DMS 221 FINAL REVIEW W/IMAGES, includes neonatal spine
gastroschisis
open abdominal wall defect where abdominal contents herniate out to the right of the cord insertion
dura
outermost layer covering the brain/spinal cord
gout
painful inflammation of joint due to buildup of uric acid crystals
filum terminale
tapering end of the spinal cord, caudal to conus medullaris
L3
the conus is considered abnormally low if it is at or below this level of the spine
conus medullaris
the most caudal portion of the spinal cord
Peritoneal dialysis
a treatment for kidney failure that uses the lining of your abdomen, or belly, to filter your blood inside your body
d. all of the above
Patients with prostate cancer may present with which of the following? a. an abnormal DRE b. An abnormal PSA c. Bladder outlet obstruction d. all of the above
hypovolemia
Pre-renal injury cause
+ posterior to the IVC + anterior to the right crus of the diaphragm + and is housed within Gerota's fascia
The right adrenal gland:
Grade I
The sonogram on the neonatal brain of a preterm infant demonstrates a focal hyperechoic area anterior to the caudothalamic groove on the parasagittal view bilaterally. The ventricles are not dilated and no other abnormalities are seen. What grade of GM-IVH would be assigned to this patient?
duration
The sonographic findings of testicular torsion are related to the _________ of the torsion.
Decreased renal reserve, renal insufficiency, uremia
The stages of chronic renal failure are, in order:
endocrine glands
The thyroid and parathyroid are both what?
iodine
The thyroid gland uses what to produce it's hormones?
Posterior enhancement and posterior shadowing
There are many common artifacts in ultrasound. What two artifacts help to characterize a mass?
>= 4 mm
Thickness of the AP pylorus wall in HPS
+ pheochromocytoma + neuroblastoma
Tumors or diseases in the adrenal medulla
esophagus
What structure may be confused for a thyroid or parathyroid mass because of it's relationship to the trachea and the posterior aspect of the left thyroid gland?
spermatic cord
What structure supports the posterior border of the testes?
cecum
When evaluating the appendix sonographically, what structure will help you locate it?
in the pelvis along the iliopsoas margin
Where are transplanted kidneys usually placed?
Submucosa
Where does inflammation start in Chron's disease?
PSA
Which blood test is used to identify men at increased risk for prostate cancer?
adrenocorticotropic hormone
Which hormone secreted by the anterior pituitary gland, controls the release of hormones by the adrenal glands?
sternocleidomastoid
Which muscle does fibromatosis colli mostly affect?
a. centripetal arteries
Which of the following arteries courses within the testicular parenchyma? a. centripetal arteries b. testicular artery c. cremesteric artery d. deferential artery e. all of the above
d. third ventricle
Which of the following is not contained in the posterior fossa? a. fourth ventricle b. cerebellum c. brainstem d. third ventricle
Hemodialysis
blood is removed from the body and filtered through a man-made membrane called a dialyzer, or artificial kidney, and then the filtered blood is returned to the body.
acidosis
caused by an increase in hydrogen ions
cauda equina
collection of nerve roots at the end of the spinal cord; includes lumbar and sacral nerve roots
Ileus
failure of the intestine to propel its contents due to diminished motility
d. A and B only
You detect a mass within the left testis on a 43-year-old male. Which of the following is a sign indicative of malignancy? a. irregular shape of testis b. intratesticular location of mass c. presence of a large hydrocele d. A and B only e. all of the above
dorsal dermal sinus
a condition that represents a very focal disruption in the development or fusion of the spinal canal and presents with a thin tract that travels from the skin to the spinal canal
produces ejaculation fluid
Function of the prostate gland?
iodine
Function of the thyroid gland is regulated via metabolism of ___________.
Addison's Disease
General hypofunction of the adrenal cortex is called:
testicular torsion
"Bell clapper" is another term used to describe which abnormality?
median raphe
1 out of 1 points The scrotum is divided into two separate compartments by the:
varicocele
A 20 year old patient presents with a tender scrotal mass. The sonographic findings is most suspicious for which abnormality?
testicular carcinoma
A 24 year old patient presents with a palpable scrotal mass. He is afebrile and denies any scrotal pain. On the basis of this clinical history, the sonographic finding is most suspicious for which abnormality?
c. varicocele
A 33-year-old male has been referred for a scrotal ultrasound as part of an infertility work-up. You will tailor your exam to include an evaluation of which of the following? a. torsion of the appendix testis b. testicular artery aneurysm c. varicocele d. testicular cyst e. epididymal cyst
hydrocephalus
A dilatation of the ventricular system that results from the impairment of the cerebrosplinal fluid dynamics or brain parenchymal loss is called:
porencephaly
A fluid-filled that has replaced normal brain parenchyma due to the result of a destructive process such as an intraparenchymal hemorrhage is called what?
