. 10 mm b. 2.5 mm c. 3 cm d. 2 mm

c. 3 cm

2. A disorder of the connective tissue characterized by tall stature and aortic and mitral valve insufficiency is: a. Wilms syndrome b. Meckel-Gruber Syndrome c. Marfan Syndrome d. Kleinman Syndrome

c. Marfan Syndrome

a sonographic sign associated with pyloric stenosis in the long axis

cervix sign

operator-applied transducer pressure on a structure during a sonographic examination

compression

16. Occlusion of the hepatic veins describes: a. Marfan syndrome b. Klinefelter Syndrome c. Morrison syndrome d. Budd-Chiari Syndrome

d. Budd-Chiari Syndrome

17. The most common shape of an AAA is: a. saccular b. bulbous c. true d. fusiform

d. fusiform

36. Enlargement of the IVC, with subsequent enlargement of the hepatic veins, is seen in cases of: a. Budd-Chiari Syndrome b. Marfan Syndrome c. left-sided heart failure d. right sided heart failure

d. right sided heart failure

the inflammation of diverticula within the digestive tract, most often in the sigmoid colon

diverticulitis

the development of small out pouchings termed diverticuli in the digestive tract, most often the sigmoid colon

diverticulosis

a stone that consists of feces

fecalith

shaped like a spindle; wider in the middle and tapering toward the ends; type of AAA

fusiform

the junction between the stomach and the esophagus

gastroesophageal junction

blood flow toward the liver

hepatopetal

the proximal segment of the bowel with intussusception

instussusceptum

observation of the intimal layer of a vessel as a result of a dissection

intimal flap

the telescoping of one segment of bowel into another; most often the proximal segment of the bowel inserts into the distal segment

intussusception

the distal segment of bowel with intussusception

intussuscipiens

to insert

invaginate

a bezoar that consists of powdered milk

lactobezoar

a malignant form of cancer found often on the skin

melanoma

abnormal rotation of the bowl that leads to a proximal small bowel obstruction

midgut malrotation

an aneurysm caused by infection

mycotic aneurysm

when the pyloric sphincter muscle is enlarged and palpable on physical examination of the abdomen; often indicative of pyloric stenosis

olive sign

a condition resulting in interruption or reduction of the blood supply to the small intestines

small bowel ischemia

another term for blood clot

thrombus

a malignant tumor of the urinary tract that is often found within the urinary bladder or within the renal pelvis

transitional cell carcinoma

the true or original channel within a vessel

true lumen

a syndrome described as the occlusion of the hepatic veins, with possible co-existing occlusion of the IVC

Budd-Chiari Syndrome

an autoimmune disease characterized by periods of inflammation of the gastrointestinal tract

Crohn disease

a point halfway between the anterior superior iliac spine and the umbilicus; the area of pain and rebound tenderness in patients suffering from acute appendicitis

McBurney point

a common congenital out pouching of the wall of the small intestine

Meckel Diverticulum

the most common solid malignant pediatric abdominal mass. A malignant pediatric renal mass that may also be referred to as nephroblastoma

Wilms Tumor

11. the second main branch of the abdominal aorta is the: a. SMA b. celiac artery c. renal arteries d. hepatic artery

a. SMA

33. What abnormality would the failure of an EVAR to isolate an aneurysm from most likely result in? a. endoleak b. aortic dissection c. pulmonary embolism d. deep venous thrombosis

a. endoleak

32. What vessel travels directly anterior to the left renal artery? a. left renal vein b. hepatic artery c. right renal vein d. superior mesenteric vein

a. left renal vein

4. What vessel can be noted coursing between the SMA and the abdominal aorta in the transverse scan plane? a. left renal vein b. left renal artery c. right renal vein d. right renal artery

a. left renal vein

40. Which of the following statements about the abdominal aorta is not true? a. most aneurysms located within the abdominal aorta are false aneurysms b. the abdominal aorta is located just left of the midline c. the most common location of an AAA is infrarenal d. the abdominal aorta is considered to be retroperitoneal in location

