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ARDMS Abdomen Board Exam Questions With 100% Correct Answers | Verified | Updated 2024 3 layers of Aorta - Correct Answer-Tunica Intima, Tunica Media, Tunica Adventitia What is the tunica intima made of - Correct Answer- endothelial cells (inner layer) What is the tunica media made of - Correct Answer-muscle, thicker and more organized layer in arteries (middle layer) What is the tunica adventitia made of - Correct Answer- epithelial cells (outer layer) Where does the aorta arise from - Correct Answer-Left ventricle Where is the aorta located - Correct Answer-Anterior and to the left of the spine and left of the IVC (most posterior abdominal vessel) Name the paired branches of aorta - Correct Answer- Suprarenal arteries, renal arteries, gonadal arteries, lumbar arteries, and common iliac arteries Name the unpaired branches of the aorta - Correct Answer- celiac axis (common hepatic artery, splenic artery, and left gastric artery), SMA, IMA, median sacral artery Name the anterior branches of the aorta - Correct Answer- celiac axis, SMA, IMA, gonadal arteries, and median sacral artery Name the lateral branches of aorta - Correct Answer- suprarenal arteries, renal arteries, and common iliac arteries Where do the common iliac arteries bifurcate - Correct Answer-L3-4 Average normal proximal measurement of aorta - Correct Answer-2.0 - 2.6 cm Dilated hemiazygos and azygos veins indicate what - Correct Answer-interrupted IVC, IVC obstruction, and IVC overload What is the largest soft tissue organ - Correct Answer-liver The liver is encapsulated by - Correct Answer-Glisson capsule Bare areas of the liver - Correct Answer-portion of liver not covered by peritoneum/capsule. Fluid cannot accumulate here because liver is indirect contact with diaphragm What are the bare areas of the liver - Correct Answer-GB fossa, porta hepatis, and superior surface to the right of IVC Where is the porta hepatis located - Correct Answer-liver hilum on the inferior surface of liver What is the porta hepatis bordered by - Correct Answer-GB fossa and lig teres What is the portal triad - Correct Answer-portal vein, hepatic artery, bile duct What is contained in the extrahepatic portal triad - Correct Answer-MPV, proper hepatic artery, and CBD What forms the right boundary of the caudate lobe - Correct Answer-GB fossa What is the normal size of the liver - Correct Answer-13.5 - 15.5 cm What is the normal size of the pediatric liver - Correct Answer- Normal liver should not extend more than 1 cm below the costal margin What separates the right and left lobes of the liver - Correct Answer-main lobar fissure Right lobe of the liver is ___x the size of left lobe - Correct Answer-6x The medial left lobe of liver was formerly called the - Correct Answer-quadrate lobe Where is the caudate lobe located - Correct Answer-between IVC and medial left lobe, occupies posterior surface of the liver What do the triangular ligaments do of the liver - Correct Answer-Right and left, attaches superior liver to diaphragm, located at medial and lateral edges of bare area What is the coronary ligament of the liver - Correct Answer- right and left suspend the posterior superior surface of the liver from diaphragm, lateral margins form the triangular ligaments What is the falciform ligament of the liver - Correct Answer- attaches anterior surface to abdominal wall from diaphragm to umbilicus What is the ligamentum teres - Correct Answer-separates medial and lateral left lobes, remnant of umbilical vein What does the common hepatic artery supply - Correct Answer-liver, GB, stomach What percent of blood does the common hepatic artery carry into the liver - Correct Answer-20% What percent of blood does the main portal vein carry into the liver - Correct Answer-80% What does the gastroduodenal artery supply - Correct Answer-pancreas and stomach What does the proper hepatic artery supply - Correct Answer- liver and GB What is the RI of the hepatic artery - Correct Answer-low resistance, .55 - .8 What does the portal venous system drain - Correct Answer- blood from the digestive tract and delivers it to the liver for filtration The IMV joins the splenic vein near the - Correct Answer-tail of the pancreas What is the portal confluence - Correct Answer-confluence of SMV and splenic vein posterior to the head of pancreas What does the MPV drain - Correct Answer-GI tract and sends blood to liver for filtration The hepatic veins divide the liver into - Correct Answer-lobes (intersegmental