MEN
A group of autosomal dominant disorders characterized by benign and malignant tumors of the endocrine glands
warthin's tumor
A lymphatic mass of the parotid gland is:
multinodular goiter
A patient presents with normal labs and no symptoms aside from a palpable, enlarged thyroid gland. Based upon the following image, what is the most likely diagnosis?
pyramidal lobe
A superior extension off of the isthmus of the thyroid gland is a:
Mineralocorticoid
Aldosterone is considered to be what type of steroid?
b. eggshell calcifications
All of the following are diagnostic findings of benign thyroid nodules except: a. cold nodule b. eggshell calcifications c. hyperechoic mass d. anechoic mass
b. echogenic mass
All of the following are sonographic findings of malignant thyroid nodules except: a. internal calcifications b. echogenic mass c. cervical node involvement d. solitary nodule
b. The adrenal glands are exocrine glands
All of the following are true statements about the adrenal glands except: a. The adrenal glands are easily identified in the fetus b. The adrenal glands are exocrine glands c. The adrenal glands may also be referred to as the suprarenal glands d. The adrenal glands are composed of a medulla and a cortex
d. iodine
All of the following hormones are produced by the thyroid except: a. triiodothyronine b. thyroxine c. calcitonin d. iodine
Waterhouse-Freidrichsen Syndrome
Bilateral hemorrhages to the adrenal gland which occur at birth is referred to as:
perhipheral zone
Carcinoma of the prostate gland most commonly develops in the:
Cystic Hygroma
Caused by congenital abnormality of the lymphatic system
a. hypercalcemia
Clinical findings of glomerulonephritis include all of the following except: a. hypercalcemia b. proteinuria c. throat infection d. azotemia
diastomyelia
Condition where spinal cord is separated into two hemicords?
Foramen of monro
Connects the lateral ventricle to the third ventricle
the patient is supine with the neck hyperextended by a pad/pillow under the scapulae
Describes the correct patient positioning for sonographic evaluation of the thyroid?
osteoperosis
Development of what condition is linked to hyperparathyroidism?
internal jugular vein
During a transverse scan of the thyroid gland , you detect two large vessels just lateral to the thyroid. What is the most lateral vessel?
Choroid Plexus
Echogenic cluster of cells located within the lateral ventricles responsible for the production of cerebral spinal fluid
oliguric
First stage of acute renal injury
peristalsis
Forward movement of intestinal contents caused by rythmic contractions of the intestines is termed:
parathyroid adenoma
Hypercalcemia is associated with?
-appendix AP diameter greater than 6 mm -non compressible bowel loops -appendicolith -free fluid
In cases of appendicits, what sonographic indicators are noted?
d. Both a & b are true
In dialysis patients: a. An indwelling catheter may be placed in the patient's forearm b. Free fluid may be noted in the abdominal and pelvic cavities c. The native kidney is removed d. Both a & b are true
Grave's disease
In the above image, the sonographic appearance of the thyroid is most likely to be indicative of:
thyroxine
Including iodide in your diet is required for the normal production of:
0.8, rejection
Increased renal resistance is indicated if the RI is greater than ____ and may indicate renal transplant ________.
A Adrenal capsule B zona fasciculata C zona glomerulosa D zona reticularis E adrenal medulla F adrenal cortex
Label [A], [B], [C], [D], [E]. Areas B,C,D - make up what part of the gland [F]
A Mucosal surface B mucosa C submucosa D muscularis F serosa
Label [A], [B], [C], [D], [F] on the following diagram.
epididymitis
Most common pathology to cause acute scrotal pain
papillary carcinoma
Most common, least aggresive thyroid cancer, associated with increased thyroid intake
Cold nodule
Non-functioning nodule
d. adenomatoid tumor
Non-seminomatous germ cell tumors include all of the following except: a. embryonal carcinoma b. choriocarcinoma c. mixed germ cell tumor d. adenomatoid tumor e. teratoma
aortic arch
On the left side of the neck the common carotid artery arises from what artery?
