This document discusses the anatomy and pathologies of the inguinal region that can be assessed with ultrasound imaging. It describes the normal anatomy including the inguinal canal and its contents. It discusses different types of hernias that can occur in the groin including indirect and direct inguinal hernias as well as femoral hernias. The document also reviews pathologies that can affect the testes such as tumors, infections, and hydroceles. It emphasizes that ultrasound is a highly accurate modality for evaluating scrotal lesions and conditions.
This document discusses renal Doppler ultrasound techniques and findings. It describes three main approaches to imaging the renal arteries - anterior, oblique, and flank. Normal and abnormal Doppler waveforms are presented. Evaluation of renal artery stenosis can be done directly by imaging the renal arteries or indirectly by imaging intrarenal arteries. Findings suggestive of stenosis include increased velocities, renal/aortic ratios over 3.5, absence of the early systolic peak, and tardus parvus waveforms. Pathologies of renal transplants like rejection, infarction, and arterial or venous stenosis are also summarized.
Doppler ultrasound of lower limb arteriesSamir Haffar
This document provides information on Doppler ultrasound of lower limb arteries. It begins with the anatomy of lower limb arteries including the abdominal aorta, iliac arteries, femoral arteries, and crural arteries. It then discusses normal Doppler ultrasound findings of lower limb arteries including normal arterial diameters, waveforms, and velocities. Finally, it covers duplex ultrasound criteria for arterial evaluation and various causes of lower limb arterial diseases such as atherosclerosis, thrombosis, aneurysms, and arterial occlusions.
This document provides an overview of ultrasonography of the normal and abnormal uterus. It describes the techniques, anatomy, measurements, and appearances of the uterus throughout the menstrual cycle. Common abnormalities such as fibroids, adenomyosis, endometrial polyps and cancers are outlined. Details on evaluating the endometrium, myometrium, cervical abnormalities and intrauterine devices are provided. Ultrasonography is an important tool for assessing the uterus but has limitations and often requires correlation with clinical history and other imaging modalities.
This document discusses Doppler ultrasonography and the spectral waveforms used to analyze blood flow patterns in vessels. It provides details on:
- The Doppler spectrum which represents blood flow velocities over time on a graph with frequency on the vertical axis and time on the horizontal axis.
- Characteristics of normal flow patterns seen in major vessels and how they relate to vessel anatomy and organ function.
- Abnormal flow patterns seen in pseudoaneurysms and arteriovenous fistulas which involve damage to vessel walls. Specific waveform patterns are described that indicate these conditions.
Presentation1, radiological imaging of undescended testis.Abdellah Nazeer
This document discusses radiological imaging techniques for undescended testes (cryptorchidism). Ultrasound has moderate sensitivity and specificity for locating undescended testes, but MRI is the best imaging method, with sensitivity around 90% and specificity of 100%. MRI can identify locations of undescended testes that may be intra-abdominal, inguinal, or ectopic. The document presents several case examples demonstrating appearances of undescended testes on different imaging techniques.
This document discusses the anatomy and ultrasound evaluation of veins in the upper extremity. It describes the cephalic, basilic, brachial, axillary, subclavian, and internal jugular veins. The technical procedure for venous doppler ultrasound is outlined, including patient positioning, scanning techniques, and diagnostic criteria. Potential pitfalls like rouleaux and limited windows are noted. Chronic changes after deep vein thrombosis like valve changes and collateral veins are also described. Ultrasound is useful for evaluating suspected deep vein thrombosis and mapping veins for dialysis access planning.
This document summarizes key findings on ultrasound examination of the thyroid gland and related structures. It describes the normal ultrasound appearance of the thyroid and measurements. It also discusses common pathologies seen on ultrasound such as Hashimoto's thyroiditis, Graves' disease, thyroid nodules, and lymph node enlargement. Additional sections cover the parathyroid glands, salivary glands, and neck lymph nodes. For each area, it provides ultrasound images along with descriptions of normal and abnormal findings.
This document discusses renal Doppler ultrasound techniques and findings. It describes three main approaches to imaging the renal arteries - anterior, oblique, and flank. Normal and abnormal Doppler waveforms are presented. Evaluation of renal artery stenosis can be done directly by imaging the renal arteries or indirectly by imaging intrarenal arteries. Findings suggestive of stenosis include increased velocities, renal/aortic ratios over 3.5, absence of the early systolic peak, and tardus parvus waveforms. Pathologies of renal transplants like rejection, infarction, and arterial or venous stenosis are also summarized.
Doppler ultrasound of lower limb arteriesSamir Haffar
This document provides information on Doppler ultrasound of lower limb arteries. It begins with the anatomy of lower limb arteries including the abdominal aorta, iliac arteries, femoral arteries, and crural arteries. It then discusses normal Doppler ultrasound findings of lower limb arteries including normal arterial diameters, waveforms, and velocities. Finally, it covers duplex ultrasound criteria for arterial evaluation and various causes of lower limb arterial diseases such as atherosclerosis, thrombosis, aneurysms, and arterial occlusions.
This document provides an overview of ultrasonography of the normal and abnormal uterus. It describes the techniques, anatomy, measurements, and appearances of the uterus throughout the menstrual cycle. Common abnormalities such as fibroids, adenomyosis, endometrial polyps and cancers are outlined. Details on evaluating the endometrium, myometrium, cervical abnormalities and intrauterine devices are provided. Ultrasonography is an important tool for assessing the uterus but has limitations and often requires correlation with clinical history and other imaging modalities.
This document discusses Doppler ultrasonography and the spectral waveforms used to analyze blood flow patterns in vessels. It provides details on:
- The Doppler spectrum which represents blood flow velocities over time on a graph with frequency on the vertical axis and time on the horizontal axis.
- Characteristics of normal flow patterns seen in major vessels and how they relate to vessel anatomy and organ function.
- Abnormal flow patterns seen in pseudoaneurysms and arteriovenous fistulas which involve damage to vessel walls. Specific waveform patterns are described that indicate these conditions.
Presentation1, radiological imaging of undescended testis.Abdellah Nazeer
This document discusses radiological imaging techniques for undescended testes (cryptorchidism). Ultrasound has moderate sensitivity and specificity for locating undescended testes, but MRI is the best imaging method, with sensitivity around 90% and specificity of 100%. MRI can identify locations of undescended testes that may be intra-abdominal, inguinal, or ectopic. The document presents several case examples demonstrating appearances of undescended testes on different imaging techniques.
