Renal: SonoSim for Bladder Scanning and Bladder: Anatomy & Physiology

A. may become trapped within the bladder

A stone (calculus) within the bladder __________. A. may become trapped within the bladder B. will appear anechoic upon ultrasound imaging C. will not cast a shadow upon ultrasound imaging D. is never seen in the far field (lowest portion) of the ultrasound screen E. All of the above

A. True

Agitated saline can be used to fill the Foley catheter balloon, to distinguish it from urine within the bladder and to highlight the catheter balloon's wall. A. True B. False

A. True

Bladder rupture that occurs at the dome of the bladder typically results in intraperitoneal extravasation of urine. A. True B. False

A. True

Bladder ultrasonography can be used to facilitate suprapubic bladder catheter placement using Seldinger technique. A. True B. False

A. True

Holding the transducer in the position illustrated in this image will produce a sagittal view of the bladder. A. True B. False

A. the bladder should be full

In order to optimize imaging of the pelvic anatomy during a transabdominal ultrasound __________. A. the bladder should be full B. the bladder should be empty C. the bladder should be avoided D. the small bowel should be used as an acoustic window E. have the patient bear down

D. The patient's head

In the sagittal bladder view, the transducer indicator should be oriented towards __________. A. The patient's anatomic left B. The patient's anatomic right C. The patient's feet D. The patient's head E. None of the above

B. the patient's anatomic right

In the transverse bladder view, the transducer indicator should be oriented towards __________. A. the patient's anatomic left B. the patient's anatomic right C. the patient's feet D. the patient's head E. the patient's left shoulder

A. True

Post-void residual bladder volumes can be accurately and noninvasively estimated by ultrasound. A. True B. False

D. between the pubic symphysis and urinary bladder

The Space of Retzius is located __________. A. between the rectum and bladder B. between the prostate and the bladder C. between the vagina and the uterus D. between the pubic symphysis and urinary bladder E. within the peritoneal cavity

A. Posterior cul-de-sac

The __________ is a very gravity-dependent location within the peritoneum and is one of the most frequent sites of intraperitoneal free fluid collection. A. Posterior cul-de-sac B. Space of Retzius C. Dome of the bladder D. All of the above E. None of the above

A. abdominal curved array

The __________ ultrasound transducer should be used to visualize the bladder. A. abdominal curved array B. intracavitary C. linear high-frequency D. 10 MHz E. None of the above

A. True

The bladder is a low-attenuating structure and tends to create posterior acoustic enhancement artifact. This artifact can be partially mitigated by decreasing the far-field gain. A. True B. False

A. True

The release of urine from the bladder relies upon synchronized contraction of the detrusor muscle and relaxation of the internal and external urethral sphincter muscle groups. A. True B. False

C. Transverse view

This probe is positioned over the bladder with the probe indicator oriented to the patient's anatomic-right side. What is the resultant sonographic view? A. Sagittal view B. Longitudinal view C. Transverse view D. Oblique view E. None of the above

B. an anteverted uterus

This sagittal ultrasound image of the female pelvis demonstrates __________. A. a distended urinary bladder B. an anteverted uterus C. a retroverted uterus D. an intrauterine pregnancy E. Choices A and C

*E. All of the above* A. diffuse bladder wall thickening B. a normal bladder wall C. focal areas of calcification within the bladder wall D. intralumenal echogenic debris

Ultrasonographic evidence of severe or recurrent episodes of cystitis can include: A. diffuse bladder wall thickening B. a normal bladder wall C. focal areas of calcification within the bladder wall D. intralumenal echogenic debris E. All of the above

A. True

Ultrasound can be used to confirm Foley catheter placement. A. True B. False

B. False

Ureteral jet visualization along the posterior bladder wall under greyscale imaging is facilitated by undergaining the image. A. True B. False

A. True

Ureteral jets can be seen using simple greyscale ultrasound (2D) or Color Power Doppler (CPD). A. True B. False

C. It will increase the artifact

What effect will amplifying or turning up the far-field gain have on posterior acoustic enhancement artifact when imaging the bladder? A. No demonstrable effect B. It will eliminate the artifact C. It will increase the artifact D. It will introduce additional B-line artifacts E. It will improve detailed visualization of far-field structure deep to the bladder

A. Bowel

What is the name of the site demarcated by the arrow? A. Bowel B. Bladder C. Rectum D. Uterus E. Psoas msucle

D. Uterus

What is the name of the site demarcated by the arrow? A. Bowel wall B. Bladder C. Rectum D. Uterus E. Space of Retzius

D. Anterior cul-de-sac

What is the name of the site demarcated by the arrow? A. Uterine fundus B. Pouch of Douglas C. Posterior cul-de-sac D. Anterior cul-de-sac E. Space of Retzius

