Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
63 Cards in this Set
- Front
- Back
|
Name 8 retroperitoneal organs
|
pancreas
kidneys adrenal glands IVC aorta lymph nodes uterus crura and psoas muscles |
|
|
What lab value would change with an intrapsoas bleed?
|
hematocrit drop
|
|
|
What lab value would be expected to increase, along with fever, in the setting of an psoas abscess
|
WBC
|
|
|
What are indications for scanning the retroperitoneum?
|
AAA
fever of unknown origin unexplained decreased Hct possible adrenal mass possible lymphoma or retroperitoneal fibrosis |
|
|
What are some causes of retroperitoneal LAD?
|
infection (AIDS)
inflammation malignancy |
|
|
What is the sonographic appearance of a benign LN?
|
ovoid, hypoechoic, with an echogenic center from central fat
|
|
|
What is the sonographic appearance of a malignant node?
|
hypoechoic or anechoic
may be hyperechoic or calcified |
|
|
What are typical locations for LAD?
|
inguinal region
neck upper abdominal perivascular around the renal hilum porta hepatis on either side of the aorta Middleton 232-3 Fig 9-25-27 |
|
|
Primary neoplasms of the retroperitoneum are rare/common.
|
rare
|
|
|
What is the most common soft tissue tumor of the retroperitoneum?
|
Liposarcoma (a fatty tissue malignancy)
|
|
|
What is a retroperitoneal tumor that involves the smooth muscle?
|
Leiomyosarcoma
|
|
|
Where are leiomyosarcomas usually found?
|
uterus or GI tract
|
|
|
Where do leiomyosarcomas usually metastasize?
Are they slow or fast growing? |
lungs
fast growing |
|
|
What is the sonographic appearance of a benign lipoma?
|
evenly echogenic mass
|
|
|
What is a condition in which a fibrous sheath envelopes the distal aorta, IVC, and sacrum?
|
retroperitoneal fibrosis
|
|
|
What causes retroperitoneal fibrosis?
|
idiopathic factors
low-grade infections ergot medicine for migrane headaches metastatic spread |
|
|
What is the sonographic appearance of retroperitoneal fibrosis?
|
smooth-boardered, echopenic tissue coats the distal aorta and IVC and extends down the sacrum
|
|
|
What are typical locations for retroperitoneal hematomas? (2)
|
psoas muscles (most common, especially in hemophiliacs)
around the kidney |
|
|
What causes retroperitoneal bleeding?
|
trauma
anticoagulation bleeding disorders (hemophiliacs) surgery |
|
|
What is the sonographic appearance of retroperitoneal hematomas?
|
hypoechoic or echogenic
|
|
|
___ fascia encloses the adrenal glands
|
Gerota's fascia
|
|
|
Where are adrenal glands located?
|
both are superior to the kidneys
left = posterior to the pancreatic tail and lateral to the aorta right = adjacent to the posterior surface of the liver, anterior to the R crus of the diaphragm, superior to the medial aspect of the kidney, and lateral and posterior to the IVC Netter 329 Middleton 328 |
|
|
Which adrenal gland is larger?
|
the left adrenal gland is usually larger
|
|
|
What is the normal shape of the adrenal glands?
|
Y or V shaped
usually, only 1 branch is seen Middleton 328 |
|
|
The adrenal gland has 2 parts. What are they?
|
cortex (outer) and medulla (inner)
|
|
|
What does the adrenal cortex produce in the 3 zones
|
Zona glomerulosa (mineralocorticoids - aldosterone)
Zone fasciculata (glucocorticoids) Zona reticularis (androgens, estrogens, and glucocorticoids) GFR = salt, sugar, sex |
|
|
What does the adrenal medulla produce?
|
epinephrine and norepinephrine
|
|
|
The anterior pituitary gland produces ___, which is responsible for the release of hormones form the adrenal cortex.
|
adrenocorticotropic hormone (ACTH)
|
|
|
Sonography does not routinely image the normal L/R adrenal gland.
|
left
|
|
|
US frequently identifies R/L adrenal masses and occasionally R/L adrenal masses.
|
right frequently
left sometimes |
|
|
What are some common causes of adrenal masses?
|
adenoma
metastasis pheochromocytoma primary carcinoma lymphoma myelolipoma hemorrhage |
|
|
What is the appearance of an adrenal cyst
|
the same as everywhere else
|
|
|
What is the sonographic appearance of an adrenal adenoma?
|
solid, hypoechoic mass
usually found on an incidental bases Middleton 239 Fig 9-38 |
|
|
1-8% of the population has an adrenal adenoma. It is the most common adrenal mass.