This document discusses the anatomy and ultrasound evaluation of veins in the upper extremity. It describes the cephalic, basilic, brachial, axillary, subclavian, and internal jugular veins. The technical procedure for venous doppler ultrasound is outlined, including patient positioning, scanning techniques, and diagnostic criteria. Potential pitfalls like rouleaux and limited windows are noted. Chronic changes after deep vein thrombosis like valve changes and collateral veins are also described. Ultrasound is useful for evaluating suspected deep vein thrombosis and mapping veins for dialysis access planning.
This document summarizes key findings on ultrasound examination of the thyroid gland and related structures. It describes the normal ultrasound appearance of the thyroid and measurements. It also discusses common pathologies seen on ultrasound such as Hashimoto's thyroiditis, Graves' disease, thyroid nodules, and lymph node enlargement. Additional sections cover the parathyroid glands, salivary glands, and neck lymph nodes. For each area, it provides ultrasound images along with descriptions of normal and abnormal findings.
Doppler ultrasound of normal venous flowSamir Haffar
This document discusses Doppler ultrasound findings of normal venous flow. It notes that normal venous flow is spontaneous without augmentation, changes with respiration, and veins compress fully in the transverse plane. It also describes augmented flow seen with distal compression and abdominal/pelvic vein patency seen during the Valsalva maneuver. The document provides images demonstrating normal venous flow patterns and measurements.
Presentation1.pptx, ultrasound examination of the 2nd & 3rd trimester pregnancy.Abdellah Nazeer
This document provides guidance on performing an ultrasound examination of the fetus in the second and third trimesters of pregnancy. It details the standard views and measurements that should be obtained, including images of the head, heart, abdomen, limbs and other structures. Potential abnormalities are also listed for each structure. Fetal echocardiography is important for detecting congenital cardiac defects, which occur in 2-6.5% of live births and can have serious consequences if not identified prenatally.
The document summarizes the radiological anatomy of the knee joint. It describes the various ligaments, tendons, bones and cartilage that make up the knee, including the medial and lateral menisci, anterior and posterior cruciate ligaments, patellar tendon, and surrounding muscles. It provides imaging protocols for MRI of the knee, covering positioning, slice thickness, pulse sequences and imaging planes used to visualize the different knee structures. Common anatomical variations and pitfalls in interpretation are also discussed.
This document provides information on performing and interpreting CT angiography of the lower limbs. It discusses scanning techniques, protocols, contrast injection, and principles of timing acquisitions. Image post-processing includes MIP, VR, and MPR. Interpretation requires scrutinizing calcifications and stents to avoid overestimating stenosis. Peripheral CTA is useful for evaluating occlusive disease, aneurysms, trauma, infections, embolism, and postoperative surveillance. Examples demonstrate various vascular pathologies.
Presentation1.pptx, radiological imaging of the thyroid gland diseases.Abdellah Nazeer
This document discusses radiological imaging modalities for evaluating thyroid diseases such as plain X-ray, ultrasound, isotope uptake scan, CT scan, and MRI. It describes indications for thyroid ultrasound including evaluating neck masses, abnormalities found on other imaging, laboratory abnormalities, thyroid size and location, risk for occult cancer, and follow-up of known nodules. Common thyroid diseases discussed include hypothyroidism, hyperthyroidism, goiter, nodules, cancer, and deficiencies. Specific conditions like Hashimoto's thyroiditis, acute infectious thyroiditis, subacute granulomatous thyroiditis, euthyroid sick syndrome, and Graves' disease are also summarized.
This document discusses ultrasound criteria for breast lesions. It describes breast anatomy and different types of breast lesions including cystic, mass, and mixed lesions. Examples of benign and malignant mass ultrasound criteria are provided such as shape, margin, texture, and vascularity. The document also discusses different breast conditions like cysts, fibroadenomas, ductal carcinoma and fibrocystic disease. It notes ultrasound is important for differentiating solid from cystic lesions and provides management diagrams. Risk factors for breast cancer are also summarized.
Presentation1.pptx, ultrasound examination of the wrist joint.Abdellah Nazeer
This document provides an ultrasound examination of the wrist joint, with descriptions of the anatomy and pathology that can be visualized. It examines the wrist in detail through 6 compartments on the dorsal side and structures on the volar side such as the carpal tunnel and Guyon's canal. Common conditions discussed include carpal tunnel syndrome, ganglion cysts, scapholunate ligament tears, tendon abnormalities, joint effusions, and other soft tissue lesions. The role of ultrasound in evaluating muscular, tendinous, ligamentous, vascular and other pathology of the wrist is outlined.
Doppler ultrasound of the portal system - Normal findingsSamir Haffar
This document provides an overview of Doppler ultrasound of the normal portal system, including:
1. Principles of Doppler ultrasound and how to adjust settings like color box size, velocity scale, gain, and wall filter to optimize the examination.
2. Sites for duplex insonation of the portal system and techniques for obtaining spectral waveforms.
3. Normal Doppler ultrasound findings of the portal vein, hepatic veins, and hepatic artery, including measurements and anatomy.
The document discusses the BI-RADS (Breast Imaging-Reporting and Data System) which classifies breast lesions identified on mammography, ultrasound, or MRI into categories based on assessment and risk of malignancy. It describes the 6 BI-RADS assessment categories ranging from BI-RADS 0, where additional imaging is needed, to BI-RADS VI for a known biopsy-proven malignancy. Key descriptors are provided for describing masses, calcifications, architectural distortion and other findings. The goal of BI-RADS is to standardize breast imaging reporting and ensure appropriate clinical management based on cancer risk.
Presentation1.pptx, ultrasound examination of the elbow joint.Abdellah Nazeer
This document provides an ultrasound summary of the normal elbow anatomy and various pathologies that can be assessed using ultrasound. It describes the lateral, anterior, medial and posterior aspects of the elbow and identifies structures like tendons, ligaments, nerves and bursae. Common pathologies discussed include tendinosis, tears, bursitis, synovitis and effusions. The role of ultrasound in evaluating muscular, tendinous and ligamentous injuries is outlined. Proper scanning technique and ultrasound equipment selection are also reviewed.
