Ch 13. and 14

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causes of tendonitis

repeated wrist extension or palmar flexion

within mediastinum

rete testis

3 layers of breast tissue

pre-mammary (subcutaneous) mammary (parenchymal, glandular) retromammary

retroperitoneal inferior to bladder between symphysis pubis and rectum

prostate

what scrotal abnormality is caused by incompetent valves within the pampiniform plexus

varicocele

creates ejaculatory duct

vas defrens and seminal vesicles

most likely tumor to metastasize to subcutaneous fat

melanoma

intratesticular mets from

melanoma, lung, kidney, prostate

inflammation of the breast that is related to pregnancy is referred to as

puerperal mastitis

site for benign prostatic hyperplasia

transitional zone

symptoms of hematocele

trauma, recent surgery, decreased hematocrit

testicular torsion is associated with

trauma, strenuous exercise, sexual activity, bell clapper deformity

dilated veins of a varicocele will measure

>2mm

oval shape

CC

what tests can be performed to determine a torn Achilles tendon

Thompson test

sono appearance of complete tendon rupture

anechoic, hetero, hematoma, refractive shadowing

tunica albuginea

beneath TV, forms mediastinum

which of the following houses the male urethra

corpus spongiosum

along length of epi

epididymal cysts

all of the following are sonographic findings consistent with the diagnosis of testicular torsion except

hyperemic flow within the testis

sono appearance of prostate cancer

hypo variable hypervascular

sono appearance of cryptorchidism

hypo to normal testis

sono appearance of hemangioma

hypoechoic blood flow

connect bone to bone

ligaments

partial dislocation

subluxation

normal testis thickness

3 cm

sex cord stromal tumors of the testicles

Leydig cell tumor. Sertoli cell tumor.

sono appearance of vascular impotence

cavernosa artery diastolic flow does not decrease

base of prostate

central zone

a 23 year old man presents to the sonography Department with the history of infertility which of the following is associated with male infertility

varicocele

symptoms of varicocele

-dull ache along spermatic cord -scrotal pain or heaviness

sono appearance of lipoma

1. Oval and well defined 2. Isochoic(although hyperechoic and hypoechoic lesions are seen) 3. Homogeneous 4. Compressible 5. Usually superficial 6. May be mistaken for a fat lobule

sono appearance of epi head

10-12 mm, isoechoic or echogenic

common ages for testicular torsion

12-18 years

normal testis width

2-4 cm

normal wall thickness of scrotum

20 mm

normal testis length

3-5 cm

common age for joint effusion

5-10 years

enlargement of the prostate in older men is often caused by

BPH

PSA elevated with

BPH cancer prostatis infarcts

surrounded by bucks fascia

CC CS

elliptical, medium level echoes

CS

barlow test

Detection of unstabloe hip by adduction and extension of hip. The "feel" of dislocation is felt as femur leaves acetabulum

symptoms of mastitis

Firm, red, swollen, tender breast w/ fever, myalgias, chills, malaise

Zinner syndrome

Renal agenesis Ipsilateral seminal vesicle cyst Obstruction of ejaculatory duct perineal pain, recurrent prostatitis, painful ejac, infertility

zinner syndrome consists of unilateral renal agenesis ejaculatory duct obstruction and

Seminal vesicle cysts

periphery of testicle, within the TA

TA cysts

symptoms of epididymitis

WBC, fever, dysuria, urethral discharge, edema

which of the following best describes a spermatocele

a cyst found within the head of the epididymis that may contain debris

all of the following are true of ganglion cyst except

a ganglion cyst is a common mass found along the superior aspect of the hand and wrist between the tarsals

orlanti test

abducting, lifting thigh

Most commonly injured ankle tendon

achilles

symptoms of testicular torsion

acute pain, often during sleep, pain in lower abd/inguinal are, swelling, nausea, vomiting, higher positioned testis

symptoms of appendix testis torsion

acute, localized pain to superior pole, blue dot sign

which of the following would most likely resemble a solid intra testicular mass and be associated with Cushing syndrome