a. most aneurysms located within the abdominal aorta are false aneurysms

35. Which vessel would be the shortest in length? a. right renal vein b. right renal artery c. left renal vein d. left renal artery

a. right renal vein

22. The main portal vein is created by the union of the: a. splenic vein and superior mesenteric vein b. superior mesenteric vein and inferior mesenteric vein c. splenic vein and inferior mesenteric vein d. splenic vein and gastroduodenal vein

a. splenic vein and superior mesenteric vein

cancer originating in glandular tissue

adenocarcinoma

any dilation of a blood vessel, whether focal or diffuse

aneurysm

a disease characterized by the accumulation of plaque within the walls of the arteries

atherosclerosis

a disorder in which the immune system attacks normal tissue

autoimmune disorder

38. The diameter of the IVC should never exceed: a. 1.5 cm b. 2.5 cm c. 3.5 cm d. 8 mm

b. 2.5 cm

7. Which of the following is not true about the abdominal aorta? a. the abdominal bifurcates into the common iliac arteries b. The proximal aorta is situated more anterior than the distal aorta c. the aorta has a thicker tunica media than the IVC d. the third major branches of the abdominal aorta are the renal arteries

b. The proximal aorta is situated more anterior than the distal aorta

3. The inner wall layer of a vessel, closest to the passing blood is the: a. Tunica media b. Tunica intima c. Tunica rugae d. Tunica adventitia

b. Tunica intima

5. The main visceral branch of the abdominal aorta is the: a. SMA b. celiac artery c. renal arteries d. hepatic artery

b. celiac artery

30. Which of the following would most likely yield a high-resistance flow pattern? a. celiac artery b. common iliac artery c. splenic artery d. right renal artery

b. common iliac artery

37. Which of the following would have a pulsatile triphasic blood flow pattern? a. renal veins b. hepatic veins c. gonadal veins d. common iliac veins

b. hepatic veins

31. What vessel may attach to the splenic vein before reaching the portal confluence? a. left renal vein b. inferior mesenteric vein c. right renal vein d. celiac vein

b. inferior mesenteric vein

34. A patient presents to the sonography department with a history of Marfan syndrome. The sonographic evaluation reveals a linear echo within the aortic lumen that extends from the celiac axis to the iliac arteries. Color Doppler reveals flow throughout the aorta on both sides of the linear echo. The patient has had no surgeries, and there is no AAA. What does the linear echo most likely represent? a. calcific thrombus b. intimal flap c. EVAR d. Aortic filter

b. intimal flap

26. The hepatic artery should demonstrate: a. high resistance flow b. low resistance flow

b. low resistance flow

25. Which of the following is not a section of the IVC? a. post renal b. pancreatic c. pre renal d. hepatic

b. pancreatic

20. The IVC terminates as the a. common iliac veins b. right atrium c. left atrium d. left ventricle

b. right atrium

masses of various ingested materials that may cause an intestinal obstruction

bezoars

28. An outpatient with a history of back pain and hypertension presents to the ultrasound department for an abdominal aortic sonogram. Sonographically, you visualize a 6 cm infrarenal aortic aneurysm with an echogenic linear structure noted gently swaying in the aortic lumen. What is the most likely diagnosis? a. aortic rupture b. chronic aortic aneurysm c. aortic dissection d. aortic rupture

c. aortic dissection

18. What branch and its tributaries of the abdominal aorta appear as a "seagull" in the transverse plane? a. SMA b. hepatic artery c. celiac artery d. common iliac artery

c. celiac artery

23. The veins seen attaching to the IVC just below the diaphragm are the: a. renal veins b. superior mesenteric vein c. hepatic veins d. celiac axis

c. hepatic veins

29. The left gonadal vein drains directly into the: a. IVC b. superior mesenteric vein c. left renal vein d. left iliac vein