This document provides information on performing and interpreting renal Doppler ultrasounds. It discusses the optimal approaches for imaging the renal arteries, including the anterior, oblique, and flank approaches. It also outlines criteria for evaluating renal artery stenosis, including peak systolic velocity measurements and the renal-aortic ratio. Common renal pathologies that can be identified with Doppler ultrasound are also summarized, such as fibromuscular dysplasia, atherosclerosis, aneurysms, and hydronephrosis.
Presentation1.pptx, radiological imaging of large bowel diseasesAbdellah Nazeer
This document discusses congenital anomalies and diseases of the large bowel. It begins by describing congenital abnormalities that can cause obstruction in neonates and the importance of radiological imaging to diagnose the location and cause. It then discusses different types of intestinal obstructions and how radiography and contrast enema exams are used to further evaluate obstructions and make a specific diagnosis. Examples of different congenital anomalies and diseases seen on imaging are also presented, including colonic atresia, meconium ileus, Hirschsprung disease, and colon cancer.
This document discusses Doppler ultrasound in peripheral arterial disease. It begins by explaining Doppler ultrasound waveforms and how they relate to blood flow direction and velocity. It then covers topics like antegrade versus retrograde flow, pulsatile versus nonpulsatile flow, and directionality. The document also discusses spectral broadening and differentiating high- versus low-resistance arteries. It provides diagrams to illustrate topics like stenosis, collateral flow, and the definitions of upstream and downstream. Finally, it outlines the criteria for classifying and grading peripheral arterial stenosis using Doppler ultrasound.
Transrectal ultrasound and scrotal ultrasound are useful in diagnosing male infertility. Transrectal ultrasound can detect midline cysts or stones obstructing the ejaculatory duct. It can also evaluate the seminal vesicles. Scrotal ultrasound can identify varicoceles, epididymitis, testicular tumors, and other abnormalities. X-rays are used for testicular venography to diagnose varicoceles. Imaging plays an important role in evaluating male infertility by detecting treatable causes and ensuring patient safety.
This document outlines an MRI study protocol for evaluating the pelvic floor. It involves filling the rectum with ultrasound gel and obtaining static and dynamic sagittal T2 weighted images at rest, during sustained contraction, Valsalva maneuver, and defecation. This allows evaluation of pelvic floor morphology and function to identify issues like prolapse or intussusception. Fasting is not required but a laxative is given beforehand to empty the bowels.
This document provides an overview of performing lower limb doppler examinations to diagnose deep vein thrombosis and other causes of limb pain. It discusses the essential techniques including recognizing the vessels, avoiding pitfalls, applying compression, and following the anatomy. Criteria for diagnosing DVT include vessel expansion, compressibility, presence of thrombus, and absent or reduced blood flow waves. The document also reviews using doppler to diagnose and grade arterial stenosis by analyzing spectral wave patterns and meanings.
This document discusses fetal neurosonography and the sonographic appearance of fetal brain structures throughout gestation. It begins with an overview of embryonic brain development and the division of the brain into sections. It then examines how the appearance of specific structures changes with gestational age, including the posterior fossa, lateral ventricles, and cerebellum. Serial images demonstrate the maturation and relationships between structures over time. The role of 3D imaging in examining the posterior fossa is also mentioned.
Presentation1.pptx, radiological imaging of scrotal diseases.Abdellah Nazeer
This document provides an overview of radiological imaging of scrotal diseases. It begins with the anatomy of the scrotum and its layers. It then discusses congenital diseases like cryptorchidism, which is the absence of one or both testes from the scrotum. Cryptorchidism can occur if the testes fail to descend from the abdomen into the scrotum. The document presents various imaging examples of cryptorchidism showing undescended testes in the inguinal canal or abdomen. It also discusses inflammatory diseases, trauma, testicular torsion, masses, and other pathologies that can be imaged and evaluated radiologically.
In this part of presentation we will discuss the role of Doppler Ultrasound in the Diagnosis of other causes of stenosis and variable pattern in circulation.
In my opinion this presentation will help u to identify even rare pathologies.
This document discusses lumbosacral transitional vertebrae (LSTV), which are congenital spinal anomalies involving sacralization of the lowest lumbar segment or lumbarization of the highest sacral segment. LSTVs can be classified based on imaging features and involve fusion of the transverse process to the sacrum. Numbering the vertebrae can be challenging with LSTVs. Prediction of LSTVs on MRI is possible based on increased A and B angles on sagittal images, which measure the inclination of the sacrum and lumbar lordosis. LSTVs can cause low back pain known as Bertolotti syndrome through various mechanisms.
This document provides an overview of ultrasound for evaluating hernias. It describes the anatomy of the inguinal region and sites of common hernias. Inguinal hernias can be indirect or direct. Spigelian hernias occur along the spigelian fascia. Femoral hernias are located in the femoral canal. Linea alba hernias occur through the abdominal wall. Umbilical and incisional hernias also are reviewed. Ultrasound is useful for diagnosing hernia contents and complications like incarceration, obstruction, and strangulation. Findings suggestive of strangulation include hyperechoic fat, thickened sac walls, fluid within the sac, and
Doppler ultrasound of normal venous flowSamir Haffar
This document discusses Doppler ultrasound findings of normal venous flow. It notes that normal venous flow is spontaneous without augmentation, changes with respiration, and veins compress fully in the transverse plane. It also describes augmented flow seen with distal compression and abdominal/pelvic vein patency seen during the Valsalva maneuver. The document provides images demonstrating normal venous flow patterns and measurements.
Presentation1.pptx, ultrasound examination of the 2nd & 3rd trimester pregnancy.Abdellah Nazeer
This document provides guidance on performing an ultrasound examination of the fetus in the second and third trimesters of pregnancy. It details the standard views and measurements that should be obtained, including images of the head, heart, abdomen, limbs and other structures. Potential abnormalities are also listed for each structure. Fetal echocardiography is important for detecting congenital cardiac defects, which occur in 2-6.5% of live births and can have serious consequences if not identified prenatally.
