ABD final

Hernia (definition)

the abnormal protrusion of part of an organ or tissue through the structures normally containing it

Three parts of AWH

1) sac

2) contents of sac

3) covering of sac

Para umbilical hernia

protrudes through linea alba in the umbilical region.

Inguinal hernia

more common in men, found in inguinal canal.

Epigastric hernia

linea alba, xyphoid to umbilicus.

Spigelian hernia

occurs laterally on abdominal wall

Lipoma

fatty tumor, often echogenic but can be hypoechoic in some superficial cases

Desmoid Tumor

benign unencapsulated fibrous tumors arising from muscle

Seroma

accumulation of serous fluid in tissues often seen near surgery site

Bladder flap hematoma

collection of blood between the bladder and lower-uterine segment from c-section

Rectus sheath hematoma

focal collection of extravasated blood contained within the rectus sheath

A rectus sheath hematoma is considered a _______hematoma

extraperitoneal hematoma

A ________ bleed will retain the shape of the organ they surround

subcapsular

Ascites

The accumulation of serous fluid in the peritoneal cavity

Inflammatory Malignant ascites (sonography)

internal echoes within the fluid, loculations, clumping of bowel loops.

Sonography of Transudative ascites

Anechoic

Free floating bowel loops

Fluid conforms to surrounding structures

GB wall thickening

Sonography of Exudative ascites

Echogenic debris

Septations

Matted bowel loops

Thickened interfaces

Loculation

__________ collections of fluid within the liver can mimic loculated subphrenic fluid.

subcapsular

Biloma

Extrahepatic loculated collections of bile

Renal carbuncle

abscess that forms within the renal parenchyma

Perinephric abscess

Usually the result of a perforated renal abscess that leaks purulent material into the tissue adjacent to the kidney

Sarcoma

A tumor, often highly malignant, composed of cells derived from CT (bone / cartilage), muscle, blood or lymphoid tissue.

Mass in peritoneum may show an _____ pattern

infiltrative

Malignant solid tumors are more likely found near the root of the _______

mesentery

Urachal cysts

Incomplete regression of the urachus during development

Urinoma

Encapsulated collection of urine

Urinoma may be caused by:

closed renal injury or surgical intervention, or spontaneously secondary to obstructing lesion

Lymphocele

Collection of fluid that occurs after surgery in the pelvis, retroperitoneum or recess cavities.

Pseudomyxoma peritonei

Metastatic spread of malignant tumor filing peritoneal cavity with mucinous material and gelatinous ascites.

Peritoneal carcinomatosis

Metastatic spread with diffuse involvement of peritoneum

Peritoneal Metastases

Develop from cellular implantation across the peritoneal cavity

Mesotheliomais

is a cancer of the linings of the lungs, chest, abdomen, and the organs contained in those areas

Lymphomas of the Omentum and Mesentery

Uniformly thick, hypoechoic, band-shaped structure that follows the convexity of the anterior and lateral abdominal wall, creating the omental band

Sandwich sign is seen with

represents a mass infiltrating the mesenteric leaves and encasing the superior mesenteric artery

The tunica vaginalis parietal lines the

scrotum

The tunica vaginalis visceral surrounds the

testicle and epididymis

Is the tunica albuginea superficial or deep to the visceral layer?

deep

Where is sperm formed?

seminiferous tubules

The epididymis becomes the ___ _______

vas deferens

The major arteries seen in the periphery of the testicle are called the ______ arteries

capsular arteries

___________ arteries are seen within the parenchyma coursing towards the mediastinum

centripetal arteries

Venous drainage of the testicles is through the ________ _______

pampiniform plexus

The right testicular vein drains into the

IVC

The left testicular vein drains into the

left renal vein

Normal sonography of testicles

smooth

homogenous

medium grey echoes

fine echotexture

__% of testes can be saved if surgical intervention occurs within 72 hours (rupture)

90%

Rupture is a disruption of which layer

tunica albuginea

Hematocele

bleeding from the pampiniform plexus (in the layers)

Hematoma can ______ the testicles

displace

Epididymitis is usually caused by

UTI

What is the most common cause of acute scrotal pain and tenderness?

epididymitis

Orchitis (definition)

inflammation of the testicle

Most common cause of orchitis

chlamydia

Epidiymo-orchitis

infection of epididymis and testicle

_____ is almost always secondary to epididymitis

orchitis

Pyocele

pus fills the space between layers of tunica vaginalis

Most common cause of acute scrotal pain in adolescents

torsion

Bell clapper deformity

faulty attachment of testis to scrotal wall

__% of patients have bell clapper deformity on both sides

60%

Salvage rate for torsion with onset of pain over 12 hours is __%

20%

Torsion can initially appear normal and then the testicle _____ and becomes _______

enlarges and becomes hypoechoic

With chronic torsion the testicle gets _______

smaller

Torsion of the appendix epididymis results in a ______ _____

scrotal pearl

Most cysts in the scrotal are _____ testicular

extra testicular

Most common scrotal mass

spermatoceles

Spermatocele (definition)

cystic dilatations of the efferent ductules

Epididymal cysts are caused by

obstruction of the efferent ductules

What is the most common substance within a scrotal hernia?

bowel

Hydroceles contain _____ fluid

serous

Most common cause of painless scrotal swelling

hydrocele

Varicoceles are _____ vessels

dilated vessels

Most common cause of infertility

varicoceles

Varicoceles are more common the ____ side

left

Varicoceles measure over _mm

3mm

Most frequently seen in patients with a history of vasectomy

sperm granuloma

Tubular ectasia

dilatation of the rete testis

Tubular ectasia is usually seen in men over the age of __

45

Testicular cysts are more common in men over __ years of age

40

Microlithiasis has an increased chance of testicular _______

malignancy

Testicular malignancy in men between ages of ________ and ______

15 and 35

Undescended testicles are ___ to ____ times more likely to develop cancer

2.5 to 8 times

__% of testicular tumors are germ cell tumors

95%

Most common type of germ cell tumor is

seminoma

Second most common germ cell tumor is

embryonal

Germ cell tumors are associated with elevated levels of ______ and _____

HCG and AFP

Embryonal tumors are ______

aggressive

Teratomas are usually benign in ______

children

Yalk sac tumor __% of testicular tumors in infants

60%

Cystadenoma is associated with

Von Hipple-Lindau

Theca call (malignant or benign)

malignant

Granulose (malignant or benign)

malignant

Cryptorchidism

undescended testicle

Increased risk of _____ and ________ in patients with cryptorchidism

infertility and malignancy

Most common site for ectopic testicle to rest is the superficial __________ ______

inguinal pouch

The prostate is a __________ organ

retroperitoneal organ

What is the shape of the prostate?

inverted pyramid, pear shaped

The prostate is ______ to the bladder

posterior

The part of the urethra that passes through the prostate is called the _______ urethra

prostatic urethra

Sonography of the normal prostate

Homogeneous, medium level grey. Symmetrical oval shape with smooth capsule.

The ______ is the inferior margin of the prostate

apex