adrenal rest

most common times for gynecomastia

after birth puberty 50-80 years old

which of the following at the sight of a forward body may produce bright echoes and therefore cause some ambiguity about the correct orientation of the object

air

sono appearance of seminal vesicle cyst

anechoic complex

sono appearance of bakers cyst

anechoic mass, posterior enhancement, echogenic fluid, debris, pannus, septations

sono appearance of transient synovitis

anechoic, hypo fluid that elevated anterior capsule on joint

sono appearance of epidermal cysts

anechoic/hypoechoic, complex/hyperechoic

most common cause of acute scrotal pain in prepubital boys

appendix testis torsion

symptoms of bakers cyst

asymp focal tenderness

extratesticular masses are assumed

benign

the most common location of a hydrocele is

between the 2 layers of the tunica vaginalis

sono appearance of adrenal rests

bilateral round hypoechoic, intratesticular mass near mediastinum

symptoms of prostate cancer

blood in urine/semen, back/pelvic/hip/thigh pain, impotence, decreased fluid

associated with DDIH

breech babies, oligo, female infants spina bifida, arthrogryposis

dense fibrous tissue

bucks fascia

second largest prostatic zone

central zone

bullet shrapnel and other metallic objects may cause

comet tail artifact

sono appearance of a pyocele

complex fluid collection with scrotum, WT, rupture of abscess

sono appearance of hematocele

complex fluid collection within scrotum, wall thickening

sono appearance of testicular abscess

complex intratesticular mass, no central flow, increased peripheral flow, pyocele

sono appearance of breast abscess

complex, focal mass with debris

sono appearance of pilonidal cyst

complex, subcutaneous mass, hyperemia, hypoechoic tract from cyst to skin surface

inner penis tissue

corpus spongiosum paired corpus cavernosa

undescended testes

cryptorchidism

clinical findings of a Baker system I mimic those of a

deep vein thrombosis

causes of vascular impotence

diabetic neuropathy

tunica vaginalis

double-layered membrane covers each testis and separates it from scrotal wall

sono appearance of ligament

echogenic

tendon sonographically appear as

echogenic fibrous structures connecting muscles to bone

sono appearance of mediastinum

echogenic linear in sag triangular in trans

sono appearance of tendons

echogenic, fibrous structures

symptoms of pilonidal cyst

edema, warmth, pain, bloody drainage

gynecomastia associated with

elevated hcg, testicular/adrenal tumors, elevated estrogen, hepatblastoma, klinefelters, drugs

elevated AFP

embryonal cell carcinoma, teratoma, yolk sac tumors

what kind of gland is the testes

endocrine and exocrine

sono appearance of epididymitis

enlarged epi, hypoechoic epi/testes, hyperemia, WT reactive hydrocele

sono appearance of prostatitis

enlarged, hypoechoic, hyperemeia

sono appearance of BPH

enlargement of inner gland, hypoechoic areas, calcs, diffusely hetero, cystic changes

sono appearance of epi after vasectomy

enlargement, cystic areas

sono appearance of acute testicular torsion

enlargements of spermatic cord, epi, testis WT, hypo/hetero testis, reactive hydrocele, no blood flow

which of the following is a benign intra testicular mass that typically has a world or onion skins on a graphic appearance

epidermoid cyst

most common cause of acute scrotal pain in adults

epididymitis

sono appearance of scrotal pearl

extremely echogenic, mobile, extratesticular structure, shadowing

hypoechoic, rounded structure, echogenic stripes

femoral head

symptoms of testicular abscess

fever, WBC, painful, swelling

sono appearance of partial tendon rupture

focal hypoechioc area

milk filled cyst

galactocele

sono appearance of varicocele

group of anechoic tubular structures located outside of testis, distended veins, fill with color

benign enlargement of breast

gynecomastia

sono appearance of DDH

head completely or partially outside of acetabulum small alpha angle large beta angle