The document summarizes the radiological anatomy of the knee joint. It describes the various ligaments, tendons, bones and cartilage that make up the knee, including the medial and lateral menisci, anterior and posterior cruciate ligaments, patellar tendon, and surrounding muscles. It provides imaging protocols for MRI of the knee, covering positioning, slice thickness, pulse sequences and imaging planes used to visualize the different knee structures. Common anatomical variations and pitfalls in interpretation are also discussed.
This document provides information on performing and interpreting CT angiography of the lower limbs. It discusses scanning techniques, protocols, contrast injection, and principles of timing acquisitions. Image post-processing includes MIP, VR, and MPR. Interpretation requires scrutinizing calcifications and stents to avoid overestimating stenosis. Peripheral CTA is useful for evaluating occlusive disease, aneurysms, trauma, infections, embolism, and postoperative surveillance. Examples demonstrate various vascular pathologies.
Presentation1.pptx, radiological imaging of the thyroid gland diseases.Abdellah Nazeer
This document discusses radiological imaging modalities for evaluating thyroid diseases such as plain X-ray, ultrasound, isotope uptake scan, CT scan, and MRI. It describes indications for thyroid ultrasound including evaluating neck masses, abnormalities found on other imaging, laboratory abnormalities, thyroid size and location, risk for occult cancer, and follow-up of known nodules. Common thyroid diseases discussed include hypothyroidism, hyperthyroidism, goiter, nodules, cancer, and deficiencies. Specific conditions like Hashimoto's thyroiditis, acute infectious thyroiditis, subacute granulomatous thyroiditis, euthyroid sick syndrome, and Graves' disease are also summarized.
This document discusses ultrasound criteria for breast lesions. It describes breast anatomy and different types of breast lesions including cystic, mass, and mixed lesions. Examples of benign and malignant mass ultrasound criteria are provided such as shape, margin, texture, and vascularity. The document also discusses different breast conditions like cysts, fibroadenomas, ductal carcinoma and fibrocystic disease. It notes ultrasound is important for differentiating solid from cystic lesions and provides management diagrams. Risk factors for breast cancer are also summarized.
Presentation1.pptx, ultrasound examination of the wrist joint.Abdellah Nazeer
This document provides an ultrasound examination of the wrist joint, with descriptions of the anatomy and pathology that can be visualized. It examines the wrist in detail through 6 compartments on the dorsal side and structures on the volar side such as the carpal tunnel and Guyon's canal. Common conditions discussed include carpal tunnel syndrome, ganglion cysts, scapholunate ligament tears, tendon abnormalities, joint effusions, and other soft tissue lesions. The role of ultrasound in evaluating muscular, tendinous, ligamentous, vascular and other pathology of the wrist is outlined.
Doppler ultrasound of the portal system - Normal findingsSamir Haffar
This document provides an overview of Doppler ultrasound of the normal portal system, including:
1. Principles of Doppler ultrasound and how to adjust settings like color box size, velocity scale, gain, and wall filter to optimize the examination.
2. Sites for duplex insonation of the portal system and techniques for obtaining spectral waveforms.
3. Normal Doppler ultrasound findings of the portal vein, hepatic veins, and hepatic artery, including measurements and anatomy.
The document discusses the BI-RADS (Breast Imaging-Reporting and Data System) which classifies breast lesions identified on mammography, ultrasound, or MRI into categories based on assessment and risk of malignancy. It describes the 6 BI-RADS assessment categories ranging from BI-RADS 0, where additional imaging is needed, to BI-RADS VI for a known biopsy-proven malignancy. Key descriptors are provided for describing masses, calcifications, architectural distortion and other findings. The goal of BI-RADS is to standardize breast imaging reporting and ensure appropriate clinical management based on cancer risk.
Presentation1.pptx, ultrasound examination of the elbow joint.Abdellah Nazeer
This document provides an ultrasound summary of the normal elbow anatomy and various pathologies that can be assessed using ultrasound. It describes the lateral, anterior, medial and posterior aspects of the elbow and identifies structures like tendons, ligaments, nerves and bursae. Common pathologies discussed include tendinosis, tears, bursitis, synovitis and effusions. The role of ultrasound in evaluating muscular, tendinous and ligamentous injuries is outlined. Proper scanning technique and ultrasound equipment selection are also reviewed.
This document provides information on performing and interpreting renal Doppler ultrasounds. It discusses the optimal approaches for imaging the renal arteries, including the anterior, oblique, and flank approaches. It also outlines criteria for evaluating renal artery stenosis, including peak systolic velocity measurements and the renal-aortic ratio. Common renal pathologies that can be identified with Doppler ultrasound are also summarized, such as fibromuscular dysplasia, atherosclerosis, aneurysms, and hydronephrosis.
Presentation1.pptx, radiological imaging of large bowel diseasesAbdellah Nazeer
This document discusses congenital anomalies and diseases of the large bowel. It begins by describing congenital abnormalities that can cause obstruction in neonates and the importance of radiological imaging to diagnose the location and cause. It then discusses different types of intestinal obstructions and how radiography and contrast enema exams are used to further evaluate obstructions and make a specific diagnosis. Examples of different congenital anomalies and diseases seen on imaging are also presented, including colonic atresia, meconium ileus, Hirschsprung disease, and colon cancer.
This document discusses Doppler ultrasound in peripheral arterial disease. It begins by explaining Doppler ultrasound waveforms and how they relate to blood flow direction and velocity. It then covers topics like antegrade versus retrograde flow, pulsatile versus nonpulsatile flow, and directionality. The document also discusses spectral broadening and differentiating high- versus low-resistance arteries. It provides diagrams to illustrate topics like stenosis, collateral flow, and the definitions of upstream and downstream. Finally, it outlines the criteria for classifying and grading peripheral arterial stenosis using Doppler ultrasound.
Transrectal ultrasound and scrotal ultrasound are useful in diagnosing male infertility. Transrectal ultrasound can detect midline cysts or stones obstructing the ejaculatory duct. It can also evaluate the seminal vesicles. Scrotal ultrasound can identify varicoceles, epididymitis, testicular tumors, and other abnormalities. X-rays are used for testicular venography to diagnose varicoceles. Imaging plays an important role in evaluating male infertility by detecting treatable causes and ensuring patient safety.