veins) What is the normal pressure in the portal vein - Correct Answer-5-10 mmHg A normal portal vein will ___________ in diameter by more than 20% with deep inspiration - Correct Answer-increase What is the normal diameter of the MPV - Correct Answer-< 13 mm What is the normal velocity of the MPV - Correct Answer-15- 20 m/s The splenic vein courses ______________ to the pancreas where it meets with the ___ - Correct Answer-posterior where it meets with the IMV After the splenic vein joins the IMV, it then joins the ___ to form the main portal vein ____________ to the neck of the pancreas - Correct Answer-SMV to form the MPV posterior to neck of the pancreas What does the splenic vein drain - Correct Answer-stomach, spleen, pancreas Where does the SMV originate - Correct Answer-at the mesentery The SMV joins the ______ vein posterior to the neck of the pancreas to form ___ - Correct Answer-splenic vein posterior to the neck of the pancreas to form the MPV 3. detoxification 4. bile production and excretion 5. albumin and globulin formation 6. lymph production What causes an increase in LFT's - Correct Answer-acquired and inherited liver disease (hepatitis, fatty liver, hemochromatosis, Wilson disease) The liver contains higher levels of ___ than ___ - Correct Answer-ALT than AST Changes in the ___ levels are more specific to liver disease - Correct Answer-ALT Elevation of AST levels indicate? - Correct Answer-NON hepatic issues (because AST is found in other organs) Where is Aspartate Aminotransferase present - Correct Answer-liver, kidneys, skeletal muscle, heart muscle, and brain AST increases with - Correct Answer-acute hepatitis, cirrhosis, metastasis, and Reye Syndrome AST is mildly increased with - Correct Answer-fatty changes AST is NOT elevated with - Correct Answer-isolated biliary obstruction Causes for increased AST with normal ALT include - Correct Answer-myocardial infarction, CHF, muscle injury, CNS disease, other NON hepatic disorders What is Alanine Aminotransferase necessary for - Correct Answer-energy production ALT is released into blood with ______ _____ damage - Correct Answer-liver cell ALT is used to evaluate the level of - Correct Answer-jaundice and monitor hepatitis and cirrhosis ALT is increased with - Correct Answer-hepatitis, cirrhosis, liver tumors, biliary obstruction, and Reye syndrome Where is alkaline phosphatase found - Correct Answer-liver, bone, and placenta Alkaline phosphatase is normally excreted with - Correct Answer-bile Increased Alkaline Phosphatase (ALP) indicates - Correct Answer-biliary obstruction from tumors, cholelithiasis, or biliary atresia If ALP is elevated alone then the cause may be - Correct Answer-related to bone disease, pregnancy, or hyperparathyroidism Where is Gamma-glutamyl transpeptidase normally found - Correct Answer-liver cells and biliary epithelium What is the most sensitive indicator for alcoholism? - Correct Answer-Gamma-glutamyl transpeptidase (GGTP) What is complete situs inversus - Correct Answer-chest and abdomen contents reversed, liver LUQ and heart in right chest What is Reidel's lobe - Correct Answer-extension of right lobe below the lower pole of right kidney (right lobe large, left lobe is normal size) Reidel's lobe is more common in _________ - Correct Answer- women Sonographic appearance of Reidel's lobe - Correct Answer- right lobe extends below lower pole of right kidney, can extend medially, NORMAL echotexture What is the normal transverse measurement of the GB - Correct Answer-< 5 cm Where is the GB fossa located? - Correct Answer-posterior inferior surface of right lobe of liver What does the main lobar fissure connect - Correct Answer- right portal vein to GB neck What artery supplies the GB - Correct Answer-cystic artery (originates from right hepatic artery) What vein is the GB drained by? - Correct Answer-cystic vein into the right portal vein Name the layers of the GB wall - Correct Answer-Mucosa (inner), muscle (middle), serosa (outer) Normal GB wall measurement - Correct Answer-< 3 mm What is increased GB wall thickness seen with? - Correct Answer-itis (cholecystitis, hepatitis, pancreatitis) Duct of Luschka - Correct Answer-located within GB wall, bile thickening occurs here What are the smallest and most proximal component of the collecting system? - Correct Answer-bile canaliculi Cystic Duct of GB - Correct Answer-carries bile to and from the GB What regulates flow in the cystic duct of the GB? - Correct Answer-spiral valves of Heister Common Hepatic duct of GB - Correct Answer-located