B. False

When imaging a bladder with an indwelling Foley catheter, the catheter balloon is not visible because it is filled with anechoic water and the bladder is also filled with anechoic urine. A. True B. False

B. The uterus becomes more retroverted with a full bladder

When imaging the female pelvis, the following statement(s) is (are) true? A. The bladder must be empty to serve as an acoustic window B. The uterus becomes more retroverted with a full bladder C. The vagina cannot be visualized D. All of the above E. None of the above

B. 90-degrees counterclockwise

When starting from a standardized orientation, sagittal view of the bladder, rotate the transducer __________ to convert your image to a transverse view. A. 90-degrees clockwise B. 90-degrees counterclockwise C. 180-degrees in either direction D. 30-degrees in either direction E. None of the above

A. Posterior acoustic enhancement

Which of the following artifacts are noted with bladder ultrasonography? A. Posterior acoustic enhancement B. Mirror artifact C. Ring-down artifact D. All of the above E. None of the above

A. Bladder

Which of the following choices correctly identifies the structure demarcated by the arrow? A. Bladder B. Uterine fundus C. Bowel D. Cervix E. Vaginal stripe

C. Bladder

Which of the following choices correctly identifies the structure demarcated by the arrow? A. Bowel B. Uterine fundus C. Bladder D. Cervix E. Vaginal stripe

*E. A and C* A. Posterior acoustic enhancement artifact C. Reverberation artifact

Which of the following imaging artifacts are most relevant to bladder sonography? A. Posterior acoustic enhancement artifact B. B-line artifacts C. Reverberation artifact D. None of the Above E. A and C

*E. A and B only* A. Transverse plane B. Sagittal plane

Which of the following planes is a standard imaging plane for bladder sonography? A. Transverse plane B. Sagittal plane C. Oblique plane D. All of the Above E. A and B only

D. The posterior aspect of the bladder, where the ureters insert into the bladder

Which of the following statements best characterizes the trigone of the urinary bladder? A. The most superior aspect of the bladder (the dome) B. The base of the bladder, located adjacent to the urethra C. The outermost histologic layer of the bladder, adjacent to the adventitia D. The posterior aspect of the bladder, where the ureters insert into the bladder E. None of the above

*E. A and C* A. The uterus tends to become anteverted as the bladder empties. C. The uterus tends to become retroverted as the bladder becomes distended with urine.

Which of the following statements is correct? A. The uterus tends to become anteverted as the bladder empties. B. The uterus does not change in location in relation to changes in bladder volume. C. The uterus tends to become retroverted as the bladder becomes distended with urine. D. None of the above E. A and C

B. A ureteral jet frequency of less than 40 percent suggests ureteral obstruction

Which of the following statements is correct? A. A ureteral jet frequency of under 70 percent is considered abnormal B. A ureteral jet frequency of less than 40 percent suggests ureteral obstruction C. Total jet frequency divided by 2 gives you the ureteral jet frequency D. None of the above

D. Blood clots in the bladder are anechoic.

Which of the following statements is incorrect? A. Bladders should be anechoic and completely devoid of internal echoes. B. The presence of debris swirling around in the bladder may represent evidence of bladder infection. C. If calculi are too large to exit through the urethra, they may continue to enlarge and reside in the bladder. D. Blood clots in the bladder are anechoic. E. None of the above

B. Post-void residual urine volumes in adult males should measure less than 150 milliliters

Which of the following statements regarding post-void residual urine volumes is (are) correct? A. Urine volumes measuring greater than 10 milliliters in an adult male indicate pathology B. Post-void residual urine volumes in adult males should measure less than 150 milliliters C. They can only be determined through Foley catheter insertion D. All of the above E. None of the above

*D. All of the above * A. The probe should be fanned through the entire volume of the bladder. B. The probe will sometimes need to be rocked (heel-toe motion) when imaging in the sagittal plane. C. Probe manipulation is often required, as the bladder will vary in its shape based on urine volume.

Which of the following statements regarding sonographic imaging technique of the bladder is correct? A. The probe should be fanned through the entire volume of the bladder. B. The probe will sometimes need to be rocked (heel-toe motion) when imaging in the sagittal plane. C. Probe manipulation is often required, as the bladder will vary in its shape based on urine volume. D. All of the above E. None of the above

*E. B and D* B. A low-frequency transducer D. A transducer with a frequency range of 5 to 2 MHz

Which of the following transducers is best suited for bladder sonography? A. A high-frequency transducer B. A low-frequency transducer C. A transducer with a frequency range of 15 to 10 MHz D. A transducer with a frequency range of 5 to 2 MHz E. B and D