This document outlines an MRI study protocol for evaluating the pelvic floor. It involves filling the rectum with ultrasound gel and obtaining static and dynamic sagittal T2 weighted images at rest, during sustained contraction, Valsalva maneuver, and defecation. This allows evaluation of pelvic floor morphology and function to identify issues like prolapse or intussusception. Fasting is not required but a laxative is given beforehand to empty the bowels.
This document provides an overview of performing lower limb doppler examinations to diagnose deep vein thrombosis and other causes of limb pain. It discusses the essential techniques including recognizing the vessels, avoiding pitfalls, applying compression, and following the anatomy. Criteria for diagnosing DVT include vessel expansion, compressibility, presence of thrombus, and absent or reduced blood flow waves. The document also reviews using doppler to diagnose and grade arterial stenosis by analyzing spectral wave patterns and meanings.
This document discusses fetal neurosonography and the sonographic appearance of fetal brain structures throughout gestation. It begins with an overview of embryonic brain development and the division of the brain into sections. It then examines how the appearance of specific structures changes with gestational age, including the posterior fossa, lateral ventricles, and cerebellum. Serial images demonstrate the maturation and relationships between structures over time. The role of 3D imaging in examining the posterior fossa is also mentioned.
Presentation1.pptx, radiological imaging of scrotal diseases.Abdellah Nazeer
This document provides an overview of radiological imaging of scrotal diseases. It begins with the anatomy of the scrotum and its layers. It then discusses congenital diseases like cryptorchidism, which is the absence of one or both testes from the scrotum. Cryptorchidism can occur if the testes fail to descend from the abdomen into the scrotum. The document presents various imaging examples of cryptorchidism showing undescended testes in the inguinal canal or abdomen. It also discusses inflammatory diseases, trauma, testicular torsion, masses, and other pathologies that can be imaged and evaluated radiologically.
In this part of presentation we will discuss the role of Doppler Ultrasound in the Diagnosis of other causes of stenosis and variable pattern in circulation.
In my opinion this presentation will help u to identify even rare pathologies.
This document discusses lumbosacral transitional vertebrae (LSTV), which are congenital spinal anomalies involving sacralization of the lowest lumbar segment or lumbarization of the highest sacral segment. LSTVs can be classified based on imaging features and involve fusion of the transverse process to the sacrum. Numbering the vertebrae can be challenging with LSTVs. Prediction of LSTVs on MRI is possible based on increased A and B angles on sagittal images, which measure the inclination of the sacrum and lumbar lordosis. LSTVs can cause low back pain known as Bertolotti syndrome through various mechanisms.
This document provides an overview of ultrasound for evaluating hernias. It describes the anatomy of the inguinal region and sites of common hernias. Inguinal hernias can be indirect or direct. Spigelian hernias occur along the spigelian fascia. Femoral hernias are located in the femoral canal. Linea alba hernias occur through the abdominal wall. Umbilical and incisional hernias also are reviewed. Ultrasound is useful for diagnosing hernia contents and complications like incarceration, obstruction, and strangulation. Findings suggestive of strangulation include hyperechoic fat, thickened sac walls, fluid within the sac, and
Ultrasound of the abdominal wall herniasSamir Haffar
This document discusses the ultrasound evaluation of anterior abdominal wall hernias. It describes the different types of hernias including epigastric, periumbilical, umbilical, inguinal, femoral and incisional hernias. For each type of hernia, it provides ultrasound images demonstrating the normal abdominal wall anatomy and signs of the hernia. It also discusses some pitfalls in hernia evaluation that can be mistaken for hernias, such as atrophied muscles, lymph nodes, hematomas and subcutaneous masses. In summary, the document provides a comprehensive overview of abdominal wall hernia ultrasound evaluation through descriptions and images of normal findings and various hernia types.
This document provides an overview of inguinal hernias. It defines a hernia as the protrusion of an organ through a weakness in the muscle wall. It then discusses the epidemiology, types, anatomy, etiology, pathogenesis, signs and symptoms, diagnosis, treatment and complications of inguinal hernias. The treatment options covered are herniotomy, herniorrhaphy, and laparoscopic repair techniques like the Lichtenstein method. The prognosis is typically good, though there is a small risk of recurrence.
Ultrasound can be used to evaluate different types of hernias in the groin and abdominal wall. Indirect inguinal hernias originate lateral to the inferior epigastric artery, while direct inguinal hernias occur medial to the artery. Spigelian hernias occur where the transverse abdominis and internal oblique muscles are torn near the inferior epigastric vessels. Femoral hernias arise in the femoral canal below the inguinal ligament. Linea alba hernias protrude through the midline fascia. Umbilical hernias occur through a widened umbilical ring. Incisional hernias develop through surgical scars. Hern
This document provides an overview of ultrasound imaging for evaluating hernias. It describes the anatomy of the inguinal region and locations where hernias commonly occur. The main types of hernias discussed are indirect inguinal, direct inguinal, femoral, and spigelian hernias. For each type, the document describes the anatomy, location, contents, and ultrasound appearance. It emphasizes how ultrasound allows dynamic evaluation through Valsalva maneuvers to identify hernias.
An inguinal hernia occurs when an organ or tissue protrudes through a weak spot in the abdominal wall. There are two main types - indirect (lateral) hernias which occur through the deep inguinal ring and direct (medial) hernias which occur through Hesselbach's triangle. Surgical repair is the standard treatment and involves identifying and reducing the hernia sac, ligating the neck if present, and reconstructing the posterior wall with sutures or a mesh. Complications can include incarceration, strangulation or infection if left untreated.
This document provides an overview of hernias, including relevant anatomy, common sites, causes, types, clinical features, investigations, and treatment. It focuses on inguinal hernias, describing the anatomy of the inguinal canal, types of inguinal hernias (indirect, direct), clinical exam findings, and surgical repair techniques including open and laparoscopic approaches. Post-operative complications are also outlined.
This document provides information on the anatomy of the inguinal canal and inguinal hernia. It describes the boundaries and structures that pass through the inguinal canal. It discusses the types of inguinal hernias including indirect, direct, and femoral hernias. It also covers the clinical features, investigations, complications and treatment options for inguinal hernias, which typically involves herniotomy (excision of the hernia sac) and herniorrhaphy or hernioplasty (strengthening of the posterior wall).