anterior to the split of the MPV, measures 4 mm or less Cystic duct + CHD = - Correct Answer-CBD What part of the CBD dilates first with any type of distal obstruction? - Correct Answer-Mid segment (located just out of the liver) Where is the distal portion of the CBD located? - Correct Answer-head of the pancreas The CBD courses posterior to the 1st segment of the duodenum to meet the duct of __________________ - Correct Answer-Duct of Wirsung (posterior to the pancreas head) Hemolytic Jaundice - Correct Answer-RBC destruction occurs rapidly, seen with anemia Hepatic Jaundice - Correct Answer-Liver disease reduces its ability to process conjugated bilirubin (hepatitis and cirrhosis) Obstructive Jaundice - Correct Answer-obstruction of the biliary tree increases bilirubin in blood and urine Jaundice + dilated intrahepatic ducts = - Correct Answer- obstructive cause Jaundice + normal intrahepatic ducts = - Correct Answer-non- obstructive cause Cholescintigraphy / HIDA Scan - Correct Answer-Nuclear medicine exam that evaluates the GB function and ejection fraction. Cholecystokinin administered to cause the GB to contract and relax the Sphincter of Oddi What is the most accurate exam for evaluating acute cholecystitis? - Correct Answer-Cholescintigraphy / HIDA Scan Oral Cholecystogram - Correct Answer-Radiopaque oral contrast given. Excreted by the liver and concentrated in the GB which extracts water, thus concentrating the excreted substance T-tube Cholangiogram - Correct Answer-fluoroscopy procedure, demonstrates bile ducts when x-ray dye is injected into a T-tube in the abdomen ERCP (endoscopic retrograde cholangiopancreatography) - Correct Answer-combines the use of endoscopy and fluoroscopy to evaluate biliary system and pancreas Normal GB wall measurement - Correct Answer-< 3 mm Fatty Meal Administration for GB - Correct Answer-Used to assess biliary dynamics, GB contractility, obstruction. Ingestion of fatty foods causes the release of cholecystokinin into the digestive tract that promotes GB contraction Positive Fatty Meal Administration Exam - Correct Answer- Ducts increase in size more than 1 mm due to increased bile levels with obstruction Negative Fatty Meal Administration Exam - Correct Answer- Ducts do not change in size or decrease in size slightly Where is the pancreas located - Correct Answer-at the level of L1-2 in the anterior pararenal space of the retroperitoneum What is the average size of the pancreas - Correct Answer-12- 18 cm length, 1-1.5 cm wide, 2.5 cm AP Name the segments of the pancreas - Correct Answer-head, uncinate process, neck, body, tail Uncinate process of pancreas - Correct Answer-hook like extension from head, anterior to IVC, posterior to SMV, right lateral to SMA Pancreatic head - Correct Answer-anterior to IVC, medial to duodenum and CBD, right lateral to SMV and aorta, CBD courses posterior to pancreatic head Superior pancreatoduodenal artery - Correct Answer-feeds head, branch of the gastroduodenal artery Splenic artery courses superior and anterior to the - Correct Answer-body and tail of pancreas Splenic artery branches supply the - Correct Answer-body/tail, dorsal pancreatic, pancreatic magnum, and caudal pancreatic arteries Inferior pancreatoduodenal artery - Correct Answer-feeds head, branch of SMA Normal variant of uncinate process of pancreas - Correct Answer-can appear hypoechoic because tissue has less fat than the rest of the gland, should have clear boundaries What is released when blood sugar goes up - Correct Answer- insulin What releases insulin - Correct Answer-Islets of Langerhans Glycogenesis - Correct Answer-formation of glycogen from glucose, controlled by insulin Glycogenolysis - Correct Answer-conversion of glycogen back into glucose, controlled by glucagon Gluconeogenesis - Correct Answer-formation of glucose and glycogen from sources other than carbohydrates Blood sugar levels should not exceed - Correct Answer-100 mg / 100 dL Acini glands secrete - Correct Answer-pancreatic juice that contains trypsin, amylase, lipase exocrine pancreas function - Correct Answer-produces substances that are used in nearby organ and delivered by a DUCT Amylase - Correct Answer-digests carbohydrates, salivary glands produce and excrete amylase and kidneys also excrete amylase through the blood filtration process pancreatic juices contain - Correct Answer-water, enzymes, sodium, potassium, chloride and bicarbonate What neutralizes gastric acid - Correct Answer-sodium bicarbonate The secretion of pancreatic juices is controlled