Sono 101
Body Systems
The Aorta and Arteries
The IVC and Veins
The Portal Vein System
The Liver and Biliary System
100
The normal echo texture appearance of soft tissue is characterized as _____, which describes uniform or similar echo patterns on a sonographic image.
Homogeneous
The opposite of homogeneous is heterogeneous which describes an irregular or mixed echo pattern.
100
This system regulates blood volume and composition by filtering waste from the blood that passes through the kidneys, regulating blood pressure and producing red blood cells.
The urinary system
Blood pressure is regulated by the urinary system by controlling blood volume, adjusting the flow of blood into and out of kidneys and secreting renin. The kidneys release erythropoietin, a hormone that tells bone marrow to increase production of RBCs when inadequate oxygen levels are detected in the blood.
100
What is the average AP measurement of an adult abdominal aorta?
2 cm
Although the size varies depending on body habitus, it is accepted that the average AP diameter is 2cm at the most superior portion of the abdomen and decreases in size of 1.5cm at the bifurcation. Considered an aneurysm at 3 cm.
100
The IVC is located _____ to the liver and intestines.
Posterior
Although it may seem like it runs through the liver and intestines on ultrasound, it does not.
100
Normal flow of the portal vein is hepato_____.
Hepatopetal
Hepatopetal means TOWARD the liver. Normally high-volume portal venous flow is characterized by minimally phasic, slightly disordered flow with low peak and mean velocities. It normally accelerates during expiration and deaccelerates during inhalation.
100
The red arrow is pointing at what structure?
Fissure for the ligamentum venosum
The caudate lobe is separated from the left hepatic lobe by the proximal portion of the left hepatic vein and the fissure for the ligamentum venosum which is seen as an hyperechoic linear structure.
200
**DOUBLE JEOPARDY**
What plane(s) do you need to be in to take these measurements:
a) Length
b) Width
c) Depth
a) Sagittal (long)
b) Transverse (axial)
c) Sagittal OR Transverse (Depth is the same as anterio-posterior measurement)
200
Fertilization typically occurs where in the reproductive system?
The fallopian tube
Fertilization usually takes place within 1 day of ovulation in the ampulla portion of the fallopian tube and is considered complete when the ovum and sperm fuse to form a zygote.
200
What artery is a branch off the celiac artery and supplies the spleen, pancreas and stomach?
The splenic artery.
The splenic artery supplies the spleen, pancreas and the left side of the greater curvature of the stomach.200
These veins have hepatofugal flow direction and yield a W-shaped waveform as a result of changes in central venous pressure, respiration and compliance of the liver parenchyma.
The hepatic veins
Hepatofugal means flow AWAY from the liver.
200
The portal triad is made up of what 3 structures?
Proper hepatic artery, common hepatic duct, main portal vein
The portal veins and hepatic arteries enter the liver and the hepatic ducts exit through the porta hepatis which can be seen as the "Mickey Mouse Sign"
200
The liver is enclosed by a tight, fibrous capsule known as what?
Glisson's capsule
The liver is also largely covered by the peritoneum of the greater sac (page 50). A portion of the posterior surface of the liver is without a peritoneal covering and is called the bare area.
300
If the planning plane is coronal left lateral, what anatomic area is the arrow pointing at?
Medial
300
This system is a collections of glands that secrete hormones directly into the bloodstream to arrive at target organs.
The endocrine system
The hypothalamus monitors the hormones in the blood. When it receives a signal that there is a rise or fall of an organ's hormone level, it communicates directly and exclusively through hormones with the "master gland", the pituitary gland. In response, the pituitary gland releases its own hormones via the bloodstream to stimulate the other endocrine glands to release their hormones.
300
This artery feeds the pancreatic head and duodenal area and is a branch of the superior mesenteric artery.
Inferoposterior pancreatic duodenal artery
300
The momentum of the blood during cardiac _____ forces the valves in the IVC to open so that blood can be pushed forward toward the heart.