The document summarizes key details about the inguinal canal and inguinal hernias. It describes the anatomy of the inguinal canal including its entrance, exit, roof, floor, and walls. It then discusses direct and indirect inguinal hernias, their causes, signs and symptoms, examination findings, and surgical repair techniques like Lichtenstein and Shouldice repairs. Femoral hernias are also briefly covered.
This document provides information about inguinal hernias, including:
1) It defines an inguinal hernia as the protrusion of abdominal contents through the inguinal canal. It describes the anatomy of the inguinal canal and surrounding structures.
2) It explains the differences between indirect and direct inguinal hernias in terms of their anatomy and presentation.
3) It outlines the physical exam findings for diagnosing an inguinal hernia and describes common surgical repair techniques like herniotomy, herniorrhaphy, hernioplasty, and laparoscopic approaches.
This document provides information about hernias, including the anatomy of the abdominal wall and inguinal canal, definitions of hernia types, causes, pathophysiology, natural history, clinical presentation, diagnosis, and management. The main types of hernias are inguinal, femoral, and incisional. Hernias occur due to weaknesses in the abdominal wall that allow internal organs or tissues to protrude through. Clinical examination involves inspecting for lumps and evaluating their reducibility, contents, and impulse. Treatment options include conservative management with trusses or surgical repair/hernioplasty to reinforce weakened areas.
The document discusses inguinal hernia and its management. It defines hernia and inguinal hernia, describing their types as direct or indirect. It details the anatomy of the inguinal region including structures like the inguinal canal, rings, and layers. It also discusses the etiology, risk factors, investigations and classifications of inguinal hernias. The management section summarizes techniques for hernia repair like herniotomy, herniorrhaphy, hernioplasty and laparoscopic repair. It highlights pioneers in the field including Bassini, Shouldice and modifications to their open tension-free techniques.
This document provides information on the anatomy of the inguinal canal and inguinal hernias. It describes the boundaries and structures that pass through the inguinal canal. It discusses the types of inguinal hernias including indirect, direct, and femoral hernias. It also covers the clinical features of inguinal hernias such as symptoms, precipitating causes, and examination findings including inspection, palpation, and tests to determine hernia type.
In this playlist I discussed about groin swellings and the various causes for this problem. I discussed about Inguinal hernia, femoral hernia, ventral hernia and undescended testis. If you watch all these videos together you will become confident in managing groin swellings
Inguinal Hernia is the commonest problem in General surgery. All medical students should know everything about this common problem. In this ppt presentation I have covered all the details regarding Inguinal hernia thoroughly.
Anesthetize the area with lidocaine gel
Surgeon: Insert anoscope and identify hemorrhoid
Procedure
Surgeon: Inject sclerosant into hemorrhoid using a fine needle
Post
Surgeon: Apply petroleum jelly to area
Instructions: Expect swelling and discomfort for a few days. Take stool softeners. Hemorrhoid will slough off in 1-2 weeks.
Follow up: As needed if symptoms persist beyond 2 weeks
Inguinal Hernia Management, Presentation, by Dr. Shabir Ahmad Shabir Ahmad
This document provides information on the management of inguinal hernias. It begins with an introduction to inguinal hernia including definitions, anatomy of the inguinal region, epidemiology, causes, types, classifications, clinical presentation, diagnosis, hernia repair techniques, complications and recent advances. The majority of the document then focuses on providing detailed descriptions and illustrations of the anatomy of the inguinal region and inguinal canal, classifications of hernias, clinical presentation, investigations for diagnosis and the open tension free Lichtenstein hernia repair technique.
The document describes the anatomy and types of inguinal hernias. It discusses the superficial inguinal ring, deep inguinal ring, and inguinal canal. It notes that inguinal hernias can be either indirect or direct. Indirect hernias are more common and travel down the side of the spermatic cord, while direct hernias come through the posterior wall. Treatment involves herniotomy to open the sac and reduce contents, followed by herniorrhaphy to repair the defect and reinforce the area. Excision of the hernia sac and ligation of its neck are important steps in the surgical procedure.
Overview of Hernias with special emphasis on Inguinal Hernias. Management of obstructed, strangulated hernia, Bassini repair, McVay's repair, Tanner's slide
The femoral triangle is a hollow region located in the supero-medial part of the anterior thigh. It appears most prominently with hip flexion, abduction and internal rotation. It is an easily accessible area through which multiple neurovascular structures pass through.
This document provides an overview of abdominal wall hernias, including definitions, types, etiologies, anatomy, clinical features, and treatments. It describes the main types of groin hernias such as indirect, direct, and femoral hernias. It discusses the composition of hernias and provides classifications. For groin hernias specifically, it outlines the anatomy of the inguinal canal and contents, compares indirect and direct hernias, and describes surgical repair techniques like Bassini, Shouldice, and Lichtenstein. Femoral hernias are also summarized, including the anatomy of the femoral ring and canal.
The document discusses several types of abdominal hernias and clinical findings related to the abdomen. It describes an umbilical cord that is tied off and shed after birth. It also discusses a patent urachus, vitelline duct, and Meckel's diverticulum. The document defines hernias and lists common types including inguinal, femoral, umbilical, epigastric, and incisional. It provides more detail on indirect inguinal, direct inguinal, and femoral hernias, describing their locations, contents, and characteristics.
Vascular brain lesions for radiology by Dr Soumitra HalderSoumitra Halder
- The document discusses various brain vascular lesions including aneurysms, vascular malformations, dural arteriovenous fistulas, and more.
- Aneurysms are abnormal bulges in arterial walls that can rupture and cause subarachnoid hemorrhage. Imaging like CTA can detect aneurysms with over 90% sensitivity. Treatment options include observation, surgical clipping, or endovascular coiling.
- Arteriovenous malformations are tangled masses of abnormal vessels that shunt blood from arteries to veins without an intervening capillary bed. They can cause headaches or neurological deficits. Treatment involves surgical excision, stereotactic radiosurgery, or endovascular embolization.
-
Vascular brain anatomy for Radiology by Dr Soumitra HalderSoumitra Halder
The document provides an overview of cerebral arterial and venous anatomy. It discusses:
1) The anterior and posterior cerebral circulations, including the internal carotid artery (ICA) and its branches that form the anterior circulation, and the vertebrobasilar system that forms the posterior circulation.