by - Correct Answer-GI tract hormones What stimulates pancreatic juice production - Correct Answer- Cholecystokinin What does secretin admisntration cause - Correct Answer- increased enzyme production and can cause an increase in duct size Endocrine function of pancreas - Correct Answer-produces substances that are used in a nearby organ and delivered through BLOOD VESSELS What is the average size of the spleen - Correct Answer-12 cm length x 8 cm width x 4 cm thick What is the normal splenic volume index - Correct Answer-8- 35 What is the lower medial portion of the spleen called? - Correct Answer-hilum where vessels and nerves enter and exit the organ What lies anterior and medial to the hilum of the spleen? - Correct Answer-fundus of stomach, lesser sac, and pancreatic tail What is adjacent to the posterior, superior, and lateral sides of the spleen? - Correct Answer-diaphragm The spleen is bordered posteriorly by _____ - Correct Answer- lung What part of the colon is medial and inferior to the splenic hilum? - Correct Answer-splenic flexure of colon What is the largest branch of the celiac axis? - Correct Answer- splenic artery The splenic artery courses through the ___________ ligament - Correct Answer-splenorenal What does the splenic artery supply? - Correct Answer-spleen, pancreas, and fundus of stomach The splenic artery is ____ resistance - Correct Answer-low What is the most tortuous artery in the human body? - Correct Answer-Splenic artery (tortuous course superior and anterior to the body and proximal tail of pancreas) What does the splenic artery branch into? - Correct Answer- superior and inferior splenic arteries The __________ arterial branches do not connect or communicate with each other - Correct Answer-intrasplenic (this is unique to the intrasplenic The lack of anastomoses in the _______ arterial circulation eliminates the possibility of collateral formation when infarction occurs - Correct Answer-intrasplenic The splenic vein originates at the ________ hilum - Correct Answer-splenic The splenic vein courses _________________ to pancreas body and tail - Correct Answer-posterioinferior The splenic veins joins with the ____ - Correct Answer-IMV What does the splenic vein drain? - Correct Answer-stomach, spleen, pancreas What is the direction of flow in the splenic vein? - Correct Answer-flow toward the liver and away from the spleen __________________ from the red blood cells is passed to the liver for storage and bile production - Correct Answer- hemoglobin Normal echogenicity of spleen - Correct Answer-homogenous, echogenicity same as or slightly below liver Where do the kidneys develop? - Correct Answer-pelvic cavity and migrate cephalad into the abdominal cavity Where are the upper poles of the kidneys usually located - Correct Answer-at the level of the T12 vertebra Where are the lower poles of the kidneys located - Correct Answer-extend to level of L4 vertebra What kidney is normally slightly lower than the left kidney due to the liver causing inferior displacement? - Correct Answer-right kidney What kidney is usually slightly larger? - Correct Answer-left kidney What triangular muscle lines both sides of the spine from hips to mid back, seen posterior medial to the kidneys? - Correct Answer-psoas muscle What flat muscle is posterior lateral to psoas and immediately posterior to the kidney? - Correct Answer-quadratus lumborum The renal _____ is most anterior at the hilum - Correct Answer-vein The renal ____ is most posterior with the _____ in between - Correct Answer-pelvis/ureter is most posterior with artery in between What is the average adult kidney size - Correct Answer-9-12 cm long, 4-6 cm wide, and 3-4 cm AP The length measurements of adult kidneys should be within ____ cm of each other - Correct Answer-2 cm Average neonatal kidney length - Correct Answer-3.5-5 cm The upper poles of the kidneys are ________________ to the psoas muscle - Correct Answer-anterior The lower poles of the kidneys are ________ to the quadratus lumborum muscle - Correct Answer-anterior The adrenal glands sit ___________-____________ to the kidneys - Correct Answer-superior-medially 3 layers of surrounding tissue of the kidney - Correct Answer- True capsule, Perirenal fat, and Gerota Fascia True capsule of kidney - Correct Answer-dense fibrous covering that is in direct contact with the renal cortex Perirenal fat of kidney - Correct Answer-layering of fat surrounding the true capsule What is the nephron responsible for - Correct Answer- removing waste products from