Pins and needles in extremities
Parasthesia
zona glomelulosa
Part of adrenal gland that produces aldosterone
zona reticularis
Part of adrenal gland that produces androgens
zona fasiculata
Part of adrenal gland that produces cortisol
adrenal medulla
Part of adrenal gland that produces epinephrine and norepinephrine
urinary tract obstruction
Post renal injury cause
+ lipomyelocele + lipomyelomeningocele + myelocystocele
Subcutaneous masses of the spinal cord
+ associated with dysraphic spinal anomalies + low-lying with a thickened filum terminale + symptoms may not present until the child grows and the cord is pulled tight
Tethered cord symptoms
zona glomerulosa, zona fasciculata, and zona reticularis (GFR helps me rememeber)
The adrenal cortex is made up of the following zones:
pheochromocytoma
The adrenal mass associated often associated with uncontrollable hypertension, tachycardia, and tremors is the:
Catecholemines
The adrenal medulla produces what substance?
6
The appendix should be no greater than __________ mm in total AP diameter.
cecum
The most common location of the vermiform appendix is the area of the:
renal
The most common type of acute renal failure is:
4.0 to 6.0 cm
The normal length of the adult thyroid lobe is approximately:
posterior to the thyroid gland and anterior to the longus colli muscle
The parathyroid glands are located:
at the corner of the mandible
The parotid gland is located:
external carotid
The superior thyroid artery is a branch of what artery?
the aorta
The suprarenal artery originates from ...
intussusception
The telescoping of one segment of bowel into another is referred to as:
abdominal aorta
The testicular artery is a branch of what artery?
mediastinum testis
What anatomy is seen at the white arrows in the above image?
ATN
What complication of renal transplants is caused by ischemia to the renal tubules?
lower urinary tract infection
What is a common cause of acute pyelonephritis?
scrotolith
What is depicted at the black arrow in the following image?
Bone spurs
What is not a likely a complication of chronic kidney disease?
hypertrophic pyloric stenosis
What is seen in the above image?
c. microlithiasis
What is seen in the above image? a. testicular carcinoma b. testicular cysts c. microlithiasis d. orchitis
epididymal cyst
What is seen the following image?
Regulation of the basal metabolic rate
What is the main function of the thyroid gland?
parathyroid adenoma
What is the most common cause of primary hyperparathyroidism?
mucoepidermoid carcinoma
What is the most common form of salivary gland carcinoma?
BPH
What is the most common symptomatic condition to affect the prostate gland?
leukomalacia
What is the softening of the white matter of the brain that occurs with ischemia called?
A lateral ventricle B Ventriculomegaly C Choroid Plexus
What structure is being measured in the above image? [A] What pathology is seen in the above image? [B] What is the echogenic structure seen under the calipers in the above image? [C]
e. all of the above are true
Which of the following is/are true regarding the pathologic conditions involving the parotid gland? a.Salivary carcinomas, which present as a rapidly growing mass accompanied by pain and facial nerve paralysis, are usually solid inhomogeneous structures that invade surrounding tissue b. acute parotititis is an inflammatory process of the parotid gland secondary to the mumps virus c. A warthin's tumor presents as a painless mass found more commonly in males and has a sonographic appearance similar to a sptated cyst d. A and B are correct e. all of the above are true
sternocleidomastoid muscle
Which of the following muscles surrounding the thyroid is not a strap muscle?
transitional zone
Which region in the prostate most commonly develops benign prostatic hypertrophy?
filar cyst
While performing an evaluation of the spine on an infant, a small, cystic structure if seen inferior to the tip of the conus medularis. no other defect is seen. What is the most likely diagnosis?
volvulus
abnormal twisting of the intestines that can lead to obstructin, gangrene, perforation, and peritonitis
ulcer
an erosion in the mucosal layer of the wall of the GI tract
lipomyelocele
an infant presents with a palpable, skin-covered mass in the lumbar region of the spine. During the evaluation, a bony defect is seen and an echogenic fatty mass is seen contained within the spinal canal. The mass appears to distort and tether the spinal cord. What is the most likely diagnosis?
dysraphism
anomalies associated with incomplete fusion of the neural tube during embryological development
L1-L2
at what level does the normal spinal cord taper to a point and terminate with the conus medularis?
