Superficial Sonography Final

All of the following structures form neighboring structures for the thyroid gland except the

1. longus colli muscle

2. parotid muscle

3. strap muscles

4. sternocleidomastoid muscle

2. parotid muscle

A solitary thyroid nodule in the presence of ipsilateral lymphadenopathy is suspect for what condition?

Follicular carcinoma

Common causes of hydrocele include all the following except

1. trauma

2. microlithiasis

3. epididymo-orchitis

4. testicular torsion

2. microlithiasis

The most common site of an Achilles tendon tear ____

distal portion (2 to 6cm from calcaneus; possible result of decreased blood flow)

Patients with carpal tunnel syndrome typically have a positive ____ sign

Phalen’s

Support and strength of a joint results, in part, from what structure?

Ligament

The mean portal vein measurement in children younger than 10 years of age is ____ millimeters (mm).

8.5 mm (10mm in 10 - 20yrs old)

Which one of the following statements regarding ectopic ureteroceles is incorrect?

1. They are more commonly found in male patients

2. They are found more often on the left side

3. They result from an ectopic insertion of the distal ureter

4. They cause cystic dilation of the distal ureter

1. They are more commonly found in male patients (Most common in female)

Sonographic findings in adrenal hemorrhage in the neonate include all of the following conditions except

1. blunting of the superior pole of underlying kidney

2. Ovoid enlargement of the adrenal gland

3. irregular-shaped small gland

4. complex echo texture

3. irregular-shaped small gland

What structure is thin in the neonate with echogenicity similar to or slightly greater than the normal liver parenchyma?

Cortex

What condition is the most common cause of renal cystic disease in the neonate?

Multi-cystic dysplasic kidney (MCDK) disease

Cyclopia (think one eye) is associated with which condition?

Alobar Holoprosencephaly

What structure produces most of the cerebrospinal fluid?

Choroid plexus

The two ovoid brain strictures located on either side of the third ventricle superior to the brainstem make up the _____

thalami

Bilateral occlusion of the carotid arteries may result in _____

hydranencephaly

What is most likely the result of a germinal matrix hemorrhage?

Subependymal Cyst

What movement does the psoas major, iliacus, and rectus femoris provide?

Flexion

The hip of a normal infant has a Graf alpha angle of _____ degrees.

greater than 60 degrees

The alpha angle is the angle between the _____ and the _____

The alpha angle is the angle between the baseline and the acetabulum roof line

What structure is responsible for one fourth of the vertebral columns length?

Intervertebral discs

The sacrum consists of _____ fused bones.

five

The neonatal coccyx should not be mistaken for a _____

both cyst or fluid collection (since it has low echogenicity)

How is Sonography able to image the spinal cord?

ossification of the posterior spinal elements is incomplete

The vascular membrane that closely covers the spinal cord is the ____

pia mater

Indications for sonography of the neonatal hip include all of the follow except

1. to rule out hip dysplasia

2. sacral dimple

3. breech birth

4. abnormal hip examination

2. Sacral dimple (cause of evaluation of neonatal spine)

With treatment of hip displacement using the Pavlik harness, the hip should be positioned in flexion with adduction and _____ rotation.

external

The pelvic girdle is the fusion of three separate bones. Which one of the following bones does not belong in this group?

1. Llium

2. Femur

3. Ischium

4. Pubis

2. Femur

What is the most important cause of abnormal neurodevelopment sequelae in premature infants is which one of the following?

White matter necrosis

Which structure separates the two cerebral hemispheres?

Interhemispheric fissure

Sonographic signs of renal vein thrombosis in the neonate include all of the following except

1. renal enlargement

2. adrenal hemorrhage

3. homogeneous echogenicity

4. venous calcification

homogeneous echogenicity

The renal hilum correlates to the _____ level

L1 - L2 level

In the “push-pull” maneuver, what finding is seen in the normal hip in the coronal neutral view?

The femoral head is never seen over the posterior lip of the acetabulum

At six weeks gestation, the amnionicity in a twin gestation can be established by

the number of yolk sacs

The physical signs of the development of a displacement of the hip include all of the following except

1. prominence of trochanter

2. extreme abduction

3. shortening of the femur

4. asymmetry of skinfolds

2. extreme abduction

What condition demonstrates a pelvocaliceal dilation without ureteral dilation?

Ureteropelvic junction obstruction

Differential considerations for hydronephrosis include all of the following except:

1. extrarenal pelvis

2. functional dilation

3. parapelvic cysts

4. renal vein thrombosis

4. renal vein thrombosis

At what age range does the incidence of Wilm’s tumor peak?

2 to 5 years

What condition is least commonly associated with vomiting in the infant?

appendicolith

What does a hypoechoic halo around a tendon represent?

normal synovial sheath

Preparation for a biliary sonographic examination of a 1 to 4 year-old child is nothing by mouth (NPO) for _____ hours

3-4 hours

The posterior glenoid labrum is a good landmark to help locate which structure?

Infraspinatus tendon

A spermatocele is always located in which portion of the epididymis?