2) The branches of major arteries like the external carotid, vertebral, and basilar arteries.
3) Anatomical variations that can be seen, like hypoplastic vessels, fenestrations, and duplications.
4) Venous anatomy, including the dural venous sinuses and cerebral veins.
This document discusses various pathologies that can involve the peritoneum and presents imaging findings. CT is often used to detect and characterize peritoneal diseases. Conditions summarized include mucinous carcinomatosis appearing as cystic tumor nodules along the peritoneum; pseudomyxoma peritonei showing septations within ascites without nodules; mesenteric cysts such as lymphangiomas with enhancing septa; and peritoneal carcinomatosis commonly from gastrointestinal cancers seen as omental metastases and ascites.
The peritoneum is a serous membrane that lines the abdominal and pelvic cavities. It consists of two layers - the parietal layer lines the cavity walls and the visceral layer covers the internal organs. Between these layers is the potential space called the peritoneal cavity, which contains a thin film of serous fluid. There are several peritoneal folds and ligaments that connect internal organs to each other and the cavity walls. These folds divide the peritoneal cavity into various spaces. The peritoneal fluid within lubricates organ movements and is cleared through lymphatic drainage into the subphrenic spaces.
The document provides details about performing and interpreting a fetal anatomy scan between 18-20 weeks of gestation. It describes assessing various fetal anatomical structures including the brain, skull, abdomen, lungs, heart, spine, and limbs. Key measurements and normal ranges are outlined. Common congenital anomalies that may be detected on the scan are also described for various structures. The purpose of the anatomy scan is to evaluate fetal anatomy and screen for potential fetal anomalies.
This document provides information about the components and operation of a darkroom for processing radiographic films. It discusses that a darkroom is needed to safely handle films without light exposure. The key components of a darkroom include storage shelves, workbenches, processing tanks, lights, and ventilation. Different types of entrances like single door, double door, and revolving doors are described. The document also explains the principles and proper use of safelights for illumination and white lights for maintenance. Finally, it provides an overview of the chemistry and stages involved in automatic film processing, including development, fixing, washing and drying.
Shoulder joint xray & usg by Dr Soumitra HalderSoumitra Halder
This document provides an overview of the shoulder joint, including its bones, joints, muscles, and common imaging techniques. It discusses the anatomy of the shoulder, describing the humerus, scapula, clavicle, and their joints. Rotator cuff muscles are identified along with their functions. Common shoulder x-ray views and what they show are outlined. Finally, common shoulder issues like dislocations, injuries, and diseases are summarized, along with how they appear on imaging.
Clinic ^%[+27633867063*Abortion Pills For Sale In Tembisa Central19various
Clinic ^%[+27633867063*Abortion Pills For Sale In Tembisa Central Clinic ^%[+27633867063*Abortion Pills For Sale In Tembisa CentralClinic ^%[+27633867063*Abortion Pills For Sale In Tembisa CentralClinic ^%[+27633867063*Abortion Pills For Sale In Tembisa CentralClinic ^%[+27633867063*Abortion Pills For Sale In Tembisa Central
Local Advanced Lung Cancer: Artificial Intelligence, Synergetics, Complex Sys...Oleg Kshivets
Overall life span (LS) was 1671.7±1721.6 days and cumulative 5YS reached 62.4%, 10 years – 50.4%, 20 years – 44.6%. 94 LCP lived more than 5 years without cancer (LS=2958.6±1723.6 days), 22 – more than 10 years (LS=5571±1841.8 days). 67 LCP died because of LC (LS=471.9±344 days). AT significantly improved 5YS (68% vs. 53.7%) (P=0.028 by log-rank test). Cox modeling displayed that 5YS of LCP significantly depended on: N0-N12, T3-4, blood cell circuit, cell ratio factors (ratio between cancer cells-CC and blood cells subpopulations), LC cell dynamics, recalcification time, heparin tolerance, prothrombin index, protein, AT, procedure type (P=0.000-0.031). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and N0-12 (rank=1), thrombocytes/CC (rank=2), segmented neutrophils/CC (3), eosinophils/CC (4), erythrocytes/CC (5), healthy cells/CC (6), lymphocytes/CC (7), stick neutrophils/CC (8), leucocytes/CC (9), monocytes/CC (10). Correct prediction of 5YS was 100% by neural networks computing (error=0.000; area under ROC curve=1.0).
8 Surprising Reasons To Meditate 40 Minutes A Day That Can Change Your Life.pptxHolistified Wellness
We’re talking about Vedic Meditation, a form of meditation that has been around for at least 5,000 years. Back then, the people who lived in the Indus Valley, now known as India and Pakistan, practised meditation as a fundamental part of daily life. This knowledge that has given us yoga and Ayurveda, was known as Veda, hence the name Vedic. And though there are some written records, the practice has been passed down verbally from generation to generation.
Histololgy of Female Reproductive System.pptxAyeshaZaid1
Dive into an in-depth exploration of the histological structure of female reproductive system with this comprehensive lecture. Presented by Dr. Ayesha Irfan, Assistant Professor of Anatomy, this presentation covers the Gross anatomy and functional histology of the female reproductive organs. Ideal for students, educators, and anyone interested in medical science, this lecture provides clear explanations, detailed diagrams, and valuable insights into female reproductive system. Enhance your knowledge and understanding of this essential aspect of human biology.
share - Lions, tigers, AI and health misinformation, oh my!.pptxTina Purnat
• Pitfalls and pivots needed to use AI effectively in public health
• Evidence-based strategies to address health misinformation effectively
• Building trust with communities online and offline
• Equipping health professionals to address questions, concerns and health misinformation
• Assessing risk and mitigating harm from adverse health narratives in communities, health workforce and health system
Hiranandani Hospital in Powai, Mumbai, is a premier healthcare institution that has been serving the community with exceptional medical care since its establishment. As a part of the renowned Hiranandani Group, the hospital is committed to delivering world-class healthcare services across a wide range of specialties, including kidney transplantation. With its state-of-the-art facilities, advanced medical technology, and a team of highly skilled healthcare professionals, Hiranandani Hospital has earned a reputation as a trusted name in the healthcare industry. The hospital's patient-centric approach, coupled with its focus on innovation and excellence, ensures that patients receive the highest standard of care in a compassionate and supportive environment.