symptoms of prostatitis

hematospermia, painful ejac., perineal pain, dysuria

sono appearance of inguinal hernia

hetero mass in scrotum, moves, may contain air, fluid, hydrocele

sono appearance of yolk sac tumors

hetero mass with areas of hemorrhage and calcs

sono appearance of choriocarcinoma

hetero mass with areas of hemorrhage, necrosis, calcs

sono appearance of embryonal cell carcinoma

hetero mass with cystic components

sono appearance of muscles

hypoechoic contain linear echogenic structure

sono appearance of gynecomastia

hypoechoic mass posterior to areola, triangular shaped

which of the following best describes the most common sonographic appearance of gynecomastia

hypoechoic retro areolar mass

sonographically normal muscle appears as

hypoechoic tissue that contains linear, echogenic strands

sono appearance of subcutaneous skin

hypoechoic with interspersed hyper linear echoes

sono appearance of retromammary layer

hypoechoic, contains fat

sono appearance of cellulitis

hypoechoic, edematous strands within soft tissue, cobblestone appearance

sono appearance of seminal vesicles

hypoechoic, enlarged, low level echoes, anechoic when fluid filled

hyperemic flow within or around a structure is often indicative of

inflammation

multiple, small along mediastinum

intratesticular cysts

most common form of testicular torsion

intravaginal

shape of prostate

inverted pyramid base superior apex inferior

sono appearance of penile trauma

irregular hypo/hyper defect at site of rupture

clinical findings of tendonitis include all of the following except

itching in the area of the tendon

A6 year old female patient presents to the sonography Department for a hip sonogram with irritability unwillingness to walk and low grade fever sonographically visualize a hypoechoic fluid collection that elevates the joint capsule what is the most likely diagnosis

joint effusion

the most common location of a varicocele is the

left side of the scrotum

secondary varicocele's are most likely associated with all of the following except left sided location right sided location hepatomegaly renal mass

left sided location

symptoms of transient synovitis

leg/knee pain reluctance to walk, irritability, low grade fever, WBCs

sono appearance of focal tendonitis

localized, enlarged hypo

elevated HCG

malignancy

all of the following are sonographic findings consistent with torsion of the testicular appendage except

no intra testicular flow

symptoms of BPH

nocturia, increased frequency, sense of frequency, constant feeling of full bladder

sono appearance of ganglion cysts

noncompressible, anechoic mass acoustic enhancement, debris/septs

sono appearance of appendix testis torsion

normal blood flo, small, avascular hyper/hypo mass adjacent to superior pole, reactive hydrocele, WT

you have been asked to perform a study to rule out cryptorchidsim which means

one or both of the testicles have not descended into the scrotum

symptoms of cryptorchidism

one or both testes not palpable in scrotum

symptoms of tendon rupture

pain, edema, audible snap

Symptoms of tendonitis

pain, swelling, warm to touch

symptoms of cellulitis

pain, tenderness, swelling, warmth

symptoms of seminoma

painless mass, hardening

symptoms of teratoma

palp elevated AFP and HCG when malignant

symptoms of spermatocele

palp when large, no pain

symptoms of embryonal cell carcinoma

palpable elevated AFP, HCG

symptoms of yolk sac tumors

palpable elevated AFP

Symptoms of choriocarcinoma

palpable elevated HCG

subluxation denotes

partial hip dislocation

largest prostatic zone

peripheral zone

most common site for malignancy

peripheral zone

posterior later, apical gland

peripheral zone

the most common location of prostatic cancer is the

peripheral zone

embedded in the muscle of proximal urethera

periurethral glandular zone

smallest prostatic zone

periurethral glandular zone

symptoms of an inguinal hernia

persistent/intermittent swelling, abd pain, blood in stool

a patient presents to the sonography Department for a penile sonogram he complains of a painful curvature of the penis and impotence what is the most likely diagnosis

peyronie disease

build up of fibrous plaque and calcs

peyronnie disease

found in natal cleft

pilonidal cyst

primary varicoceles are associated with all of the following except left sided location retroperitoneal mass infertility Palpable extra testicular mass

retroperitoneal mass

sono appearance of extratesticular cysts

round, anechoic mass, acoustic enhancement, may have layering debris

sono appearance of galactocele

round, complex mass, fluid-fluid level

sono appearance of mastitis

rule out abscess ill defined areas of echogenicity with diffuse edema, hypoechoic fluid, >2 mm WT, enlarged lymph nodes

