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)