Head

The primary source of blood flow to the testicles is via the _____ arteries

testicular

Which type of tendinitis causes pain over the lateral wrist or thumb side of the wrist?

de Quervain tendinitis

A seminoma of the testicle generally appears on ultrasound as a(n) _____ mass

Homogenous (hypoechoic mass)

A condition in which nodular enlargement causes hyperactivity of the thyroid gland and hyperthyroidism is called

Toxic multinodular goiter

Sonographic characteristic of fibroadenoma

uniform, low-level homogeneous echoes

The breast is sonographically divided into three layers. What are these three layers?

Subcutaneous, Mammary and Retromammary layers OR Skin, Nip ple, Subareolar

Most common cause of thyroid malignancy is _____ carcinoma

papillary

The most common malignant neoplasm of the breast is which of the following?

Invasive ductal carcinoma (80% of breast cancers)

A common cause of acute scrotal pain in adults is

pididymo-orchitis

Sonographic appearance of the normal muscle appears

Homogenous with multiple parallel echoes

A complete tear of a muscle with a straightforward appearance of a retracted hyperechoic muscle surrounded by a hematoma is known as the

Clapper in the bell

Indications for wrist sonography includes all except

1. Pain and swelling

2. Thompson's sign

3. Trauma

4. Tinel's sign

2. Thompson's sign

Narrowing or underdevelopment of the biliary ductal system may be due to

Bililary atresia

Hepatoblastoma has been associated with what condition?

Precocious puberty

Which of the following structures lies at the bases of the corticomedullary pyramids and appears as echogenic structures?

Arcuate Arteries

Neuroblastoma is typically a malignant tumor of the

adrenal gland

The portion of the brain that forms the lateral borders of the frontal horns and lies anterior to the lateral ventricles and thalamus is which of the following?

Caudate nucleus

In the coronal neutral view, the sonographic finding of a frankly dislocated hip suggests what?

The labrum may be deformed

Select the maneuver that induces a “clunk” as the femoral head returns to the acetabulum

Ortolani

Dilation of the central canal of the spinal cord is

Hydromelia

The spinal cord in the 3 month old infant ends at the upper border of the

L1 - L2

The functional portion of the breast consists of _____ lobes

15 to 20

Characteristic findings of breast carcinoma include all of the following except

1. attenuation of sound

2. irregular margins

3. strong posterior margin

4. inhomogeneous low-level internal echo pattern with calcifications

3. Strong posterior margin

The retromammary layer appears sonographically as

hypoechoic

A cystic formation located in the submandibular region of the neck is typically a _____

branchial cleft cyst

The approximate dimensions of the thyroid gland in the normal adult include all except:

1. 25 to 30 mm in length

2. 40 to 60 mm in length

3. 20 to 30 mm in AP diameter

4. 15 to 20 mm in width

1. 25 to 30 mm in length

What is the most common cause of thyroid disorders worldwide?

Iodine deficiency

The epididymis courses _____ to the testis

superior and posterolaterally

What imaging artifact bends the sound beam to an oblique path?

Refractile shadowing

The proximal portion of the muscle is considered the _____

origin

What structure is bandlike flat tendon connecting muscle to bone

Aponeurosis

What is a pitfall in diagnosing appendicitis?

Enlarged lymph nodes

Hypertrophic pyloric stenosis most commonly occurs in all of the following patient populations except:

1. In male patients

2. In female patients

3. Infants between 2 and 6 weeks of age

4. Infants with bile-free projectile vomiting

2. In female patients

Children with intussusception may exhibit all of the following except:

1. colicky abdominal pain

2. vomiting

3. bloody stools

4. tenderness over McBurney’s point

4. tenderness over McBurney’s point

Identify the most common acute abdominal in early childhood

Intussusception

The adrenal medulla in the neonate appears _____

as an echogenic stripe

The left adrenal gland _____

extends medial to the kidney

What condition causes the abnormal reflux of urine from the urinary bladder through the ureters and into the kidney?

Vesicoureteral

The junction of the anterior, occipital, and temporal horns is called the _____

atrium (trigone)

The sonographic protocol of the basic hip anatomy is imaged in _____ different views

four

Which term means moving sideways outward?

Abduction

An anechoic mass in the cauda equina region is most likely what?

cyst of the spinal cord

How many lumbar vertebrae are in the vertebral column?

5

Cooper’s ligaments are best characterized as _____

Echogenic line interfaces in the subcutaneous layer

Clinical findings of lumpy, painful, tender breast that vary with monthly cycles usually represent

Fibrocystic disease

The pyramidal lobe of the thyroid gland extends from?

superior isthmus

The thyroid is an endocrine gland that regulates metabolic function through the production of all of the following hormones except:

1. thyroxine

2. triiodothyronine

3. thyrocacitonin

4. thryoliberin

4. thryoliberin

The parathyroid glands produce a hormone that affects the

kidneys, bones, and intestines

The rete testis is located

at the hilum of the testis

The crass position is used to evaluate which of the following structures?

Shoulder

The pylorus muscle connects the ____ with the duodenum

antrum of the stomach

In patients with appendicitis, the outer diameter should measure at greater than _____ mm.

6

The easiest tendon to image in the adult shoulder is the ___.

biceps

The most common cause of bladder outlet obstruction in the male neonate is which of the following?

Posterior Urethral Valves

Which three mechanisms account for the development of hydrocephalus?

Outflow obstruction, decreased absorption, and overproduction of cerebrospinal fluid

Bending the hip backward is called:

extension