common areas for epidermal cysts

scalp, face, neck, trunk, back

from vas defrens to

seminal vesicles

paried, superior to prostate, posterior to bladder

seminal vesicles

converge at rete testis

seminferous tubules

spermatogenesis occurs within the

seminiferous tubules

the most common germ cell tumor of the testis is the

seminoma

what are germ cell tumors of the testicles

seminoma teratoma embryonal cells carcinoma yolk sac tumor choriocarcinoma

sono appearance of hydrocele

simple fluid anterior to testes, WT, debris/septations with chronis

sono appearance of seminoma

solid hypoechoic intratesticular mass, large-hetero

sono appearance of mets

solid, vascular, hypoechoic mass

most common scrotal mass

spermatocele

causes of epididymitis

spread of bacteria form UT or prostate trauma, chlamydia, gonorrhea

a standoff pad is most often useful in imaging

superficial structures

orchipexy

surgical transfer of an imperfectly descended testicle into the scrotum and suturing it there

corpus cavernosa

surrounded by TA, dorsal

corpus spongiosum

surrounds the urethra ventral

symptoms of gynecomastia

tender palp retroaerola mass firm to touch

connect muscle to bone

tendons

fluid within the synovial sheath is indicative of

tendosynovitis

inflammation of the tendon in synovial tendon sheath is referred to as

tendosynovitis

acute onset of testicular pain at rest is a common clinical finding with

testicular torsion

the endocrine function of the testicles is to produce

testosterone

which of the following best describes the Thompson test part 2

the calf squeeze in the foot should plantarflex in a patient who does not have a complete tear of the Achilles tendon

all of the following will aid in sonographic assessment of an Achilles tendon except

the patient is scanned standing with a small amount of pressure placed on the symptomatic side

which of the following best describes the Thompson test

the patient lies prone while the symptomatic calf is squeezed

which of the following is true about patients with a lipoma

they feel no pain in the area of the mass

sono appearance of diffuse tendonitis

thickened, hypoechoic

sono appearance of peyronnie disease

thickening TA, calcs

A 7 year old boy presents to the emergency room with testicular pain localized to the superior pole of his right testis what is most likely diagnosis

torsion of the testicular appendage

the blue dot sign is indicative of

torsion of the testicular appendage

most common cause of painful hip and joint effusion in children

transient synovitis

what is the most likely cause of a hip joint effusion in infants

transient synovitis

which of the following techniques is used for providing sonographic evidence of a varicocele

valsalva

symptoms of epidermal cysts

visible, palp mass just under skin, pain, redness

echogenic linear structure, extending from head acoustic shadow

ilium

sono appearance of scrotal trauma

possible fracture line, indistinct margins, hematocele

cryptorchidism is associated with

infertility, increased risk for malignancy

what lab value can be assessed as a tumor marker to evaluate a patient for testicular malignancy

AFP

is cystic mass located within the popliteal fossa is most likely a

Baker cyst

the accumulation of synovial fluid from a weakening in the joint capsule of the knee as seen in conditions as rheumatoid arthritis can result in a

Baker cyst

the lack of normal fixation of the testis to the posterior scrotal wall is referred to as

Bell Clapper deformity

inflammation and infection of the skin and subcutaneous tissue is termed

Cellulitis

superficial lipomas may appear as all of the following except hypoechoic isoechoic hyperechoic anechoic

anechoic

Which of the following is not a component of the spermatic cord epididymis testicular artery cremaster muscle lymph nodes

epididymis

stores sperm and transports it from the testes to vas defrens

epididymis

which of the following techniques is used to measure the relationship of the femoral head and acetabulum by evaluating the Alpha and beta angles

graf

the Achilles tendon connects the

heel to the calf muscle

which of the following would best describe a benign tumor composed of blood vessels

hemangioma

which of the following transducers would be best suited to sonographically assessed for a splinter in a patient's hand

high frequency linear array transducer

a simple fluid collection surrounding the testis is referred to as a

hydrocele

which of the following is consistent with the sonographic features of testicular Abscess

hyperemic flow around the Abscess but not within it

what would be the most likely sonographic appearance of a seminoma

hypoechoic

which of the following would best describe a benign tumor comprised of fat

lipoma

which of the following is a clinical test for developmental hip dysplasia that is used to evaluate the hip for reduction or relocation of a dislocated hip

ortolani

a patient presents with a palpable oozing mass at the level of the Natal cleft what is the most likely etiology of this mass

pilonidal cyst

Where are the seminal vesicles located?

