Superficial Structures Review

When imaging the breast parenchyma, the thickness of the standoff pad should not exceed? a. 0.5cm b. 1cm c. 2cm d. 2.5cm e. 3cm

b. 1cm

Which of the following is not a sonographic sign of tendonitis? a. thickening of the tendon b. absence of vascularity on color Doppler imaging c. decreased echogenicity d. blurred margins e. calcifications in chronic tendonitis

b. absence of vascularity on color Doppler imaging

Bullets, shrapnel, and other metallic objects may cause: a. acoustic enhancement b. comet-tail artifact c. edge enhancement d. mirror image artifact

b. comet-tail artifact

Clinical findings of a baker cyst may mimic those of a/an: a. arteriovenous malformation b. deep venous thrombosis c. knee fracture d. ganglion cyst

b. deep venous thrombosis

A retroareolar mass developing shortly after childbirth is most suspicious for: a. fibroadenoma b. galactocele c. hamartoma d. cystosarcoma phyllodes e. invasive ductal carcinoma

b. galactocele

The location of the rectus abdominus muscles is described as lateral to the: a. iliac crests b. linea alba c. external oblique muscles d. internal oblique muscles e. psoas muscles

b. linea alba

Which of the following would be best described as a benign tumor composed of fat? a. hemangioma b. lipoma c. hamartoma d. oncocytoma

b. lipoma

A patient has been referred for sonographic evaluation of a right lateral breast mass seen on mammography. what is the correct patient positioning to evaluate this mass? a. patient supine with right arm adducted b. patient in left posterior oblique position with right arm abducted c. patient supine with arms folded across chest d. patient in right posterior oblique position with right arm adducted e. patient in left decubitus position with right arm adducted.

b. patient in left posterior oblique position with right arm abducted

A patient has been referred for ultrasound evaluation of tendinitis of the wrist. What is the ultrasound appearance of a tendon? a. the sonographic appearance of a tendon varies greatly by location within the body b. tendons are highly echogenic with fibrillar echotexture c. tendons are markedly hypoechoic and homogeneous d. tendons have a heterogeneous sonographic appearance with mixed echodensity e. tendons cannot be recognized sonographically

b. tendons are highly echogenic with fibrillar echotexture

Fluid within the synovial sheath is indicative of: a. hyperemic flow b. tendosynovitis c. cartilaginous inflammation d. cartilaginous extension

b. tendosynovitis

Which of the following best describes the Thompson test? a. the patient lies prone and performs plantarflexion b. the patient lies prone while the symptomatic calf is squeezed c. the patient lies supine and performs plantarflexion d. the patient lies prone and performs dorsiflexion

b. the patient lies prone while the symptomatic calf is squeezed

the breast parenchyma is composed of approximately: a. 1 to 10 lobes b. 5 to 15 lobes c. 15 to 20 lobes d. 20 to 30 lobes e. 40 to 50 lobes

c. 15 to 20 lobes

Thickness of a normal achilles tendon should not exceed: a. 3 mm b. 5 mm c. 7 mm d. 10 mm e. 15 mm

c. 7 mm

The accumulation of synovial fluid from a weakening in the joint capsule of the knee, as seen in conditions such as rheumatoid arthritis can result in a: a. hemangioma b. lipoma c. baker cyst d. ganglion cyst

c. baker cyst

You have been asked to perform an ultrasound to rule out the presence of a popliteal aneurysm. Where will you look? a. groin b. calf c. behind the knee d. elbow e. shoulder

c. behind the knee

Inflammation and infection of the skin and subcutaneous tissue is termed: a. ascites b. retroperitoneal fibrosis c. cellulitis d. subcutaneous edema

c. cellulitis

Which of the following structures provides support to the breast parenchyma? a. deep fascia b. pectoralis muscles c. cooper ligaments d. subcutaneious fat e. superficial facia

c. cooper ligament

Painful breasts 1 week prior to the onset of menstruation is a common symptom in which of the following conditions? a. mastisis b. gynecomastia c. fibrocystic disease d. metastatic breast disease e. inflammatory carcinoma

c. fibrocystic disease

A teenager arrives to the ER following a skiing injury. A nonvascular hypoechoic mass is identified in the posterior popliteal fossa. This mass most likely represents: a. baker cyst b. lymph node c. hematoma d. aneurysm e. pseudoaneurysm