Systole
Systole=heart contracts; diastole=heart relaxes
Once the momentum decreases and the blood is not pushed forward, the valve closes and prevents retrograde flow. Blood is also moved forward by a decrease in thoracic pressure, which pulls the blood into the right atrium.
300
**DOUBLE JEOPARDY**
Name the three main tributaries of the portal vein?
Splenic vein, Superior Mesenteric vein, and Inferior Mesenteric vein
Other tributaries include the cystic, pyloric, left gastric, right gastric, pacreaticoduodenal and gastroepiplioc veins
300
The liver is a ______ structure, which means it in enclosed in the parietal peritoneum and is attached to the cavity wall by mesentery.
Intraperitoneal
The perietal peritoneum is the portion of peritoneum lining the cavity that forms a closed sac. The enclosed structures are intraperitoneal, and the structures located posterior to the sac and covered anteriorly with peritoneum are termed retroperitoneal. Look at page 49 for list of associated structures.
400
If a mass contains both fluid and tissue components, then it is said to be what kind of mass?
Complex
Masses can be described as either solid, cystic or complex according to it's composition. Complex masses may be primarily cystic or primarily solid. But if there is a combination of both appearances within the same structure, it is complex.
400
This is the processing area of the nervous system that is made up of the brain and spinal cord.
The central nervous system
It is responsible for receiving, interpreting, and responding to electrical signals from the peripheral nervous system.
400
In gross anatomy, the splenic artery is located _____ to the tail of the pancreas.
Superior
400
Venous flow in the lower extremities is accomplished primarily by means of what?
Skeletal muscle contractions
Blood in the legs would stagnate were it not for the presence of valves in the veins and the skeletal muscle contractions that help move the venous blood up through the veins against the effects of gravity.
400
**DOUBLE JEOPARDY**
The right portal vein divides the right lobe of the liver into ______ and _____ segments and the left portal vein divides the left lobe of the liver into ______ and _______ segments.
Anterior, posterior
Medial, lateral
400
The right and left lobes of the liver are related to the ______________ of the diaphragm.
Undersurface
500
Documented areas of interest, especially abnormal ultrasound findings, must be documented in at least two what?
Scanning planes (that are perpendicular to each other)
This gives a more dimensional and more accurate representation. SINGLE PLANE REPRESENTATION OF A STRUCTURE IS NOT ENOUGH CONFIRMATION.
500
This is a part of the nervous system that relays information from the brain and spinal cord to the limbs and organs.
The peripheral nervous system
The peripheral nervous system is divided into somatic and autonomic systems. Somatic nervous system is voluntary and autonomic nervous system is involuntary.
The autonomic nervous system is further broken down into sympathetic division (flight or fight) and parasympathetic division(after the danger has passed)
500
What type of waveform will the SMA have post-prandial?
Low-resistant
A Doppler spectral waveform from the postprandial superior mesenteric artery demonstrates low diastolic flow because of the change in the vascular resistance of the stomach and small intestine that occurs with digestion.
500
**Double Jeopardy**
From inferior to superior, identify the veins that converge to form the IVC.
Common iliac veins, lumbar veins, right gonadal vein, renal veins, right suprarenal vein, hepatic veins, inferior phrenic veins
The left gonadal and suprarenal veins drain into the left renal vein, not the IVC.
500
**DOUBLE JEOPARDY**
What three things affect portal venous flow?
Posture, exercise, and dietary state
Exercise and postural changes usually cause a decrease in portal venous flow, whereas eating will increase flow as a result of splanchnic vasodilation and hyperemia.
500
What is the opening in the duodenum where the common bile duct and pancreatic duct enter.
Ampulla of Vater (hepatopancreatic ampulla)
The CBD either joins the pancreatic duct(s) to form a single duct or remains separate and enters the ampulla of Vater where the intraduodenal CBD empties bile. A muscle sheath known as the sphincter of Oddi surrounds this CBD at the ampulla of Vater. When fats and amino acids are ingested, the duodenal mucosa releases cholecystokinin (CCK) which causes the gallbladder to contract and the sphincter of Oddi to relax.