Exam 2 Intro 5
Anteroposterior measurement of the adult liver should not be larger than
15cm
The size of the aorta is normal up to
3cm
The size of the IVC is normal up to
4cm
The CHD is considered normal in size up to
4mm
What percentage of the total blood flow to the liver does the portal system supply?
75
The normal range in size of the kidney is _____.
9 to 14cm
What is the normal diameter of the gallbladder wall?
<3mm
The common bile duct and the hepatic artery follow a/an ____ course to the portal vein within the liver.
Anterior
The normal contour of the kidney
Appears smooth and even on ultrasound
Which part of the pancreas does the duodenum encircle?
Head
Hepatic veins ____ in size as they drain toward the IVC.
Increase
Normally the diameter of the IVC will _____________ during a valsalva maneuver or inspiration.
Increase
_____ describes a folded gallbladder fundus.
Phrygian cap
The splenic vein joins the SMV and forms the _____.
Portal vein
Which portion of the pancreas is the least commonly visualized by ultrasound?
Tail
Which sentence is true regarding the normal anatomy of the kidney?
The kidneys are retroperitoneal in location.
Which sentence describes the normal echogenicity of the renal corterx?
The normal kidney echogenicity is frequently isoechoic with the liver and spleen.
Segmental lobar anatomy divides the liver into ____ lobes.
Three (right, left, caudate)
Longitudinal views of the splenic artery and common hepatic artery are seen in a
Transverse scanning plane
A fold on the gallbladder fundus is called the Phrygian cap. True/ False
True
Intrahepatic bile ducts are not routinely visualized on ultrasound. True/ False
True
Just anterior to the portal vein within the liver lies the common bile duct and the hepatic artery.
True
The biliary ducts are subdivided into intrahepatic and exrtrahepatic ducts. True/ False
True
The common duct usually lies at a right angle to the costal margin. True/ False
True
The gallbladder is an intraperitoneal organ. True/ False
True
The gallbladder serves as a storage site for bile and is variable in size according to the amount of bile it's storing. True/ False
True
The spleen is part of the reticuloendothelial system and is
a large mass of the lymphatic tissue.
A standard alternative approach for scanning the pancreas tail is
a posterior approach
The tail of the pancreas is in contact with which structure(s)? a) left kidney b) splenic flexture of the colon c) spleen d) all of the above
all of the above
The liver is divided into lobes according to ___ and into segements according to____.
anatomy; function
Beginning posteriorly, and in correct order by the location in the body, the abdominal aorta is
anterior and just to the left of the spine, posterior to the gastroesophageal junction, CA, SMA, splenic vein, body of the pancreas, portion of the stomach, left lobe of the liver.
Beginning posteriorly, and in correct order by the location in the body, the IVC is
anterior and just to the right of the spine, anterior to the right renal artery, posterior of the head of the pancreas, gastroduodenal artery, portal splenic confluence, and the liver.
The neck of the pancreas is
anterior to the SMV, portal splenic confluence, and uncinate process
The body of the pancreas is
anterior to the splenic vein and SMA; inferior to the splenic artery
The tail of the pancreas is
anterior to the splenic vein, left renal vein, and left kidney; posterior to the stomach
The psoas and quadratus lumborum muscles
appear sonographically as the low-gray structures posterior to the kidneys
The gallbladder tends to lie in the
are between the right medial angle of the ribs and the superior pole of the right kidney.
The infundibula
are the major and minor calyces
In the following transverse scanning plane image, a(n) ____ section of the IVC is visualized.
axial
In the sagittal scanning plane above, a(n) ____ section of the right renal artery is visualized.
axial
The proximal abdominal aorta is the portion
between the diaphragm and CA trunk
The distal portion of the common duct is
called the CBD
The proximal portion of the common duct is
called the CHD
The primary function of the IVC is to
carry deoxygenated blood to the heart.
The IVC lies along the posterior surface of what lobe of the liver?
caudate
The IVC is medial to all of the following except a) right adrenal gland b) caudate lobe c) right kidney d) right ureter
caudate lobe
The IVC is right lateral to all of the following except the a) aorta b) caudate lobe c) left renal vein d) portal splenic confluence
caudate lobe
The IVC passes through a deep fossa on the posterior surface of the liver between the ____ and _____.
caudate lobe; bare area
The cystic duct connects the
common duct and gallbladder neck
In most cases, the long axis of the left kidney is most easily resolved from which scanning plane?
coronal oblique scanning plane
The long axis of the gallbladder is visualized in
either transverse, sagittal, or coronal scanning planes depending on its position.
The right, left, and middle hepatic veins
empty into the IVC
Which of the following is not a direct branch of the abdominal aorta? a) celiac trunk b) renal artery c) mesenteric artery d) external iliac artery
external iliac artery
What structure is identified at the anterior aspect of the head of the pancreas?
gastroduodenal artery
The gallbladder is described in three major sections:
head, neck and fundus
The overall sonographic appearance of the kidneys can be described as
heterogeneous
The sonographic appearance of the normal renal sinus is
highly reflective
The sonographic appearance of normal liver parenchyma may be described as
homogeneous with medium- level echoes.
The sonographic appearance of the normal spleen is
homogeneous, midgray,isosonic, or hypoechoic relative to the liver.
The normal liver should have a/an ____ sonographic appearance.
homogenous
The sonographic appearance of the pancreas is descibed as
homogenous and hyperechoic relative to the liver
The medullary pyramids are
hypoechoic or anechoic relative to renal cortex depending on the amount of urine they contain.