c. hematoma

20. A defect in the muscles of the abdominal wall is most likely related to a: a. cyst b. polyp c. hernia d. hematoma e. diverticulum

c. hernia

What is the sonographic appearance of a normal peripheral nerve? a. markedly hypoechoic structure with scattered bright internal foci b. striated, hypoechoic, linear structure c. markedly hyperechoic structure with parallel internal linear echoes d. homogeneous, hyperechoic, structure with barbell shape e. peripheral nerves cannot be detected sonographically

c. markedly hyperechoic structure with parallel internal linear echoes

You detect a hypoechoic region within an otherwise normal appearing tendon. What causes false hypoechogenicity within a tendon? a. use of too much scan gel between the skin and transducer surface b. scanning with the beam perpendicular to the tendons axis c. oblique incidence of the beam to the tendon axis d. use of a transducer frequency greater than 10 MHz e. overuse of receiver gain

c. oblique incidence of the beam to the tendon axis

5. Which of the following most accurately describes the location of the transversus abdominus? a. anterior to the internal oblique muscle b. medial to the external oblique muscle c. posterior to the internal oblique muscle d. lateral to the internal oblique muscle e. anterior to the external oblique muscle

c. posterior to the internal oblique muscle

which of the following is not an accepted indication for breast ultrasound? a. differentiation of cysts from solid masses b. evaluation of a palpable mass that is not visible in a radiographically dense breast c. screening for malignancy in the general population d. assessment of a mass that is inaccessible to mammography due to location e. evaluation of a young patient with a palpable mass

c. screening for malignancy in the general population

What test can be performed to determine a torn achilles tendon? a. McBurney test b. McDonald test c. thompson test d. baker test

c. thompson test

7. Which of the following artifacts if likely to occur when the ultrasound beam is not perpendicular with a fibrillar tendon? a. duplication b. reverberation c. refraction d. anisotrophy e. shadowing

d. anisotrophy

The valsalva manuever is a common technique used when evaluating the: a. pediatric hip b. rotator cuff c. achilles tendon d. anterior abdominal wall e. gastrointestinal tract

d. anterior abdominal wall

Estrogen levels most frequently influence which of the following breast lesions? a. mastitis b. lipoma c. papilloma d. fibroadenoma e. galactocele

d. fibdroadenoma

A common malignancy of the breast demonstrating posterior acoustic shadowing describes which of the following neoplasms? a. lobular carcinoma b. colloid carcinoma c. medullary carcinoma d. invasive ductal carcinoma e. papillary carcinoma

d. invasive ductal carcinoma

All of the following correctly describe the cenous system of the breast parenchyma except? a. deep veins may empty into the subclavian vein b. superficial veins lie deep to the superficial fascia c. deep veins may empty into the axillary vein d. lymph vessels generally course parallel with the cooper ligaments e. superficial veins from the left and right breast can communicate

d. lymph vessels generally course parallel with the cooper ligaments

Echogenicity of glandular breast tissue when compared to a fatty breast lobule is best described as: a. isoechoic b. hyperechoic c. heterogenous d. moderately hyperechoic e. moderatly hypoechoic

d. moderately hyperechoic

You have been requested to perform an ultrasound exam to rule out the presence of a baker's cyst. Where will you look? a. breast b. neck c. mediastinum d. popliteal fossa e. groin

d. popliteal fossa

The deep layer of the superficial fascia is located within the a. subcutanous fat b. cooper ligaments c. mammary zone d. retromammary space e. pectoralis muscles

d. retromammary space

A patient has been referred for sonographic evaluation of the rotator cuff. What part of the body should you image? a. hip b. elbow c. wrist d. shoulder e. ankle

d. shoulder

the echogenicity of a fatty breast lobule is most commonly described as an a anechoic oval shaped mass b. smooth heterogenous mass c. hyperechoic band of tissue d. smooth moderately hypoechoic mass e. smooth hyperechoic mass

d. smooth moderately hypoechoic mass

A standoff pad is most useful in imaging: a. deep structures that produce acoustic enhancement b. deep structures that produce acoustic shadowing c. structures that produce refractive shadowing d. superficial structures

d. superficial structures

All of the following will aid in the sonographic assessment of an achilles tendon except: a. the patient lies prone, with his or her feet hanging off the end of the bed b. both the symptomatic and asymptomatic achilles tendon should be scanned for comparison c. the entire tendon should be evaluated in sagittal and transverse scan planes d. the patient is scanned in the erect position, with a small amount of pressure placed on the symptomatic side

d. the patient is scanned in the erect position, with a small amount of pressure placed on the symptomatic side

