130 unit 1

American College of Radiology

who accredits facilities?

protocol

standardized procedure for performing medical imaging

add images to; take images away from

you can ___ protocol, but you cannot ___

pathology, congenital abnormalities

what are two reasons you may need to tweak protocol?

top

whatever the transducer touches is at the ___ of the screen

MSK injuries

painful injuries resulting from repetitive motion, overextension, pinch grip, etc. over time

early stage

stage of MSK injury where you experience aching & discomfort, but stretching & resting helps

intermediate stage

stage of MSK injury with increased pain that disrupts sleep & repetitive tasks becoming difficult

chronic stage

stage of MSK injury where one experiences weakness, dropping objects, & difficulty sleeping

MSK injury prevention steps

taking time b/w exams, minimize bending, have the patient move closer to you, monitor facing you

superficial, better

a high frequency transducer goes more ___ with ___ resolution

deep, worse

a low frequency goes more ___ with ___ resolution

top left

where should the indicator be on the screen?

sagittal / longitudinal plane

plane that divides body into right & left sections

transverse plane

divides the body into superior to inferior sections

coronal plane

divides body into anterior & posterior sections

oblique

angle which is not sagittal, transverse, or coronal

sliding

moving the transducer from one area to another region

sweeping

angling from side-to-side in a sagittal scan plane, or from right to left on a transverse plane

rocking

angling from superior to inferior on a sagittal scan plane, or from right to left on a transverse scan plane; 1 end of the transducer loses contact with the skin

rotating

turning the transducer from one scan plane to another scan plane

anechoic

without internal echoes, such as a cyst

artifacts

echoes that do not correspond to real structures

complex

ultrasound of a heterogeneous structure w/ both cystic fibrosis and& solid components, such as a necrotic mass

cystic

a fluid-filled structure that does not produce any echoes, such as a normal gallbladder

echogenicity

the ability of tissue to reflect sound waves & produce echoes; brightness

diffused

spread out

focal

in one place

heterogeneous

a structure that produces echoes of various amplitudes/textures

homogeneous

a structure that is composed of similar echo brightness/texture

hyperechoic

more echogenic than the surrounding tissue

hypoechoic

less echogenic than the surrounding tissue

isoechoic

areas having similar echogenicity/texture

brightens, darkens

posterior enhancement ___ , while posterior shadowing ___

contralateral

opposite sides of the body

ipsilateral

same sides of the body

12:00, 9:00

the transducer orientation is ___ in longitudinal & ___ in transverse

as low as reasonably achievable

ALARA principal stands for

away, toward

arteries carry blood ____ from the heart, while veins carry blood ___ the heart

tunica interna

inner layer of blood vessels

tunica media

middle, stronger layer of arteries made of smooth muscle; thicker in arteries than veins

tunica adventitia

external layer of blood vessels

veins

hollow, collapsible tubes with diminished tunica media that carry blood toward the heart

veins, aorta

___ collapse with respiration while ___ don’t

contracting, valves

arteries move blood through ____ while veins move blood through ___

aorta

largest principal artery in the body

6+, supine, decubitus, 2.5-4

AO protocol requires patient to be NPO for ___ hours, lay in ___ or slightly ___ position, & the transducer selection is ___-___ MHz curvilinear

anterior, left

in longitudinal, the aorta is pictured as a long pulsatile tubular structure ___ & ___ to the spine

anterior, left

in transverse, the aorta is a circular structure ___ to the spine & slightly ___ of the midline

bilateral

one on each side

anechoic

in a sonographic appearance, the aorta has an ___ lumen with thin parallel walls

3cm, 1cm

the aorta should measure less than ___ , & the iliac arteries should measure less than ___

vasa vasorum

makes up the tiny arteries & veins that supply the walls of blood vessels

outer, outer

aorta is measured from ___ edge to ___ edge

posterior

abdominal aorta is ___ to the left lobe of the liver, the body of the pancreas, the gastroesophageal junction, the pylorus of the stomach & the splenic vein

abdominal aorta

the section from diaphragm to the bifurcation of the iliac arteries; retroperitoneal cavity

root of the aorta, ascending aorta, descending aorta, abdominal aorta, bifurcation into iliac arteries

5 sections of the aorta

CPT codes

defines what is a complete/incomplete scan, sent to insurance companies for reimbursement

rejected payment, fines

incorrect scanning can lead to ___ or ____ form insurance companies

left gastric artery, common hepatic artery, splenic artery

what are the three vessels that the celiac trunk branches into?

anterior

the celiac trunk & SMA arise from the ___ wall of the abdominal aorta

anterior

the gastroesophageal junction may be seen ___ to the abdominal aorta

tunica media

the difference b/w the artery & vein is found in which layer of the vessel?

common hepatic artery

the gastroduodenal artery is a branch of the ___

splenic vein

which vascular structure relates to the medial & posterior borders or to the pancreatic body & tail?

intestinal tract

the portal vein carries blood from the ___ to the liver

lateral, inferior

the renal arteries branch from the ___ wall of the aorta, ___ to the SMA

the left renal vein

which vascular structure courses b/w the aorta & SMA?

SMA

which vessel arises from the aortic wall & takes a parallel course to the aorta?

posterior

the right renal artery passes ___ to the IVC?

couinaud’s system of hepatic nomenclature

the system of hepatic nomenclature that provides the functional division between/w the right & left lobes based on the vasculature, not the falciform ligament

falciform ligament

the liver is suspended from the diaphragm & anterior abdominal wall by the ___

ligamentum teres

the falciform ligament extends from the umbilicus to the diaphragm in a parasagittal plane containing the ___

main lobar fissure

the fossae of the right portal vein (RPV) & the gallbladder are found in the ___

portal vein, hepatic artery

the liver receives blood supply from the ___ & ___

reidel lobe

what is the normal liver variant described as a tongue-like projection of the right lobe?

celiac trunk, SMA, IMA

3 major branches of the abdominal aorta

intestines

the mesenteric arteries feed the ___

right, right

the ___ renal artery is longer than the left b/c the it has to cross the ___ side of the body

posterior

generally, arteries are seen ___ to veins

IVC

formed by the union of the common iliac veins posterior to the right common iliac artery; returns blood to the right atrium

renal veins

arise anterior to the renal arteries from the sides of the IVC at the 2nd lumbar level

hepatic veins

largest visceral tributaries of the IVC, return unoxygenated blood from the liver & drain posteriorly into IVC at diaphragm level

duodenum & stomach

the GDA & right gastric artery lead to the ___ & ___

left hepatic

the ___ ___ artery leads to the caudate & left lobe of the liver

right hepatic

the ___ ___ artery leads to the gallbladder (cystic artery) & liver

lower esophagus & stomach

the left gastric artery leads to the ___ & ___

non resistive vessels

vessels w/ a high diastolic component, feeds organs that need constant blood flow

resistive vessels

vessels w/ very little flow in diastole, feeds organs that do not need constant blood supply

resistive index

peak systole is compared w/ minimum diastole

resistive, nonresistive

the SMA is ___ in a fasting patient, but ___ in a non fasting patient

right/left/middle hepatic veins

3 anterior tributaries to the IVC

left & right renal veins

2 lateral tributaries to the IVC

the portal vein, portal confluence

the SMV & SV join posterior to the neck of the pancreas to make ___ at the ___

bare area

the only place the liver is not covered by the peritoneum