Chapter 14: Peritoneal Cavity and Abdominal Wall Sonography II

1) portal system 2) ascending cholagitis of the CBD 3) hepatic artery 2ndry to bacteria 4) direct extension from an infection 5) implantation of bacteria after trauma to the abdominal wall

5 major pathways through which bacteria can enter the liver and cause access formation

coronary

Because of the ____ ligament attachments, collections in the right posterior subphrenic space cannot extend between the bare area of the liver and the diaphragm

lymphocele

Collection of fluid that occurs after surgery in the pelvis, retroperitoneum, or recess cavities.

1) abdominal wall defect 2)bowel loops or mesenteric fat within a lesion 3) exaggeration of lesion with strain (valsalva) 4)reducibility of lesion by gentle pressure

Four sonographic criteria for a hernia

abcess

Localized collection of pus

mesentery

Loops of the digestive tract are anchored to the posterior wall of the abdominal cavity by this large double fold of peritoneal tissue

ovaries, stomach, colon

Most Common primary sites of Peritoneal Metastases.

inferior

Subcapsular liver and splenic collections are seen when they are ___ to the diaphragm unilaterally and conform to the shape of an organ capsule

posteromedially

The pleural fluid tends to distribute ___ in the chest

abscess .

a cavity formed by necrosis within a solid tissue or a circumscribed collection of purulent material is a(n) ____

lesser omentum

a double layer of peritoneum extending from the liver to the lesser curvature of the stomach is known as the ____

symmetry

a key factor in determining whether an abdominal wall mass is present is the _____ of the rectus sheath muscles

left

a large right-sided retroperitoneal mass rotates the intrahepatic portal veins to the _____

ureters

a mass is confirmed to be within the retroperitoneal cavity when anterior renal displacement or anterior displacement of the dilated __ can be documented

infiltrative

a mass or lesion within the mesentery and omentum may have solid or cystic characteristics where a mass within the peritoneum may show a(n) ____ pattern

spigelian

a variant of the ventral hernia that is found more laterally in the abdominal wall is a(n) ___ hernia

ascites

accumulation of serous fluid in peritoneal cavity

carbuncle

an abcess that forms within the renal parenchyma is a(n) renal _____. Clinical symptoms vary from none to fever, leukocytosis, and flank pain

hernia

an abdominal ___ is the protrusion of a peritoneal-lines sac through a defect in the weakened abdominal wall

urinoma .

an encapsulated collection of urine, may result from a closed renal injury or surgical intervention or may develop spontaneously secondary to an obstructing lesion.

urachal cyst

an incomplete regression of the urachus during development is a(n) _____

subphrenic

below the diaphragm

hemorrhage

collection of blood

urinoma

cyst containing urine

bilomas

extrahepatic loculated collections of bile that may develop because of iatrogenic, traumatic, or spontaneous rupture of the biliary tree are _____

hematoma

extraperitoneal rectus sheath _____ are acute or chronic collection of blood lying either within the rectus muscle or between the muscle and its sheath

sagittal

fatty and collagenous connective tissues in the perirenal or anterior pararenal space produce echoes that are best demonstrated on ___ scans

inferior

hepatic and subhepatic lesions produce ______ and posterior displacement.

leukocytosis

increase in the number of white blood cells (leukocytes)

septicemia

infection in the blood

subhepatic

inferior to the liver

peritonitis

inflammation of the peritoneum

fine or course internal

inflammatory or malignant ascites appear with ___ echoes; loculation; unusual distribution, matting, or clumping of bowel loops; and thickening of interfaces between the fluid and neighboring structures

epiploic

less sac communicates with the greater sac through a small vertical opening known as the ____ foramen

subphrenic ; subhepatic

ligaments on the right side of the liver form the _______ & ________ spaces

multiloculated

mesenteric and mental cysts may be uniloculated or ______ with smooth walls and thin internal septations

gutters

most dependent areas in the flanks of the abdomen and pelvis where fluid may accumulate

omentum

pouchlike extension of the visceral peritoneum from the lower edge of the stomach, part of the duodenum, and the transverse colon

pyogenic

pus producing

ventrally

retroperitoneal lesions displace echoes _________ and cranially

sandwich sign

sonographic sign that you see when a vessel or organ is surrounded by a tumor on either side

Morison's pouch

space anterior to the right kidney and posterior to the inferior border of the liver where ascites or fluid may accumulate or an abscess may develop

sepsis

spread of an infection from its initial site to the bloodstream

greater omentum

the ____ is an apron-like fold of peritoneum that hangs from the greater curvature of the stomach

sandwich

the ____ sign of lymphoma represents a mass infiltrating the mesmeric leaves and encasing the superior mesenteric ARTERY

peritoneum

the _____ is a smooth membrane that lines the entire abdominal cavity and is reflected over the contained organs

ligamentum teres

the ________ ascends from the umbilicus to the umbilical notch of the liver within the free margin of the falciform ligament before coursing within the liver

location ; volume ; position

the amount of intraperitoneal fluid depends on the ___ , ____ , and patient _____.

douglas

the ascitic fluid first fills the pouch of _____, then lateral paravesical recesses before it ascends to both paracolic gutters

greater

the general peritoneal cavity is known as the ____ sac of the peritoneum

anteriorly

the mass interposed ___ or superiorly to kidneys can be located either intraperitoneally or retroperitoneally

acute appendicitis

the most common abdominal pathologic process is ______ that requires immediate surgery

rectus

the paired ____ abdominis muscles are delineated medially in the midline of the body by the linea alba

parietal ; visceral

the part that lines the walls of the cavity is the ___ peritoneum, whereas the part covering the abdominal organs to a greater and lesser extent is the ____ peritoneum

viscera ; walls

the peritoneal cavity is made up of multiple peritoneal ligaments and folds that connect the ____ to each other and to the abdominal-pelvic _____

floats ; sinks

the small bowel loops ____ or _____ in the surrounding ascitic fluid depending on relative gas content and amount of fat in the mesentery

falciform

the subphrenic space is divided into right and left components by the ____ ligaments

pelvis

when the patient is lying supine, the lowest part of the body is the _____

lesser

with the development of the stomach and the spleen, a smaller sac, called the ______ sac (omental bursa), is the peritoneal recess posterior to the stomach

omentum ; mesenteries

within the cavity are found the lesser and greater ____, the _____, and multiple fluid spaces (lesser sac, perihepatic, subhepatic spaces)