Chapter 15 Breast, Abdominal Wall, and Musculoskeletal Sonography

The sinus of a lactiferous duct is located near the:

:Lactiferous ducts are channels that carry milk from the breast loves to the nipple. The sinus is an enlargement of the duct near the areola

A patient presents with a history of sharp burning foot pain radiating to the third and fourth toes. Based on this clinical history, the calipers are most likely measuring a:

A Morton neuroma appears as a hypo echoic inter-metatarsal mass on ultrasound. Patients will complain of sharp pain in the foot radiating toward the toes

A complete tear of the Achilles tendon is most commonly located:

A complete tear of the Achilles tendon is most commonly located in the distal portion of the tendon approximately 2 to 6 cm from the calcaneus (inferior insertion).

A patient presents to the ultrasound department with a palpable umbilical mass. The finding in this sonogram is most consistent for an:

A defect is identified in the anterior abdominal wall allowing extension of the omentum and intestines. This is a hernia.

A retro areolar mass developing shortly after child birth is most suspicious for an:

A galatocele describes a palpable retroareolar mass developing shortly after childbirth. this is most likely caused by an obstruction of the lactating duct.

The hypo echoic linear structure identified by the arrow is most consistent with:

A hyper echoic linear structure is identified in the subcutaneous fat layer of the right breast. This is most consistent with Coopers ligament which provides skeletal framework for the breast.

An afebrile older patient hospitalized with pneumonia presents with a palpable abdominal wall mass. Amass is identified adjacent to the urinary bladder. This finding is most suspicious for an:

A hypo echoic mass within the rectus sheath is identified in the left lower quadrant.

An older patient presents with a history of acute ankle swelling. A sonogram is ordered is ordered to rule out deep vein thrombosis. A non vascular anechoic structure is identified in the popliteal fossa. Based on these sonographic findings, the anechoic structure is most suspicious for a:

A non vascular anechoic fluid collection is identified in the medial portion of the popliteal fossa or knee joint. This is most suspicious for a synovial Baker cyst.

A teenager arrives at the emergency department following a skiing injury. A nonvascular hypoechoic mass is identified in the posterior popliteal fossa. This mass most likely represents an:

A non vascular hyper echoic mass following a recent injury is most suspicious for a hematoma.

What is the normal alpha angle when evaluating for developmental displacement of the hip in a 1 month old infant?

A normal infant hip demonstrates an alpha angle of 60 degrees or greater and a beta angle less than 50 degrees.

The most common benign breast lesion in women between the ages of 35 and 50 is a:

A simple cyst is the most common benign breast lesion in middle aged women. fibroadenomas are more common in young females

A 45 year old women presents with a firm, non tender, palpable breast mass. The finding in this sonogram is most consistent with a:

A well defined anechoic mass demonstrating posterior acoustic shadowing is identified in a middle aged female. This is a simple cyst

In the breast, the lymph vessels gernerally course parallel with the:

Lymph vessels in the breast generally course parallel with the venous system.

Complete absence of one or both breast is termed?

Amastia is defined as the complete absence of one or both breast.

A defect in the muscles of the abdominal wall is most likely related to a:

An abdominal wall defect allows extension of the intestines or omentum.

A lipoma located in the anterior abdominal wall most commonly appears on ultrasound as a

An abdominal wall lipoma most commonly appears on ultrasound as an isoechoic to hypo echoic superficial mass.

A 35 year old woman presents with a history of painful lump on her left wrist. Based on this clinical history, the sonogram is most likely demonstrating a:

An anechoic smooth wall mass that demonstrates posterior acoustic enhancement is identified near the tendon connection to the carpal cone, this is most suspicious for a ganglion cyst.

A patient is referred for an ultrasound to evaluate a mass identified on a recent mammogram.. A radial image of the right breast demonstrates an abnormality most suspicious for:

An ill defined mass demonstrating posterior acoustic shadowing is identified in the upper outer quadrant of the right breast. A possible breach of the superficial fascial plane is also identified. Invasive ductal carcinoma is the most common breast malignanc

A 25 year old woman presents with a firm, non tender, palpable breast mass. An anti radial image of the right breast demonstrates a hypo echoic mass. On the basis of the clinical history, the sonographic finding is most suspicious for a:

An oval shaped well defined hypo echoic mass is identified in a child bearing patient. This is a fibroadenoma.

Which of the following artifacts is likely to occur when the ultrasound beam is not perpendicular with a fibrillar tendon?

Anisotropy can be a problem in musculoskeletal imaging. It is associated with a false hypo echoic area within the tendon. This occurs when the ultrasound beam is not perpendicular with the beam

The breast parenchyma is composed of approximately:

Approximately 15 to 20 individual lobes form the parenchyma of each breast.

Which of the following benign breast neoplasms may undergo malignant transformation?

Cystosarcoma phylloides is an uncommon benign breast neoplasm that may undergo malignant transformation.

Estrogen levels most frequently influence which of the following breast lesions?

Estrogen levels frequently influence fibroadenomas. Mastitis is generally caused by a bacterial infection. Galactoceles are linked to an obstruction of a lactating duct.

The echogenicity of a fatty breast lobule is most commonly described as an:

Fatty breast lobules most commonly demonstrate a medium grey echo pattern moderately hypo echoic.

. Abnormal enlargement of the male breast parenchyma is most likely a clinical finding in which of the following pathologies?

Fatty enlargement of one or both breast in a male patient is a clinical finding of gynecomastia.