T/F |
true
|
|
|
What is the sonographic appearance of adrenal hemorrhage or hematoma?
|
neonates
bilateral cystic or complex appearance becomes cystic over time and eventually calcifies |
|
|
What is the sonographic appearance of a pheochromocytoma?
|
benign = too small to be seen
malignant = small, echopenic mass Middleton 240 Fig 9-40 |
|
|
What is the clinical presentation of pheochromocytoma?
|
episodic hypertension from adrenaline-secretion
|
|
|
What lab values are associated with pheochromocytoma?
|
elevated epi and norepi levels
|
|
|
What is the sonographic appearance of an adrenal metastasis?
|
solid masses
Middleton 239 Fig 9-39 |
|
|
What are the 4 most common sites for metastasis?
|
1 = lungs
2 = liver 3 = bone 4 = adrenal |
|
|
Bronchogenic lung cancer may metastasize to both adrenal glands, forming large, bilateral, hypoechoic masses. This is termed "___" sign
|
headlight sign
|
|
|
What causes Cushing's Disease?
|
excessive glucocortisol
|
|
|
What adrenal lesions can cause Cushing's disease?
|
adrenal hyperplasia (most common cause)
adenoma malignancy (rare) |
|
|
What are the clinical features of Cushing's disease?
|
hirsutism
hypertension abnormal fat distribution |
|
|
What is the sonographic appearance of Cushing's disease?
|
almost all masses are too small to see
|
|
|
What is the sonographic appearance of myolipoma?
|
hyperechoic, due to lots of fat in the tumor
Middleton 241 Fig 9-43 |
|
|
Are myolipomas benign or malignant?
|
rare, benign, nonfunctioning tumor that contains fat and bone marrow elements
|
|
|
What is a common malignancy found in small children between ages 0-5 years?
|
Neuroblastoma
|
|
|
What is a neuroblastoma?
|
a sympathetic nervous system tumor
|
|
|
What lab value is elevated with neuroblastoma?
|
vanilmandelic acid (VMA)
|
|
|
What is the sonographic appearance of neuroblastoma?
|
hypoechoic or heterogenous, large, solid mass +/- calcifications
|
|
|
Where does neuroblastoma spread?
|
it spreads locally around the aorta and vena cava and metastasizes to the liver and brain rapidly
|
|
|
What is Conn's syndrome?
|
hyperaldosteronism
|
|
|
Pheochromocytomas are chatecholamine tumors that arise from the adrenal cortex/medulla.
|
medulla
|
|
|
Primary adrenal carcinoma is common/rare.
|
rare
|
|
|
What is the sonographic appearance of Non-Hodgkins lymphoma in the adrenals?
|
Middleton 241 Fig 9-42
|
|
|
When making measurements of the aorta, AP dimension should be measured in a ___ view and transverse measurements from a ___ view.
|
AP measurement from sagittal view
transverse measurement from coronal view |
|
|
T/F
In general, the larger the LN, the more likely it is to be neoplastic. |
true
|
|
|
What is "pseudokidney" sign?
|
Extensive LAD can produce a mantle of concentric tissue that surrounds the vessels, which sometimes looks like a kidney.
Middleton 232 Fig 9-25 |
|
|
Adenopathy that pushes the IVC or aorta away from the spine is almost always located in the retroperitoneum.
T/F |
true
|
|
|
What are the sonographic findings of a rectus sheath hematoma?
|
acute = solid appearance, lenticular
chronic = more hypoechoic Middleton 230 Fig 9-20A/B |
|
|
Above the ___ line, rectus sheath hematomas are unilateral, and below, they involve both rectus muscles.
|
arcuate line
Netter 255 |
|
|
When rectus sheath hematomas dissect inferior into the suprapubic region, they can enter the ___ space, assume a more spherical shape, and exert significant mass effect on the bladder.
|
prevesicle space
Middleton 230 Fig 9-20C |