Which of the following is true concerning patients with a lipoma? a. they often complain of pain in the area of the mass b. they are often obese c. they are only slightly tender in the area of the mass d. they feel no pain in the area of the mass

d. they feel no pain in the area of the mass

You have been asked to perform an ultrasound exam of the achilles tendon. Which transducer would provide the most optimal image of this structure? a. 5 MHz linear array b. 5 MHz curved linear array c. 7.5 MHz curved linear array d. 10 MHz curved linear array e. 12 MHz linear array

e. 12 MHz linear array

The diameter of a normal lactierous duct should not exceed: a. 1mm b. 1.5mm c. 2mm d. 2.5mm e. 3mm

e. 3mm

which of the following is suggestive of malignancy of a solid mass seen on ultrasound? a. a mass that is taller than it is wide b. spiculation c. angular margins d. markedly hypoechoic solid lesion e. all of the above

e. all of the above

Clinical symptoms associated with mastitis may include all of the following except: a. fever b. erythema c. breast pain d. malaise e. blood nipple discharge

e. bloody nipple discharge

Which of the following benign breast neoplasms may undergo malignant transformation? a. simple cyst b. fibroademoma c. complex cyst d. hamartoma e. cystosarcoma phyllodes

e. cystosarcoma phyllodes

Abnormal enlargement of the male breast parenchyma is most likely a clinical finding in which of the following pathologies? a. mastitis b. polymastia c. hamartoma d. galactocele e. gynecomastia

e. gynecomastia

2. Which of the following joints has the largest range of motion? a. hip b. elbow c. wrist d. knee e. shoulder

e. shoulder

Which of the following structures is considered the "skeletal" framework in the breast? a. acini b. elbow c. wrist d. knee e. shoulder

e. shoulder

Breast pathology most commonly originates in which of the following structures? a. lymph node b. breast lobule c. lactiferous duct d. connective breast tissue e. terminal ductal lobular unit

e. terminal ductal lobular unit

A cystic mass located within the popliteal fossa is most likely: a. baker cyst b. thompson cyst c. ganglion cyst d. lipoma

a. baker cyst

A partial tear of a tendon typically appears as: a. focal hypoechoic areas within the tendon b. a focal echogenic area within the tendon c. a diffusely heterogeneous area within the tendon d. edema and refractive shadowing in the area of the divided tendon

a. focal hypoechoic areas within the tendon

Which of the following would be best described as a benign tumor composed of blood vessels? a. hemangioma b. lipoma c. hamartoma d. oncocytoma

a. hemangioma

Which of the following transducers would be best suited to sonographically assess for a splinter in a patient's hand? a. high-frequency, linear-array transducer b. low-frequency, curved array transducer c. high-frequency, sector transducer d. low-frequency, linear-array transducer

a. high-frequency, linear-array transducer

Clinical findings of tendonitis include all of the following except: a. itching in the area of the tendon b. pain c. edema d. the area is warm to the touch

a. itching in the area of the tendon

what comprises the terminal ductal lobular unit in the breast? a. lobule with its terminal branches, short intralobular and longer extralobular duct b. coopers ligament areola, and duct c. lobule, coopers lig, and areola d. skin, subcut fat and glandular tissue e. fatty lobule retromam fat, prepectoral fascia and subcut fat

a. lobule with its terminal branches, short intralobular and longer extralobular duct

All of the following are keys to identifying foreign bodies with sonography except: a. most foreign bodies appear hypoechoic b. a linear-array transducer should be used c. most foreign bodies are better visualized using a standoff pad d. comet-tail artifact may be seen posterior to metallic objects

a. most foreign bodies appear hypoechoic

You have been asked to perform an ultrasound exam on a patient with recent muscular trauma. Which of the following is true regarding the normal sonographic findings in a muscle? a. on sagittal scans, oblique, parallel, echogenic fibers are seen against a hypoechoic background b. color Doppler reveals no signals in a normal muscle at rest c. ultrasound is extremely useful in identifying strained muscles d. muscle fibers cannot be recognized sonographically e. all of the above statements are true

a. on sagittal scans, oblique, parallel, echogenic fibers are seen against a hypoechoic background