Corpora amylacea
calcifications commonly seen in the inner gland of the prostate
meningitis
condition that patients with dorsal dermal sinus are at risk for developing
athyrosis
congenital absence of thyroid gland
isthmus
connects the two lobes of the thyroid?
Glucocorticoids
cortisone and hydrocortison
omphalocele
covered abdominal wall defect where abdominal contents herniate into the base of the umbilical cord
myelomeningocele
defect that occurs when there is a failure of the spinal cord to fold into a neural tube, and presents with the skin, musculature, and bony vertebral arches splayed laterally to the defect
carotid body tumors
develop in the adventitia of the at the level of the carotid bifurcation
dysphagia
difficulty swallowing
hydromelia
dilatation of the central canal of the spinal cord
Uremia
end stage renal failure
Thyrotoxicosis
excess thyroid hormones
maintaining homeostasis of blood calcium concentrations
function of the parathyroid gland?
store sperm
function of the seminal vesicles?
7
how many vertebrae make up the cervical spine?
5
how many vertebrae make up the lumbar spine?
5
how many vertebrae make up the sacral spine?
12
how many vertebrae make up the thoracic spine?
grave's disease
hyperthyroidism
hyperkalemia
increased potassium levels
parotid gland
largest salivary gland
pia mater, arachnoid mater, dura mater
meninges that cover and protect the brain and spinal cord?
hypothyroidism
most common functional disorder of the thyroid gland?
sacral dimple or pit
most common indication for a spinal sonogram
Adenoma
most common thyroid neoplasm
Aqueduct of sylvius
most likely place to cause ventriculomegaly
hypertropic pyloric stenosis
narrowing of the opening from the stomach to the first part of the small intestines (the pylorus)
Azotemia
nitrogenous waste in the bloodstream
Thalamus
paired ovoid structures in the central brain responsible for relaying nerve impulses and carrying sensory information into the cerebral cortex
thoracolumbar
region of the spine where diastomyelia most commonly occurs
Cerebellum
regulates balance and controls equilibrium
peristalsis
rhythmic dilatation and contraction that propels contents of the GI tract
follicular carcinoma
second most common thryoid carcinoma, associated with decreased iodine, metastasis via vascular system
diuresis
second stage of acute renal injury
eiffel tower sign
shadowing created by calcification in the area of the urethra and verumontanum
fontanelle
soft spot between the cranial bones
myelomalacia
softening of the spinal cord frequently caused by lack of blood supply
infants under 6 months
sonography of the spine is limited to what age
epidural space
space between the outermost layer of the spinal cord(dura) and the spinal column
4-6mm
stomach undistended - bowel wall measurement
bezoar
undigested material causing gastric or intestinal obstruction
sjogren syndrome
which autoimmune disease affects the glands that produce moisture, leading to dysfunction of the salivary glands and dryness of the eyes, nose, skin, and mouth?
orchitis
A large complex hydrocele is most commonly associated with which of the following?
Verumontanum
A longitudinal ridge within the prostatic urethral wall where the orifices of the ejaculatory ducts are located on either side
a. parapelvic cyst
A postrenal transplant perirenal fluid collections can be all of the following except: a. parapelvic cyst b. urinoma c. lymphoma d. hematoma e. abscess
carcinoma
A solitary hypoechoic thyroid nodule demonstrating irregular borders and microcalcifications is most suspicious for:
thyroid isthmus and tongue
A thyroglossal duct cyst is located between which of the following structures?
midgut malrotation
An infant presents with a history of vomiting . While evaluating the patient, you notice a vessel immediately anterior to the SMA. With further evaluation, this vessel is identified as the SMV. What condition is associated with the finding?
Cisterna Magna
Anechoic fluid filled space posterior to the cerebellum
2 to 10 weeks of age
Hypertrophied pyloric stenosis most commonly develops in infants between:
Hashimoto's thyroiditis
Hypothyroidism
A foramen of monro B anterior horn of lateral ventricle C third ventricle D Atria/trigone E body of lateral ventricle F posterior horn of lateral ventricle G temporal/inferior horn of lateral ventricle H aqueduct of sylvius I fourth ventricle
Label the following Image: Please be specific. Label [A], [B], [C], [D], [E], [F], [G], [H], [I].