the blood and production of urine The nephron contains the renal ____________ and renal ___________ - Correct Answer-renal corpuscles and renal tubules What does the renal corpuscle include - Correct Answer- Bowman capsule and glomerulus Renal corpuscle - Correct Answer-the blood supply initially comes into close relationship with the nephron by a network of capillaries derived from the afferent arteriole (Glomerulus) resting in a cuplike depression of tubular system (Bowman capsule); filters urine What does the renal tubule include - Correct Answer-proximal convoluted tubule, loop of Henle, distal convoluted tubule, and collecting duct; collects urine produced by the corpuscle Where does the collecting duct pass - Correct Answer-the fluid through the renal pyramids which empty into the calyces and then the renal pelvis Where does the minor calyces originate? - Correct Answer- papilla What is the juxtaglomerular apparatus? - Correct Answer- point at which the distal convoluted tubules comes in contact with the afferent arteriole What does the juxtaglomerular apparatus secrete - Correct Answer-rennin what is rennin - Correct Answer-an enzyme important for regulating sodium and water retention; regulates blood pressure The renal arteries originate ______ below the origin of the SMA - Correct Answer-2-3 cm ___% of patients have duplicated renal arteries - Correct Answer-30% What does the renal artery supply - Correct Answer-kidneys, adrenals, and ureters The right renal artery courses ___________ to the IVC - Correct Answer-posterior to the IVC (retrocaval) Both renal arteries course _______ to the renal veins - Correct Answer-posterior to the renal veins A RI > .7 for the kidneys indicate - Correct Answer-renal dysfunction and ischemia What do the renal veins drain - Correct Answer-kidneys, ureters and adrenals The RRV courses _________ to the RRA to enter the IVC - Correct Answer-anterior The LRV courses between the ______ and ______ - Correct Answer-aorta and SMA Lower serum levels of ADH cause ______________ water excretion from body and can cause ______________ - Correct Answer-increased water EXCRETION from body and can cause dehydration What secretes aldosterone - Correct Answer-adrenal cortex due to increased potassium levels in blood The __________ gland is stimulated to release aldosterone by _________________ blood volume - Correct Answer-adrenal gland is stimulated to release aldosterone by decreased blood volume As aldosterone levels increase, the rate of sodium resorption and potassium excretion in the kidneys ______________ - Correct Answer-increases Higher sodium levels will _____________ water retention by reducing ______________ _____________ - Correct Answer- higher sodium levels will increase water retention by reducing urine output Elevated aldosterone levels = - Correct Answer-increased blood volume and pressure Reduced aldosterone levels = - Correct Answer-decreased blood volume and pressure What does autoregulation of the systemic blood pressure refer to - Correct Answer-when renin is produced by the kidneys to prompt the release of angiotensin (protein found in liver) to cause vasoconstriction = increased systemic blood pressure When the systemic blood pressure increases, glomerular filtration rate (GFR) _____________ - Correct Answer- increases What is the normal glomerular filtration rate - Correct Answer-90 mL/min or mroe List the steps of urine formation - Correct Answer-1. glomerular filtration 2. tubular resorption 3. tubular secretion glomerular filtration - Correct Answer-fluid is forced across membrane into nephron, increases with increased blood pressure, decreased with kidney disease tubular resorption - Correct Answer-while fluid is within the renal tubules, it can be resorbed according to the body's needs; electrolytes and components of the fluid are selectively resorbed to allow for excretion of intended waste products tubular secretion - Correct Answer-selective process of disposing of the waste products and pH regulation Intravenous Pyelogram (IVP) - Correct Answer-radiographic exam that uses iodinates dye that is injected into the blood steam and filtered from the blood by the kidneys; used to evaluate the collecting system of the kidneys Arteriography - Correct Answer-used to detect renal artery stenosis Banana Peek sign - Correct Answer-long aorta with renal arteries branching off What is the number one tool for evaluating the bladder? - Correct Answer-Cystoscopy 95% of bladder pathology are > - Correct Answer-2 cm Scrotum is surrounded