How long is the alimentary canal?
What is the largest endocrine organ in the body?
What are the 3 glands that secrete digestive juice?
Where does the esophagus begin and end?
mouth to the stomach
Where is the cardiac sphincter?
between the esophagus and the stomach
where is the pyloric sphincter?
between the stomach and the duodenum
Where is the greater curvature of the stomach?
left lateral border
Where is the lesser curvature of the stomach?
medial ( right lateral)
Where is the lesser omentum?
from the lesser curve to the hilum of the liver
What artery supplies the lesser curvature?
left gastric artery
What artery supplies the greater curvature?
right & left
Where is the greater omentum?
extends inferiorly from greater curve
folds back on self
inserts on transverse colon
What is the greater omentum?
double fold membrane
What does the stomach consist of?
What are the layers of the alimentary canal?
Where does the gastroesophageal junction lie to the aorta?
How are lesions classified in the alimentary canal?
What is the sonographic appearance of the gastroesophageal junction?
What is the sonographic appearance of the pyloric antrum?
What is rugae?
idges produced by folding of the wall of the stomach
How is the stomach visualized with ultrasound?
fill with fluid
What are the sections of the duodenum?
superior - 1st
descending - 2nd
transverse - 3rd
ascending - 4th
What is the first part of the duodenum sometimes called?
The duodenum is ____ to visualize when filled with _____
Where is valvulae conniventes located?
Where is the bulb of the duodenum located?
What is valvulae conniventes?
extends surface area
slows down bolus
Who long is the duodenum?
How long is the jejunum?
How long is the ileum?
Explain the walls of the jejunum?
What are brunner's gland's?
produce a mucus-rich alkaline secretion (containing bicarbonate)
What is the cecum?
beginning of colon (bulb)
bind ending tube
What is inferior to the cecum?
What is the significance of McBurney's point?
the point over the right side of the abdomen that corresponds to where the appendix lies
What is the route of the colon?
extends superiorly to hepatic flexure
left lateral to splenic flexure
inferiorly to sigmoid colon
through the sigmoid notch into rectum
What is the narrowest portion of the colon?
What part of the colon is the most distendable?
What is the most superior point of the colon?
What is the colon called once it passes the iliac crest?
What are the walls of the ileum?
What are the 5 layers of the colon?
sub serosal fatty tissue
What is the normal wall thickness of the colon?
What method is used to image the colon?
fill with fluid
What is a gastric duplication cyst?
Lined with alimentary epithelium
well developed muscular walls
continuous with stomach
usually in women
What is the sonographic appearance of a gastric duplication cyst?
Where are gastric duplication cyst found?
What does a gastric duplication cyst cause?
What is a gastric bezoar?
moveable intraluminal masses of congealed materials on UGI
What is a trichobezoar?
What is a phytobezoar?
What is a concretion?
sand asphalt, shellac, barium
What is the most common benign tumor of the stomach?
What is a gastric polyp?
solid immovable mass
asymptomatic when small
What is a Leiomyomas?
seen as a mass similar to a carcinoma
asymptomatic when small
What is the sonographic appearance of a Leiomyomas?
contiguous with muscularis
can have central necrosis
What is gastric carcinoma?
more common in males
Where do most gastric tumors occur?
What is the most common malignant gastric tumor?
What is the 6th leading cause of death?
What is the sonographic appearance of gastric carcinoma?
gastric wall thickening
What is gastric lymphoma?
3% of stomach tumors
What is the sonographic appearance of gastric lymphomas?
gastric wall thickening with a space occupying lesion
may become huge
NOT able to make call
What is a Leiomyosarcoma?
large intraluminal or submucosal mass of stomach wall
1% - 5 % of gastric tumors
50s & 60s
What is the sonographic appearance of Leiomyosarcoma?
large solid mass
continuous with muscularis
can be circular space occupying lesions
can be mixed
What is the sonographic appearance gastric mets?
gastric wall thickening with space occupying lesion
NOT able to make call
What causes gastric obstruction?
dilated loops of bowel
What is the sonographic appearance of gastric obstruction?
smooth echo free loops
may have hyperperistalsis
wall should be pliable
Where is the appendix located?
inferior to cecum
What is appendicitis?
luminal obstruction & inflammation
What are the symptoms of appendicitis?
pain in McBurney's point
elevated WBC - leukocytes
What does appendicitis cause?
What are the differentials for appendicitis?
mesenteric lymph nodes
inflamed Meckel's diverticulum
What is gastroenteritis?
inflammation of stomach
What is Mittelschmerz?
middle cycle pain
What is Regional enteritis?
What is ovarian torsion?
What is the sonographic appearance of appendicitis?
thickened muscular wall
lack of peristalis
lack of compressibility
sometimes adjacent abscess
What is a fecalith?
What is an abnormal diameter for the appendix?
What is an abnormal wall thickening of the appendix?
What is a mucocele of the appendix?
gross enlargement of appendix from mucoid substance
What is the cause of a mucocele of the appendix?
fecalith left behind
What is the sonographic appearance of mucocele of the appendix?
looks like complex mass
What is Meckel's diverticulum?
Occurs in ileum 2 feet from ileocecal valve
What causes a Meckel's diverticulum?
the yolk sac persists as a diverticulum of the ileum in an adult
What is sets the seen for problems with a Meckel's diverticulum?
unable to differentiate from appendicitis
What is Crohn's disease?
a regional enteritis
thickening of bowel wall
What does Crohn's disease affect?
terminal ileum & colon
Where does Crohn's disease usually occur?
deep in the lining
What is the ultrasound appearance of Crohn's disease?
rigidity to pressure
absent or sluggish peristalsis
What does the dorsal cavity contain?