1 RT thyroid lobe 2 Thyroid isthmus 3 LT thyroid lobe 4 Trachea 5 Esophagus 6 Common Carotid Artery 7 Internal jugular vein 8 sternocleidomastoid muscle 10 sternothyroid muscle 11 sternohyoid muscle 12 Longus colli muscle
Label the following diagram:
A Vas Deferens/Ductus Deferens B Rete Testes C Head of Epididymis D tunica albuginea E seminiferous tubules F Tunica vaginalis G body of epididymis H tail of Epididymis
Label the following diagram: [A],[B],[C],[D],[E],[F],[G],[H] D & F label the layers
1 Peripheral Zone 2 Central Zone 3 Transitional Zone
Label the prostate zonal anatomy: [1], [2], [3]
cerebrum
Largest section of the brain; divided into two hemispheres joined by the corpus callosum
corpus callosum
Largest white matter structure in the brain, contains nerve tracts.
umbilicus and right iliac crest
McBurney point is best described as a point between the:
lumbosacral spine
Most common location for a spinal dysraphism?
> 1.6 cm
length of pyloric channel in cases of positive HPS
<= 1 cm
normal lateral ventricle width
appendicitis
A 20-year old women presents to the ER complaining of severe pelvic pain. Lab results show a negative pregnancy test and leukocytosis. A pelvic ultrasound is ordered to rule out pelvic pathology. The Long and transverse image above lateral to the right ovary shows a non compressible tender mass. On the basis of the clinical history, this mass is most suspicious for a(n):
pyloric stenosis
A 4-month old presents with a history of projectile vomiting and a palpable upper abdominal mass . The finding in this ultrasound is most suspicious for:
thyroglossal duct cyst
A cystic remnant of thyroid development and migration is a ________.
Ultrasound-guided biopsy
A definitive diagnosis of prostate cancer can be made by:
two layers of the tunica vaginalis
A hydrocele is defined as an abnormal fluid collection between the
appendicitis
Rebound tenderness is associated with:
e. excessive use of non-steroidal anti-inflammatory drugs
Risk factors for testicular neoplasms include all of the following except: a. history of testicular carcinoma b. cryptorchidism c. intratubular germ cell neoplasia d. testicular mal-evelopment e. excessive use of non-steroidal anti-inflammatory drugs
epididymal head
The echogenic structure superior to the testis most likely represents the:
colloid
The fluid produced by the thyroid gland that contains thyroid hormones is referred to as:
left renal vein
The left suprarenal vein drains directly into the:
left renal vein
The left testicular vein drains into what vein?
appendicitis
The longitudinal scan through the right lower quadrant. This image is consistent with which one of the following diagnosis?
neuroblastoma
The most common adrenal infant tumor is a:
+ Addison disease + adrenal myelolipoma + Cushing syndrome + conn syndrome
Tumors or diseases in the adrenal cortex
d. All of the above are true
Which of the following is true regarding hemodialysis? a. An artificial AV fistula is created b. It is scheduled about 3 times per week c. Solutes are directly filtered from the blood d. All of the above are true
hematocele
You are imaging a patient presenting with trauma, pain, and scrotal swelling. You detect a large hydrocele with prominent internal echos. This most likely represents?
e. all of the above
You are performing a Doppler analysis of the spermatic cord. which of the following arteries or structures is found within the spermatic cord? a. testicular artery b. vas deferens c. cremesteric artery d. deferential artery e. all of the above
c. microlithiasis
You are performing a scrotal ultrasound on a 38-year old male with acute scrotal pain to rue out orchitis. Which of the following would NOT be associated with orchitis? a. thickened scrotal wall b. hypoechoic testis c. microlithiasis d. hyperemic testicular flow e. enlargement of testis
pilonidal cyst
a patient presents for a spinal sonogram with a sacral dimple. a hypoechoic tract is visualized extending from the skin to a cystic structure. neither the hypoechoic tract nor the cystic collection appears to be connected to the spine. What is the most likely diagnosis?
psammoma bodies
fine, internal eggshell calcifications seen with papillary carcinoma
syrinx
fluid-filled cavity in the spinal cord
Falx cerebri
fold of dura matter that divides the two hemispheres of the brain
anaplastic carcinoma
least common thyroid carcinoma
medullary carcinoma
least common thyroid carcinoma, most aggressive, arises from parafollicular cells
decreased protein intake, dialysis, and careful monitoring of sodium and potassium intake
possible treatments for chronic kidney injury
myoglobinuria
presence of myoglobin in the urine