Ch. 10 GI Tract & Abdominal Wall

HPS is most often found in infants between:

2-6 weeks of age

What are the diagnostic criteria for pyloric stenosis?

3 mm in thickness and 17 mm in length

An autoimmune disease characterized by periods of inflammation of the GI tract describes:

Crohn disease

Abnormal pyloric channel and muscle measurements:

The abnormal pyloric channel with measure greater than 17 mm in length, and the muscle will measure greater than 3 mm

Gastric cancer is most often in the form of:

adenocarcinoma

inguinal hernia

Can be further described as direct or indirect; bowel protrudes into the groin

When is appendicitis indicative?

When the inflamed appendix is NONcompressible and measures GREATER than 6 mm

What anatomic structure may be noted as a bulls-eye structure anterior to the abdominal aorta and posterior to the left lobe of the liver in the sagittal scan plane? a. pyloric sphincter b. duodenal antrum c. gastroesophageal junction d. distal jejunum

gastroesophageal junction

Which of the following is not a layer of gut identified within sonography? a. visceral b. serosa c. submucosa d. mucosa

visceral

The situation when bowel protrudes into the groin is referred to as a(n):

inguinal hernia

Which of the following types of obstruction refers to the bowel being physically blocked by something? a. mechanical b. nonmechanical c. obstreperous d. bezoarine

mechanical

Traditionally, treatment for intussusception is by means of:

theraputic enema

Linea alba hernia

Bowel protrudes through the fascia of the linea alba

How does sonography utilize compression to analyze bowel?

In many situations, normal bowel is compressible, whereas abnormal bowel is noncompressible.

The area of pain and rebound tenderness with acute appendicitis is most likely at:

McBurney point

Layers of gut and echogenicities

Superficial mucosa (innermost layer) = echogenic Deep mucosa = hypoechoic Submucosa (muscularis propria interface) = echogenic Muscularis propria = hypoechoic Serosa (outermost layer) = echogenic

What is the olive sign?

The clinical finding where the enlarged pyloric muscle can be palpated is referred to as the olive sign

Talk about pylorus and its' orientation within the abdomen.

The pylorus is TRANSVERSLY oriented in the abdomen. Therefore, pyloric stenosis yields a cervix appearance when the transducer is placed transverse to the abdomen, while in the longitudinal plane to the abdomen, the enlarged pylorus yields a doughnut appearance.

The olive sign is best described as:

an enlarged palpable pyloric sphincter

Which of the following would be most likely a cause of colitis? a. gastroesophageal reflux disease b. antibiotic therapy c. dehydration d. rectus sheath hematoma

antibiotic therapy

Rebound tenderness is associated with: a. appendicitis b. intussusception c. diverticulitis d. gastric carcinoma

appendicitis

Upon sonographic evaluation of the right lower quadrand in a patient complaining of focal abdominal pain in that area, you visualize a hyperemic blind-ended, tubular structure that contains a shadowing focus. What is the most likely etiology of the shadowing focus? a. ureteral stone b. appendicolith c. gallstone d. herniated omentum

appendicolith

Pseudomyxoma peritonei can result from:

appendix cancer

Incisional hernia

bowel protrudes into a surgical incision site

Spigelian hernia

bowel protrudes into a weakened area in lower one-fourth of rectus muscle

umbilical hernia

bowel protrudes into the umbilicus

The most common location of the vermiform appendix is in the area of the:

cecum

All of the following are sonographic findings of acute appendicitis except: a. appendicolith b. compressible, blind-ended tube c. periappendiceal fluid collection d. hyperemic flow

compressible, blind-ended tube

Clinical findings of acute appendicitis include all of the following except: a. leukocytosis b. right lower quadrant pain c. constipation d. rebound tenderness

constipation

A patient presents to the sonography department with a painful, superficial abdominal mass located within a prior cesarean scar. What clinical feature would be most consistent with scar endometriosis? a. hematuria b. chorinic headaches c. cyclical pain d. bloody diarrhea