c. left renal vein

24. The aorta originates at the: a. left atrium b. right atrium c. left ventricle d. right ventricle

c. left ventricle

1. In the sagittal plane, you recognize a circular, anechoic vascular structure posterior to the IVC. Which of the following would this structure be most likely? a. abdominal aorta b. left renal vein c. right renal artery d. SMA

c. right renal artery

39. Which of the following statements about the IVC is not true? a. the diameter of the IVC is variable b. respiration can affect the size of the IVC c. the IVC is located to the left of the abdominal aorta d. the IVC is considered retroperitoneal in location

c. the IVC is located to the left of the abdominal aorta

a sonographic sign associated with the appearance of intussusception

cinnamon bun sign

12. which of the following vessels show a different flow pattern after eating? a. celiac artery b. splenic artery c. renal artery d. SMA

d. SMA

19. Which vascular structure may be confused for the main pancreatic duct? a. hepatic artery b. left gastric artery c. SMA d. Splenic artery

d. Splenic artery

27. Clinical findings of a AAA include all of the following except: a. lower extremity pain b. back pain c. abdominal bruit d. elevated hematocrit

d. elevated hematocrit

13. Which of the following vessels would most likely yield a high-resistance flow pattern? a. celiac artery b. common hepatic artery c. renal artery d. fasting SMA

d. fasting SMA

6. An aneurysm associated with infection is termed: a. recanalized b. saccular c. fusiform d. mycotic

d. mycotic

21. A patient presents with unexplained abdominal pain for a vascular assessment of the SMA. Sonographically, you note that the patient's SMA yields a persistent high-resistive flow pattern. This is indicative of: a. Crohn Disease b. Intussusception c. Bowel obstruction d. small bowel ischemia

d. small bowel ischemia

9. The outer wall layer of a vessel is the: a. tunica media b. tunica intima c. tunica rugae d. tunica adventitia

d. tunica adventitia

a sonographic sign associated with pyloric stenosis in the short axis

doughnut sign

the proximal portion of the duodenum closest to the stomach

duodenal bulb

a blockage caused by an abnormal mass (embolus) within the bloodstream that hinders circulation downstream, leading to tissue damage

embolism

functional endometrial tissue located outside the uterus

endometriosis

nonsurgical method for treating abdominal aortic aneurysms

endovascular aortic stent graft repair

a contained rupture of a blood vessel that is most likely secondary to the disruption of one or more layers of that vessel's wall

false aneurysm /pseudoaneurysm

The residual channel of a vessel created by the accumulation of a clot within that vessel

false lumen

an abnormality in which the fluid is allowed to reflux out of the stomach back into the esophagus

gastroesophageal reflux

the flow pattern that results from small arteries or arterioles that are contracted, which produces an increase in the resistance to blood flow to the structure that is being supplied

high-resistance flow

a defect in the relaxation of the pyloric sphincter that leads to the enlargement of the pyloric muscles and closure of the pyloric sphincter

hypertrophic pyloric stenosis

an elevated white blood cell count

leukocytosis

the flow pattern characterized by persistent forward flow throughout the cardiac cycle

low-resistance flow

a situation in which bowel is physically blocked by something

mechanical obstruction

not containing bile

nonbilious

a situation in which the bowel is blocked because of the lack of normal peristalsis of a bowel segment or segments; also referred to as paralytic ileus

nonmechanical obstruction

after a meal

post-prandial

blood clot that has traveled to the lungs and is obstructing the pulmonary arterial circulation, most often the result of a deep venous thrombosis

pulmonary embolus

a saclike dilation of a blood vessel (type of AAA)

sacular

the enlargement of a vessel that involves all three layers of the wall

true aneurysm

the outer layer of a vessel

tunica adventitia or tunica externa

the inner wall layer of a vessel

tunica intima

the middle, muscular layer of a vessel

tunica media