posterior to the urinary bladder superior to prostate

in what position should the patient be placed to better evaluate the Achilles tendon

prone

acoustic shadowing caused by bending of a sound beam at the edge of a curved reflector is referred to as

refractive shadowing

what is the most common malignancy of the testicles

seminoma

the exocrine function of the testicles is to produce

sperm

a common cyst most often seen in the head of the epididymis that contains nonviable sperm is the

spermatocele

what is the most common malignancy of the penis

squamous cell carcinoma

a patient presents to the sonography Department with a history of Cellulitis on his abdomen the patient has fever edema and complaints of focal tenderness in a specific region affected by the Cellulitis sonographically you identify a localized complex collection of fluid what is the most likely diagnosis

superficial Abscess

the most common location of BPH is the

transitional zone

during a sonographic examination of the right testis you visualize multiple small cysts located along the mediastinal what is the most likely diagnosis

tubular ecstsia of the rete testis

a dilated group of veins found within the scrotum is called a

varicocele

what is the most common correctable cause of male infertility

varicocele

sono appearance of fascia

hyperechoic varying thickness

Symptoms of achilles tendon rupture

posterior ankle/leg pain, audible snap

symptoms of penile trauma

hx of audible pop during sex, subcutaneous bleeding

larger than normal amount of fluid between 2 layers of TV

hydrocele

sono appearance of most foreign bodies

hyperechoic

sono appearance of mammary tissue

hyperechoic contains ducts and glandular tissue

sono appearance of superficial abscess

hypoechoic, focal fluid collection, complex peripheral rim of hyperemia

sono appearance of primary melanoma

hypoechoic, increased vasc

sono appearance of subcutaneous tissue

hypoechoic, mostly fat

symptoms of peyronie disease

impotence, painful erections palp area of scar, marked curvature

symptoms of galactocele

palpable, near areola, can be painful if infected

venous drainage of the testicles is through the

pampiniform plexus

a complicated Baker cyst may contain a thin flap of tissue referred to as

pannus

what is the most common cancer found in men

prostate cancer

sono appearance of chronic testicular torsion

hyperemic flow around testis, hetero testis with areas of necrosis

types of varicocele

primary secondary

symptoms of ganglion cysts

palpable mass, painful

Inability to obtain or maintain an erection.

vascular impotence

a common mass found along the dorsal aspect of the hand and wrist is the

ganglion cyst

which of the following is also referred to as a Bible bump

ganglion cyst

dorsal aspect of hand and wrist

ganglion cysts

most intratesticular tumor are

germ cell origin other are sex-cord stromal, lymphoma, leukemia, mets

all of the following are keys to identifying foreign bodies with sonography accept

most foreign bodies appear hypoechoic

sono appearance of microlithiasis

multiple echogencs foci, no shadowing

symptoms of breast abscess

palpable painful lump

separates testes

median raphe

Symptoms of Hemangioma

asymptomatic red/purple mass

symptoms of lipoma

asymptomatic compressible mass

a partial tear of a tendon typically appears as

focal hypoechoic areas within the tendon

symptoms of DDH

asymmetric skin folds, leg length discrepancy, limited limb abduction

symptoms of seminal vesicle cyst

asymptomatic

associated with microlithiasis

malignancy, infertility, Klinefelter, cyrpto

intratesticular masses are assumed

malignant

sono appearance of teratoma

hetero with calcs, hair, teeth

symptoms of hydrocele

transilluminates light, painless swelling, pain with infection, torsion, trauma, tumor

on both sides of proximal urethra

transitional zone

second most common site of malginancy

transitional zone


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