cyclical pain

An adult patient presents to the sonography department with left lower quadrant pain, fever, and bouts of both constipation and diarrhea. Which of the following would be the most likely etiology? a. diverticulitis b. intussusception c. midgut malrotation d. appendicitis

diverticulitis

Which of the following is the development of small outpouchings within the sigmoid colon? a. diverticulitis b. Crohn disease c. diverticulosis d. midgut malrotation

diverticulosis

All of the following are common clinical findings in infants who present with pyloric stenosis except: a. weight loss b. dehydration c. olive sign d. first-born female

first-born female

All of the following are common clinical findings in infants who present with intussusception except: a. vomiting b. first-born male infant c. red currant jelly stools d. leukocytosis

first-born male infant

Which of the following best describes the location of McBurney point? a. Left lateral to the umbilicus and medial to the left iliac crest b. halfway between the anterior superior iliac spine and the umbilicus c. midway between the umbilicus and the symphysis pubis d. medial to the superior iliac spine

halfway between the anterior superior iliac spine and the umbilicus

Which of the following is not associated with a rectus sheath hematoma? a. palpable abdominal mass b. increased hematocrit c. child birth d. sneezing

increased hematocrit

Which of the following is not a sonographic finding consistent with Crohn disease? a. bowel wall thickening b. noncompressible bowel that has a target appearance c. increased peristalsis d. hyperemic wall

increased peristalsis

The sonographic findings of fluid-filled, distended loops of bowel is consistent with: a. Meckel diverticulum b. divertiulitis c. gastroesophageal reflux disease d. intestinal obstruction

intestinal obstruction

Other abnormalities that can present much like pyloric stenosis include all of the following except: a. midgut malrotation b. pylorospasm c. gastroesophageal reflux disease d. intussusception

intussusception

The most common cause of intestinal obstruction in children less than 2 yrs of age is:

intussusception

The telescoping of one segment of bowel into another is referred to as:

intussusception

What abnormality associates red currant jelly stools?

intussusception

A patient presents to the sonography department with bilious vomiting. While investigating the pediatric patient for pyloric stenosis, you note that while the pyloric sphincter appears normal, the SMA is abnormally located to the right of the SMV. What is the most likely diagnosis? a. pylorospasm b. intussusception c. Crohn disease d. Midgut malrotation

midgut malrotation

All of the following are true of normal intestinal findings with sonography except: a. normal bowel does not compress b. normal bowel should have observable peristalsis c. inestinal wall should measure less than 5 mm d. normal bowel has little to no color Doppler signals

normal bowel does not compress

Clinical findings of a patient with Crohn disease include all of the following except: a. palpable abdominal mass b. rectal bleeding c. abdominal pain d. weight loss

palpable abdominal mass

What is a key clincial finding of intussusception?

red currant jelly stool

In what position is the infant often placed for better sonographic visualization of the pyloric sphincter?

right lateral decubitus

The situation when bowel protrudes into a weakened area in the lower one-fourth of the rectus muscle is referred to as a(n):

spligelian hernia

Pediatric patients could suffer from bowel obstructions that are caused by a buildup of ingested hair. The mass associated with this type of obstruction is termed a:

trichobezoar

Which of the following would be useful to emply during a sonographic evaluation of a suspected abdominal wall hernia? a. upright positioning b. prone positioning c. graded compression d. valsalva

valsalva

All of the following are sonographic criteria in the diagnosis of pyloric stenosis except: a. wall of the pylorus is focally thinned b. length of the pylorus measures more than 17 mm c. doughnut appearance in transverse d. cervix appearance in longitudinal

wall of the pylorus is focally thinned

Which of the following would be the most likely clinical feature of colitis? a. inguinal herniation of the bowel b. right shoulder pain c. watery diarrhea d. midline hematoma

watery diarrhea