The sonorgraphic appearance of normal real cortex is
hypoechoic relative to the liver
The long axis view of the common duct is seen
in an oblique sagittal scanning plane
The distal abdominal aorta is the portion
inferior to the SMA trunk and inferior to the bifurcation
The mid portion of the abdominal aorta is
inferior to the celiac trunk and along the length of the SMA
What is the most common location of an abdominal aortic aneurysm?
infrarenal
The spleen is
intraperitoneal in the left hypochondruim
The renal pelvis
is formed by the expanded superior end of the ureter where it divides into the infundibula; not visualized sonographically when collapsed.
The long axis of the spleen
is seen in a left coronal oblique plane
The spiral valve
is the tortuous connection of the gallbladder and cystic duct.
Different patient positions are used when evaluating the gallbladder because
it distinguishes certain abnormalities from eachother
The left renal vein has a(n) ________ course compared with the right renal vein.
longer
In the following sagittal scanning plane image, a(n) _____ section of the IVC is visualized.
longitudinal
In the transverse scanning plane image above, a(n) ____ section of the left renal vein is visualized.
longitudinal
A(n) _____ section of the RRA is seen_____.
longitudinal; in a transverse scanning plane posterior to an axial section of the inferior vena cava and longitudinal section of the right renal vein.
The contour of the normal pancreas
may be difficult to evaluate due to retroperitoneal fat infiltration
Periodic ureteral "jets" are a sign of ________.
normality
The spleen is
ovoid with a convex superior surface and concave inferomedial surface
The aorta is posterior to all the following except the a) left renal vein b) SMA c) esophageal gastric juntion d) pancreas head
pancreas head
The IVC
passes though a deep fossa on the posterior surface of the liver between the caudate lobe and bare area.
The portal triad is found at the level of the ____ and consists of the ____.
porta hepatis; hepatic artery, bile duct, and portal vein
The vascular branches seen scattered throughout the liver parenchyma are
portal and hepatic veins
What vein does the splenic vein drain into?
portal vein
The caudate lobe is located on which surface of the liver?
posterior
The right and left common iliac veins are _____ the right and left common iliac arteries.
posterior to
The mid portion of the IVC is
posterior to the head of the pancreas at the level of the renal veins.
The head of the pancreas is
posterior to the liver, medial to the duodenum, anterior to the IVC
What is the relationship of the pancreas to the superior mesenteric vein?
posterior to the neck
The three major functions of the spleen are
red blood cell and platelet destruction, defense, hematopoeisis, blood reservoir.
The right lobe of the liver is divided into the anterior and posterior segments by the
right hepatic vein
The CBD is located to the hepatic artery.
right lateral
In most cases the best patient position to visualize the spleen is
right lateral decubitus
Which of the following vessels runs posterior to the IVC? a) left renal vein b) right hepatic artery c) right renal artery d) left renal artery
right renal artery
The main lobar fissure of the liver
runs between the right branch of the portal vein and the neck of the gallbladder.
The splenic artery
runs superior and slightly anterior to the splenic vein
Axial views of the renal vein tributaries are seen in a
sagittal or coronal scanning plane
The long axis of the IVC is seen from a(n)
sagittal or coronal scanning plane
The long axis of the aorta is visualized best in a
sagittal or coronal scanning plane
A longitudinal view of Wirsung's duct is
seen in a transverse plane
The long axis of the pancreas is
seen in a transverse plane
In a sagittal scanning plane at the level of the porta hepatis the portal vein will be ?
seen in short axis
The biggest risk factor for rupture of an abdominal aortic aneurysm is
size
The IVC is posterior to all of the following except the a) uncinate process b) spine c) hepatic veins d) common bile duct
spine
Accessory spleen is
splenic tissue found separate from the spleen.
When scanning near the splenic hilum, what structure will you encounter?
splenic vein
The portal vein is formed by the confluence of the
splenic vein, and superior and inferior mesenteric veins
The biliary system has three main functions. which of the following is not a function? a) transports bile to the gallbladder b) stores bile c) transports bile to aid in digestion of fat. d) stores enzymes
stores enzymes
All of the following are IVC tributaries except the a) hepatic veins b) right renal vein c) superior mesenteric vein d) left renal vein
superior mesenteric vein
The lie of the IVC within the body is
superior to inferior
The lie of the aorta within the body is
superior to inferior
The distal IVC is the portion
that extends superior to the renal veins to the right atrium of the heart
The proximal IVC is the portion
that extends superiorly from the common iliac veins to just below the level of the renal veins
The liver is intraperitoneal except for interruptions at the gallbladder fossa, porta hepatis, and falciform ligament, portions around the IVC, and ____.
the bare area
The exocrine function of pancreas is
to aid digestion in conjunction with the biliary system
The IVCis anterior to all of the following except the a) transverse duodenum b) right crus of the diaphragm c) right adrenal gland d) psoas major muscle
transverse duodenum
A longitudinal section of the right and left branches of the portal vein is seen in a
transverse scanning plane
Axial views of the SMA are seen in a
transverse scanning plane
Longitudinal views of the renal arteries are seen in a
transverse scanning plane
Longitudinal views of the renal vein tributaries are seen in a
transverse scanning plane
What can help in the evaluation of the retroduodenal portion of the CBD?
use water to displace bowel gas.
Which of the following is not part of the urinary tract? a) kidneys b) uterus c) ureters d) urinary bladder
uterus
Which ligament seperates the left lobe from the caudate lobe?
venosum
The orientation of the IVC within the body is
vertical
A scanning technique to help resolve the structures at the splenic hilum is to
very slightly rotate/twist the transducer, first one way and then the other.