by dense fibrous capsule called - Correct Answer-tunica albuginea What form mediastinum testis - Correct Answer-septula arise from tunica albuginea mediastinum testis creates an incomplete septum and provides support for testicular ________________ - Correct Answer-vessels Each testicle contains approximately _____ seminiferous tubules that converge to form 20-30 larger _______ ducts - Correct Answer-840 seminiferous tubules that converge to form 20-30 larger efferent ducts the efferent ducts form channels called the _____ ______ that carry seminal fluid from testicle to _________ - Correct Answer-rete testis that carry seminal fluid from testicle to epididymis Average size of each testicle - Correct Answer-3-5 cm x 2-4 cm wide x 3 cm AP Lambert formula - Correct Answer-pediatric patient formula to calculate testicle volume, L x W x H x .71 Ellipsoid formula - Correct Answer-pediatric patient formula to calculate testicle volume, L x W x H x .52 Tunica Vaginalis of scrotum - Correct Answer-extension of peritoneum into the scrotal sac, has 2 layers Name 2 layers of tunica vaginalis - Correct Answer-visceral and parietal visceral layer of tunica vaginalis - Correct Answer-inner layer covering testes, epididymis and lower part of spermatic cord parietal layer of tunica vaginalis - Correct Answer-lines the walls of the scrotal pouch Tunica albuginea - Correct Answer-thin layer of tissue that is in direct contact with the testicular tissue Folds of tunica albuginea form the - Correct Answer- mediastinum testis The ______ testis is a series of channels within the mediastinum - Correct Answer-rete testis The ____________ layer of tunica vaginalis covers the tunica albuginea - Correct Answer-visceral Blood vessels and ductules enter and exit the testicle at the ________________ - Correct Answer-mediastinum The epididymis is a curved structure lying ______________ ______________ to the testicle - Correct Answer-posterior lateral Where do the deferential arteries originate from? - Correct Answer-internal iliac artery what does the deferential artery feed - Correct Answer- epididymis and vas deferens (high resistance) Where does the cremasteric artery originate from - Correct Answer-external iliac artery What does the cremasteric artery feed - Correct Answer- peritesticular tissues (high resistance) What veins drain the testis? - Correct Answer-right testicular (drains into IVC) vein and left testicular vein (drains into left renal vein) exocrine function of testicles - Correct Answer-produce sperm endocrine function of testicles - Correct Answer-testosterone secretion Epididymis aids in sperm ___________ - Correct Answer- maturation Ejaculatory duct - Correct Answer-sperm and seminal vesicle fluid urethra - Correct Answer-drainage channel for semen, sperm and urine seminal vesicle - Correct Answer-secretes alkaline components of semen and nutrients for sperm prostate - Correct Answer-secretes alkaline fluid into semen Cowper's gland - Correct Answer-secretes mucous for lubrication Normal echogenicity of testicles - Correct Answer- homogenous, uniform, medium level echoes mediastinum testis appears as a linear ____________ band within testicle on ultrasound - Correct Answer-band Doppler waveform of testicle demonstrate ____ levels of antegrade, ____________ flow - Correct Answer-antegrade, monophasic flow (low RI) Normal echogenicity of epididymis on ultrasound - Correct Answer-normal isoechoic or mildly hyperechoic to testicle when does the thyroid begin to form - Correct Answer-4 weeks gestation the thyroid is attached at the midline by ______________ duct - Correct Answer-thyroglossal the thyroglossal duct should regress as the thyroid descends to just below the level of the _____________ - Correct Answer-larynx What are the functional thyroid tissues called - Correct Answer-follicles Normal measurement of thyroid - Correct Answer-4-6 cm long, 1.5-2 cm wide, 1.3-1.8 cm AP normal measurement of isthmus of thyroid - Correct Answer- 2-6 mm AP volume of thyroid - Correct Answer-l x w x h x .529 average volume of thyroid - Correct Answer-19 mL What can cause increased thyroid volume - Correct Answer- iodine deficiency, acute hepatitis and chronic renal failure what can cause decrease thyroid volume - Correct Answer- chronic hepatitis, thyroxine treatment nd radioactive iodine treatment what are the 3 branches of the aortic arch - Correct Answer- innominate artery, Left CCA, Left subclavian artery what gives rise to the right CCA and the right subclavian artery - Correct Answer-innominate