Where is the ventral cavity?
How is the ventral cavity divided?
What does thoracic cavity contain?
lungs and heart
What does the abdominopelvis cavity contain?
What does the abdominal cavity contain?
What is the peritoneum?
double folded lining walls of the abdominal cavity
covers the abdominal viscera
How is the omentum divided?
Where is the lesser omentum?
from the lesser curvature to liver and porta hepatis
Where is the Greater curvature?
greater curveture to the transverse colon
What is the omentum?
stretchy stuff holds vessels
What does the visceral peritoneum cover?
What does the parietal peritoneum cover?
What organs lie in the peritoneum?
Where is the anterior subphrenic space?
Rt & Lt of falciform ligament
posterior to diaphragm
anterior to liver
Where is the Rt. posterior subphrenic space?
anterior to Rt kidney
posterior to liver
What is another name for the Rt. posterior subphrenic space?
Where is the peritoneal recesses?
duodenum becomes jejunum
ileum becomes cecum
Explain the inguinal canal in men.
abdominal to scrotum
spermatic cord runs through
Explain the inguinal canal in women.
round ligaments reach labia
Why is the inguinal canal important?
common place for hernia
Why do abdominal hernias occur?
weakness in abdominal wall peritoneal covered abdominal structure
Why are the potential spaces significant in sonographic exams?
fluid can collect
What is the sonographic appearance of ascites?
Where is the most dependent space in women?
What is ascites filled with?
What is the sonographic appearance of malignant or inflammatory ascites?
fine or coarse echoes
What is the path of ascites?
posterior cul de sac
gas filled loops of bowel will float
when upstream it flows downstream
What is the sonographic appearance of peritoneal abscesses?
depends on age of abscess
thick irregular margins
septations are common
floating debris is common
How do you tell if an peritoneal abscess is producing gas?
bright echogenic area
What is the sonographic appearance of peritonitis?
What causes lesser sac abscesses?
pancreatic fluid leaks
Where is an intrarenal abscess?
What is a perinephric abscess?
intrarenal abscess that has leaked
What are appendiceal abscess?
complex mass in RLQ
When will an exam on abdominal wall mass be examined?
frequently post surgery
What transducer should be used for abdominal wall exams?
7.5 Mhz linear
What are the abdominal wall masses?
What is a biloma?
collection of bile
what is a lymphocele?
simple loculated cyst
What are the causes of peritoneal masses?
What is the sonographic appearance of peritoneal masses?
What are the peritoneal masses?
abdominal cystic lesion
abdominal wall abscesses
What is a urinoma?
urine filled cyst
What is a urachal cyst?
cystic mass between umbilical and bladder
What is the sonographic appearance of peritoneal mets?
multiple smooth nodules
What is the sonographic appearance of peritoneal lymphoma?
uniformly thick hypoechoic band shaped structure following anterolateral abdominal wall
Where is the retroperitoneal?
between peritoneal and posterior abdominal wall
What three spaces does the retroperitoneal consist of?
What borders the anterior wall of the retroperitoneum?
What borders the posterior wall of the retroperitoneum?
What borders the lateral wall of the retroperitoneum?
The retroperitoneum lies between the diaphragm to the ______.
What lies in the anterior pararenal space?
What lies in the posterior pararenal space?
branches of great vessels
What lies in the perirenal space?
What organs are in the perirenal space?
duodenum 2, 3, 4
What is the preparation for a peritoneal exam?
What position should patient be in for a peritoneal exam?
prone or supine
Where are the adrenal glands located?
medial to kidneys
What is the vascular supply of the adrenal glands
suprarenal branch of inferior phrenic artery
suprarenal branch of aorta
suprarenal branch of renal artery
How is the adrenal gland divided
What hormones does the cortex of the adrenal gland produce?
- Sex hormones
What does Conn's syndrome cause?
What does cushing's disease affect?
muscle & bone disease
fertility problems in emn
masculating effects in women
What are the symptoms of addison's disease?
loss of appetite
What is the cause of cushing syndrome?
What is the function of glucocorticoids?
diminish inflammatory reactions
What are the glucocorticoids?
What causes Conn's syndrome?
What are mineralocorticoids?
What is the function of mineralocorticoids?
regulate Na & Ca ions
What does Conn's disease cause?
What are the two sex hormones?
What does increased sex hormones cause?
What is androgenital syndrome?
A genetic disorder present at birth characterised by a deficiency of the hormones aldosterone and cortisol and an overproduction of male sex hormones (androgens).
males - enlarged penis, small testes and early development
females - ambiguous genitalia, failure to menstruate, deep voice and excessive hair
What is virilization?
changes that make a male body different from a female body
What hormones does the adrenal medulla secrete?
What is the function of Epinephrine?
acceleration of the heart
What is the function of Norepinephrine?
What does increased catecholamines cause?
What is the sonographic appearance of the adrenal glands?
Difficult to image
What are the pitfalls of examining the adrenal glands?
medial lobes of spleen
tail of pancreas
What is the sonographic appearance of an adrenal cyst?
early - simple cyst
hemorrhage - complex
What pathology of the adrenal glands cause masses?
What is Waterhouse-Friedrichson's syndrome?
bilateral hemorrhage of the adrenal glands
What causes Waterhouse-Friedrichson's syndrome in a baby?
What is Pheochromocytoma?
large bulky tumor
intermittent by hypertension
What causes Pheochromocytoma?
What is a neuroblastoma?
huge pediatric tumor