A complicated baker cyst may contain a thin flap of tissue referred to as: a. pannus b. plicae c. septation d. lipoma

a. pannus

To better evaluate the achilles tendon, the patient should be placed in what position? a. prone b. supine c. right lateral decubitus d. left lateral decubitus

a. prone

the most common benign breast lesion in a women between the ages of 35 and 50 is a a. simple cyst b. papilloma c. fibroadenoma d. cystadenoma e. hamartoma

a. simple cyst

What is the appearance of a normal lymph node in the breast? a. small ovoid structure with a hypoechoic rim and echogenic hilum b. large round structure with a hyperechoic rim and hpoechoic hilum c. small rounded nodule with a homogeneous hypoechoic echo texture d. small nodule with microlobulations and heterogeneous echo texture e. small ellipsoid nodule frequently containing cystic areas

a. small ovoid structure with a hypoechoic rim and echogenic hilum

Muscle attaches to bone by which of the following structures? a. tendon b. fibril c. bursa d. ligament e. synovial membrane

a. tendon

Which of the following best describes a negative Thompson test? a. the calf is squeezed and the foot should plantarflex in a patient who does not have a complete tear of the achilles tendon b. the calf is squeezed and the foot should not plantarflex in a patient who does not have a complete tear of the achilles tendon c. the achilles tendon is squeezed and the foot should plantarflex in a patient who does not have a complete tear of the achilles tendon d. the achilles tenon is squeezed and the foot should not plantarflex in a patient who does not have a complete tear of the achilles tendon

a. the calf is squeezed and the foot should plantarflex in a patient who does not have a complete tear of the achilles tendon

All of the following are true of ganglion cysts except: a. a ganglion cyst is a common mass found along the anterior aspect of the hand and wrist, between the carpals b. ganglion cysts typically appear sonographically as an incompressible, anechoic mass with acoustic enhancement c. clinically, ganglion cysts may be hard to the touch and painful d. ganglion cysts are often treated with an injection of cortiocsteroids

a. a ganglion cyst is a common mass found along the anterior aspect of the hand and wrist, between the carpals

the sinus of a lactiferous duct is located near the a. areola b. axilla c. sternum d. chest wall e. tail of spence

a. areola

A patient has been referred for an ultrasound study of the parotid gland. Where is this gland located? a. between the external auditory canal and the inferior edge of the mandible b. superior to the CCA between the ICA and ECA c. lateral to the sternocleidomastoid muscle on each side of the neck d. midline in the neck, superior to the isthmus of the thyroid e. medial to the carotid sheath, anterior to the longus colli muscle and inferior to the carotid bifurcation

a. between the external auditory canal and the inferior edge of the mandible

Tendons sonographically appears: a. echogenic, fibrous structures connecting muscles to bone b. echogenic, fibrous structures connecting bone to bone c. hypoechoic, linear arrangements within hyperechoic tissue d. hyperechoic tissue that contains linear, echogenic strands

a. echogenic, fibrous structures connecting muscles to bone

You have detected a cyst in a patient referred for sonographic evaluation of a wrist nodule Which of the following is a cyst that occurs adjacent to a joint? a. ganglion cyst b. colloid cyst c. branchial d. dermoid e. hydatid

a. ganglion cyst

Inflammation of the tendon and synovial tendon sheath is referred to as: a. tendosynovitis b. tendonitis c. cellulitis d. pannus

a. tendosynovitis

In the breast, the lymph vessels generally course parallel with the a. venous system b. lactiferous ducts c. cooper ligaments d. retromammary zone e. terminal ductal lobular units

a. venous system

A mass is identified in the upper outer quadrant of the right breast near the axilla and chest wall. this mass should be annotated as: a. 2:00 1a b. 10:00 3c c. 2:002b d. 10:00 1c e. 10:00 3a