artery Where does the left CCA originate from - Correct Answer- aortic arch What supplies the superior and anterior thyroid - Correct Answer-the superior thyroidal artery where does the superior thyroidal artery branch from - Correct Answer-ECA What supplies the inferior and posterior thyroid - Correct Answer-inferior thyroidal artery where does the inferior thyroidal artery originate from - Correct Answer-thyrocervical trunk of subclavian artery The superior and anterior gland of thyroid is drained by the superior thyroidal vein which empties into the ______ - Correct Answer-IJV the inferior and posterior gland of thyroid is drained by the inferior thyroidal vein which empties into the ____________ _____ - Correct Answer-innominate vein jugular veins course __________ to carotid arteries - Correct Answer-lateral internal jugular vein merges with subclavian vein to form - Correct Answer-innominate vein right and left innominate veins merge to form the - Correct Answer-superior vena cava The thyroid regulates - Correct Answer-metabolism Triiodothyronine AKA - Correct Answer-T3 Thyroxine AKA - Correct Answer-T4 Name the 3 thyroid hormones - Correct Answer-T3, T4 and calcitonin symptoms of hypothyroidism - Correct Answer-lethargy, sluggish reactions, deep voice, obesity, increased TSH In some cases what can cause hypothyroidism - Correct Answer-iodine deficiency and iron deficiency normal echogenicity of thyroid - Correct Answer-hyperechoic, homogenous, smooth borders where is esophagus located in relation to thyroid - Correct Answer-posterior to left lobe of thyroid - Correct Answer- Normal number of parathyroid glands - Correct Answer-4-6 Where do the parathyroid glands arise from - Correct Answer- 3rd and 4th pharyngeal pouches at 7 weeks gestational age Where are parathyroid glands located - Correct Answer-mid and lower posterior region of thyroid the ____________ glands are usually more _____________ than the superior glands - Correct Answer-inferior glands more anterior The inferior glands arise from ___ pouch and superior parathyroid glands arise from the ___ pouch - Correct Answer- inferior arise from 3rd pouch and superior arise from 4th pouch Normal measurement of parathyroids - Correct Answer-5-7 mm length 3-4 mm wide 1-2 mm AP What hormones control calcium absorption and excretion in the intestines and kidneys - Correct Answer-PTH and calcitonin Increased serum levels of calcium leads to - Correct Answer- hypercalciuria and hypercalcemia Parathyroid glands may be found - Correct Answer-below clavicles, in lower neck, upper mediastinum or retrotracheal in location The parathyroid glands __________ usually seen during ultrasound exam - Correct Answer-are not What are the largest saliva glands - Correct Answer-parotid glands where are parotid glands located - Correct Answer-anterior to ear, wrapped around mandibular ramus what duct carries saliva into mouth form parotid gland - Correct Answer-Stensen duct Where are submandibular glands located - Correct Answer- under the mandible What duct carries saliva into mouth from submandibular gland - Correct Answer-Wharton duct The anterior prostate is attached to symphysis pubis and pubic bones by ________________ ligaments - Correct Answer-puboprostatic The base of the prostate is the ____________ portion - Correct Answer-superior The base of the prostate which is the superior portion of the gland is situated below the ___________ margin of bladder - Correct Answer-inferior The apex of the prostate is the __________ portion - Correct Answer-inferior The apex of prostate is situated ___________ to the urogenital diaphragm - Correct Answer-superior Each vas deferens empties spermatic fluid into an _______________ duct of the ipsilateral seminal vesicle - Correct Answer-ejaculatory The right and left ejaculatory ducts pass through the _____________ zone of prostate and empty into urethra - Correct Answer-central What is the verumontanum - Correct Answer-longitudinal ridge within urethra that holds the openings from ejaculatory ducts Inferior vesicular arteries - Correct Answer-comes from internal iliac, small perforating arteries to prostate perforating arteries following nerve branches for _____________, neurovascular bundles - Correct Answer- erection Anterior plexus of Santorini merges with dorsal penile vein to - Correct Answer-drain venous blood into internal iliac vein Zones of prostate - Correct Answer-Transitional, central, peripheral, periurethral, fibromuscular Transitional zone of prostate - Correct Answer-central