Echogenicity of glandular breast tissue when compared to a fatty breast lobule is best described as:

Glandular tissue appears moderately hyper echoic when compared with the normal fatty tissue of the breast. Fatty breast lobules demonstrate a medium level gray echogenicity

When imaging the breast parenchyma, the thickness of the standoff pad should not exceed

In breast imaging, the standoff pad should not exceed 1.0 cm in thickness because of the fixed focus in elevation plane of the transducer

A common malignancy of the breast demonstrating posterior acoustic shadowing describes which of the following neoplasms?

Invasive ductal carcinoma is the most common malignant breast neoplasm. An irregular heterogeneous breast mass demonstrating posterior acoustic shadowing is suspicious for invasive ductal carcinoma.

Painful breast 1 week before the onset of menstruation is a common symptom in which of the following conditions?

Painful or tender breast 7 to 10 days before the onset of menses is mostly likely a symptom of fibrocystic disease.

The most common congenital breast anomaly is:

Polythelia (accessory nipple) is the most common congenital breast anomaly. Amastia describes the complete absence of one or both breast. The presence of a nipple without breast tissue describes amazia. athelia is complete absence of the nipple.

A patient presents with an aching over the right Achilles tendon. A sagittal image of the tendon shows which of the following findings?

Sonographic findings include a homogeneous Achilles tendon demonstrating smooth margins. The thickness of the tendon does not exceed 5 mm. These findings are most consistent with a normal Achilles tendon. Focal disruption is generally identified in a complete or incomplete tear of the tendon.

Which of the following structures is considered the "skeletal" framework in the breast?

Strands of connective tissue provide the support or skeletal framework in the breast parenchyma. These strands are termed Cooper ligaments. they appear as hyper echoic linear structure on ultrasound.

Muscle attaches to bone by which of the following structures?

Tendons attach muscles to bone with bands of dense fibrous tissue binding joints together defines a ligament.

Breast pathology most commonly originates in which of the following structures?

Terminal ductal lobular units are formed by the acini and terminal ducts mealy all breast pathology originates in the TDLU.

Measurement of the Achilles tendon should be made in the:

The Achilles tendon should be measured in the transverse plane. The position of the patient is irrelevant.

Which of the following structures provides support to the breast parenchyma?

The Cooper ligaments provide the shape and support of the breast parenchyma. The pectoralis muscles surround the muscles of the chest.

The Thompson test is used to check the integrity of the:

The Thompson test (pointing the toes while squeezing the calf) is used to check the integrity of the Achilles tendon. A positive Thompson test is suspicious for a ruptured Achilles tendon.

The Valsalva maneuver is a common technique used when evaluating the:

The Valsalva maneuver is a common technique used when evaluating the anterior abdominal wall groin or lower extremity venous system.

Which of the following is the smallest functional unit in the breast parenchyma?

The acini is the smallest functional unit in the breast parenchyma. The lobule is considered the simplest functional unit in the breast parenchyma.

A toddler with a recent upper respiratory infection presents with a history of limping. Asymmetric hip joints are identified on ultrasound. On the basis of the clinical history, the sonographic findings is most suspicious for which of the following conditions?

The anterior recess of the left hip joint is 2.3 mm thicker in diameter when compared to the contralateral right hip. Asymmetry exceeding 2 mm in diameter is considered abnormal. this is septic left hip and can be a complication of a recent infection. clinical findings include limping or change in gait.

The deep layer of the superficial fascia is located within the:

The deep layer of the superficial fascia is located within the retro mammary space. The mammary zone is located between the subcutaneous fat and the retro mammary space.

The fascial interface of the anterior abdominal wall is located directly anterior to the

The fascial interface of the anterior abdominal wall is located directly anterior to the peritoneum. The linea alba rectus abdominis muscles and the subcutaneous fat are located anterior to the fascial plane.

A patient complains of pain in the forearm following a hiking trip. A soft tissue image over the area of discomfort demonstrates a hyperechoic linear structure outlined by the calipers.

The hyper echoic structure is most suspicious for a foreign body. Fascial planes appear as a continuous hyper echoic line. Ligament bind joints togethe

The diameter of the normal lactiferous duct should not exceed:

The lactiferous ducts normally enlarge near the areola but should not exceed 3.0 mm in diameter

The location of the rectus abdominis muscles is described as lateral to the:

The linea alba is a mid line tendon extending from the xiphoid process to the symphysis pubis. the rectus abdominis muscles are located lateral to the linea alba and extend the entire length of the anterior abdominal wall.

A mass is identified in the upper outer quadrants of the of the right breast, near the axilla and chest wall. This mass should be annotated as:

The mass is located in the upper outer quadrant of the right breast (10:00) near the axilla (3) and chest wall(c).

Which of the following joints has the largest range of motion

The muscle and joints of the shoulder allow a full range of motion (360) in the sagittal plane. The shoulder can abduct and adduct, extend in front, behind, above the torso, as well as rotate. This remarkable motion makes the shoulder the most mobile joint in the body.

Which of the following muscles extends the entire length of the anterior abdominal wall?

The rectus abdominis muscles extend the entire length of the anterior abdominal wall. The linea alba is a tendon mot a muscle.

Which of the following most accurately describes the location of the transverse abdominis muscle?

The transverse abdominis muscle is located posterior to both the internal and the external oblique muscles

The thickness of a normal Achilles tendon should not exceed:

Thickness of a normal Achilles tendon should not exceed 7 mm. Tendinitis is suggested after the thickness exceeds 7 mm in diameter.