b. 10:00 3c

Which of the following is the smallest functional unit in the breast parenchyma? a. lobe b. acini c lobule d. terminal duct e. terminal ductal lobular unit

b. acini

The fascial interface of the anterior abdominal wall is located directly anterior to the: a. linea alba b. peritoneum c. retroperitoneum d. subcutaneous fat e. rectus abdominus muscles

b. peritoneum

Measurement of the achilles tendon should be made in the: a. sagittal plane b. transverse plane c. coronal plane d. prone position e. supine position

b. transverse plane

A patient has been referred for ultrasound evaluation to rule out the presence of a carotid body tumor. Where is this tumor located? a. at the origin of the CCA on each side of the neck b. lateral to the carotid bifurcation and medial to the sternocleidomastoid muscle c. at the level of the carotid bifurcation between the ICA and ECA d. superomedial to the submandibular gland on each side of the neck e. within the sternocleidomastoid muscle, lateral to the carotid bifurcation

c. at the level of the carotid bifurcation between the ICA and ECA

A common mass found along the dorsal aspect of the hand and wrist is the: a. baker cyst b. thompson cyst c. ganglion cyst d. lipoma

c. ganglion cyst

The achilles tendon connects the: a. ankle to the knee b. heel to the ankle c. heel to the calf muscle d. knee to the calf muscle

c. heel to the calf muscle

Sonographically, the normal muscle appears a: a. a hyperechoic tissue that contains linear, echogenic strands b. complex tissue that contains linear, hypoechoic strands c. hypoechoic tissue that contains linear, echogenic bands d. echogenic tissue that contains linear, hypoechoic strands

c. hypoechoic tissue that contains linear, echogenic bands

Hyperemic flow within or around a structure is often indicative of: a. malignancy b. benignancy c. inflammation d. rupture

c. inflammation

Possible etiologies of rectus sheath hematoma may include all of the following conditions except: a. trauma b. pregnancy c. severe coughing d. abdominal wall defect e. anticoagulant therapy

d. abdominal wall defect

The thompson test is used to check the integrity of the: a. calf muscles b. knee joint c. rotator cuff d. achilles tendon e. anterior abdominal wall

d. achilles tendon

Which of the following at the site of a foreign body may produce bright echoes and therefore cause some ambiguity about the correct orientation of the object? a. fluid b. enhancement c. dust d. air

d. air

Complete absence o one or both breast is termed: a. amazia b. athelia c. amaurosis d. amastia e. amyelia

d. amastia

Superficial lipomas may appear as all of the following except: a. hypoechoic to the surrounding tissue b. isoechoic to the surrounding tissue c. hyperechoic to the surrounding tissue d. anechoic to the surrounding tissue

d. anechoic to the surrounding tissue

Which of the following muscles extends the entire length of the anterior abdominal wall? a. linear alba b. psoas c. external oblique d. rectus abdominus e. internal oblique

d. rectus abdominus

Acoustic shadowing caused by bending of a sound beam at the edge of a curved reflector is referred to as: a. mirror image artifact b. indirect artifact c. reflective shadowing d. refractive shadowing

d. refractive shadowing

Sonographic findings associated with invasive ductal carcinoma may include all of the following except: a. hypoechoic mass b. ill defined borders c. posterior acoustic shadowing d. width of mass is larger than height e. thich cooper ligaments

d. width of mass is larger than height

Which transducer will provide the most optimal imaging for ultrasound imagin of the breast? a. 3.5 MHz curved linear array b. 5MHz curved linear array c. 5MHz linear array d. 7.5MHz linear array e. 10MHz linear array

e. 10MHz linear array

A complete tear of the achilles tendon is most commonly located: a. at the superior insertion b. in the medial portion of the tendon near the medial malleolus c. approximately 2 to 6 cm from the superior tendon insertion d. in the lateral portion of the tendon near the lateral malleolus e. in the distal portion of the tendon near the calcaneus

e. in the distal portion of the tendon near the calcaneus

A patient has been referred for an ultrasound study to rule out the presence of a rectus sheath hematoma. Where will you look? a. lateral aspect of the affected thigh b. popliteal fossa c. calf d. neck e. mid abdominal wall

e. mid abdominal wall

The most common congenital breast anomaly is: a. amastia b. amazia c. athelia d. polymastia e. polythelia

e. polythelia