zone surrounding proximal prostatic urethra, 2 lobes What percent of cancers originate in the transitional zone of prostate - Correct Answer-20% What percent of BPH originates in the transitional zone - Correct Answer-95% Central zone of prostate - Correct Answer-seminal vesicle and vas deferens merge to form ejaculatory ducts, ejaculatory duct course through to join urethra, at base of gland posterior to urethra What percent of cancers originate in the central zone of prostate - Correct Answer-10% Peripheral zone of prostate - Correct Answer-posterior and lateral to distal prostatic urethra What percent of cancers originate in the peripheral zone of prostate - Correct Answer-70% The _____ penis extends over ends of corpora cavernosa - Correct Answer-glans Corpus spongiosum - Correct Answer-urethra and urethral arteries travel through this portion, covered by tunica albuginea Internal iliac arteries give rise to what 3 penile arteries - Correct Answer-internal pudendal arteries, bulbourethral artery, penile arteries the penile artery branches into the - Correct Answer-dorsal and cavernosal arteries the right and left cavernosal arteries entre the - Correct Answer-right and left corpus cavernosa What arteries are multiple tiny branches of the cavernosal arteries that penetrate the tissue - Correct Answer-helicine what are the primary venous outflow of penis - Correct Answer-superficial dorsal vein and deep dorsal vein Adrenal glands are located in the - Correct Answer-perirenal space adrenals are ____ the size of the kidney - Correct Answer-1/3 The adrenals are surrounded by the __________ fascia along with the kidneys - Correct Answer-Gerota Right adrenal gland - Correct Answer-triangle shaped, medial to right lobe, posterior to IVC, superomedial to right kidney, lateral and anterior to diaphragm crus Left adrenal gland - Correct Answer-crescent shaped, medial to spleen, posterior to pancreas tail and stomach, lateral to aorta, lateral and anterior to diaphragm crus The cortex of the adrenal is the ________ layer of tissue of the gland - Correct Answer-outer The cortex of adrenal composes ___ of gland - Correct Answer-90% The cortex of adrenal are controlled by - Correct Answer- pituitary gland and ACTH ACTH stimulates - Correct Answer-the cortex of adrenal to increase adrenal function Increased adrenal function slows the pituitary production of - Correct Answer-ACTH Endocrine function of cortex of adrenal - Correct Answer- synthesizes cortisol, androgens, estrogen, progesterone, and aldosterone Name the 3 Zona of cortex of adrenals - Correct Answer-Zona glomerulosa, fasciculata, reticularis zone glomerulosa of adrenal - Correct Answer-produces mineralcorticoids when stimulated by aldosterone, responsible for fluid and electrolyte regulation What are the 2 most common causes of pleural effusion - Correct Answer-CHF and malignancy Esophagogastric Junction - Correct Answer-point where esophagus passes through diaphragm and joins stomach small intestine sections - Correct Answer-duodenum, jejunum, ileum duodenum - Correct Answer-c shaped first portion of small intestine, divided into 4 sections Jejunum - Correct Answer-second portion of small bowel ileum - Correct Answer-terminates at the cecum portion of colon in RLQ What controls flow from small to large intestine - Correct Answer-ileocecal valve name 4 segments of large intestine - Correct Answer- ascending, transverse, descending, sigmoid/rectum ascending colon - Correct Answer-begins with cecum that connects to ileum of the small intestine and extends to hepatic flexure Where does the appendix most common attach to - Correct Answer-cecum Transverse colon - Correct Answer-begins at hepatic flexure and ends at splenic flexure Descending colon - Correct Answer-from splenic flexure to sigmoid sigmoid/rectum - Correct Answer-terminal segment of large bowel Name the accessory glands - Correct Answer-salivary, pancreas, liver Anatomic Gut wall layers - Correct Answer-mucosa, submucosa, muscularis, serosa Ultrasound layers of gut - Correct Answer-superficial mucosa, deep mucosa, submucosa, muscularis, serosa (1,3,5 are echogenic) Normal wall thickness in distended bowel - Correct Answer-3 mm normal wall thickness in non distended bowel - Correct Answer-5 mm What wall thickness is considered abnormal of gut - Correct Answer-> 7 mm Keyboard sign - Correct Answer-haustra of colon may be identified as a series of echogenic lobulations Gastrin - Correct Answer-hormone that controls release of acid in stomach; food triggers a release