Cell Therapy Expansion and Challenges in Autoimmune DiseaseHealth Advances
There is increasing confidence that cell therapies will soon play a role in the treatment of autoimmune disorders, but the extent of this impact remains to be seen. Early readouts on autologous CAR-Ts in lupus are encouraging, but manufacturing and cost limitations are likely to restrict access to highly refractory patients. Allogeneic CAR-Ts have the potential to broaden access to earlier lines of treatment due to their inherent cost benefits, however they will need to demonstrate comparable or improved efficacy to established modalities.
In addition to infrastructure and capacity constraints, CAR-Ts face a very different risk-benefit dynamic in autoimmune compared to oncology, highlighting the need for tolerable therapies with low adverse event risk. CAR-NK and Treg-based therapies are also being developed in certain autoimmune disorders and may demonstrate favorable safety profiles. Several novel non-cell therapies such as bispecific antibodies, nanobodies, and RNAi drugs, may also offer future alternative competitive solutions with variable value propositions.
Widespread adoption of cell therapies will not only require strong efficacy and safety data, but also adapted pricing and access strategies. At oncology-based price points, CAR-Ts are unlikely to achieve broad market access in autoimmune disorders, with eligible patient populations that are potentially orders of magnitude greater than the number of currently addressable cancer patients. Developers have made strides towards reducing cell therapy COGS while improving manufacturing efficiency, but payors will inevitably restrict access until more sustainable pricing is achieved.
Despite these headwinds, industry leaders and investors remain confident that cell therapies are poised to address significant unmet need in patients suffering from autoimmune disorders. However, the extent of this impact on the treatment landscape remains to be seen, as the industry rapidly approaches an inflection point.
These lecture slides, by Dr Sidra Arshad, offer a quick overview of the physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar lead (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
6. Describe the flow of current around the heart during the cardiac cycle
7. Discuss the placement and polarity of the leads of electrocardiograph
8. Describe the normal electrocardiograms recorded from the limb leads and explain the physiological basis of the different records that are obtained
9. Define mean electrical vector (axis) of the heart and give the normal range
10. Define the mean QRS vector
11. Describe the axes of leads (hexagonal reference system)
12. Comprehend the vectorial analysis of the normal ECG
13. Determine the mean electrical axis of the ventricular QRS and appreciate the mean axis deviation
14. Explain the concepts of current of injury, J point, and their significance
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. Chapter 3, Cardiology Explained, https://www.ncbi.nlm.nih.gov/books/NBK2214/
7. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
3. The inguinal ligament
The deep inguinal ring …
anatomic defect in the transversalis
fascia.
The superficial inguinal ring….
defect in the external oblique
aponeurosis immediately superior
and lateral to the pubic tubercle.
ANATOMY
4. Inguinal canal
--from the deep to the superficial inguinal
ring
--3.75 cm long
--directed downwards and medially from
the deep to the superficial inguinal ring
11. in areas of natural weakness
vessels penetrate the abdominal wall (femoral and spigelian)
fetal migration of testis, spermatic cord, or round ligament have
occurred (indirect inguinal)
broad flat weak tendons called aponeuroses (direct inguinal).
Why does hernia occurs ?
15. 1. Bubonocele.... The hernia is limited to the
inguinal canal.
2. Funicular.... The processus vaginalis is closed
just above the epididymis. The contents of the sac
can be felt separately from the testis, which lies
below the hernia.
3. Complete ( scrotal).... The testis appears to lie
within the lower part of the hernia.
Types of indirect inguinal hernia
16.
17.
18.
19.
20.
21. Long-axis views
Left, Image shows the right direct inguinal hernia sac lying posterior to the
spermatic cord (SC).
Right, Image shows the left indirect inguinal hernia sac lying anterior to the
spermatic cord (SC).
22. Spigelian fascia, the complex
aponeurotic tendon that lies
between the oblique muscles
laterally and the rectus
muscles medially.
Spigelian Hernias
23.
24.
25.
26. Femoral hernias arise within the femoral canal, which lies medial to the
common femoral vein just superior to the saphenofemoral junction and
inferior to the inguinal ligament.
Femoral hernias
27. 31-year-old woman with femoral hernia. Sonogram of right inguinal
region parallel to and caudad to inguinal ligament corresponding to
transducer position 4.
Pre-Valsalva maneuver sonogram shows (hernia not visible) femoral
artery (A), femoral vein (V), and superior pubic ramus (curved
arrow).
28. Post-Valsalva maneuver sonogram shows dilated femoral vein (V)
lateral to femoral hernia (arrows). Superior pubic ramus (curved
arrow) is also seen.
97. usually well-defined,
hypoechoic,
solid ± lobulation.
They don't have calcification nor tunica invasion.
Most seminomas demonstrate increased flow on color Doppler
examination
heterogeneous echotexture
irregular or ill-defined margins.
Echogenic foci within the substance of the tumors represent areas of
hemorrhage, calcification, or fibrosis.
They frequently have cystic components, consistent with regions of
necrosis.
SEMINOMA
Nonseminomatous germ-cell neoplasms
126. High-resolution real-time sonography has a high degree of accuracy and
sensitivity in the detection, characterization, and localization of scrotal lesions,
making it the undisputed modality of choice for imaging the scrotum.
In the pediatric population, sonography is helpful in the diagnosis of
developmental abnormalities, epididymitis, testicular torsion, and testicular
neoplasms.
CONCLUSION
Condensation of the internal oblique and trans-versus abdominis aponeuroses forms the conjoint tendon, and a reflection of the inguinal ligament forms the lacunar ligament.
originates from the external iliac artery proximal to the inguinal ligament, initially passing along the medial boundary of the deep inguinal ring, and ascends obliquely and medially to the rectus abdominis muscle
Image 1 -The inferior epigastric artery and its paired veins lie along the midlateral posterior surface of the rectus abdominis muscle.
Image 2 - IEVs lie more laterally.
Image 3 - is obtained at a level where the IEVs (arrow)lie at the edge of the rectus muscle. This is the level at which most spigelian hernias occur.
40-year-old man with right inguinal anatomy. Sonogram of inguinal region parallel and cranial to inguinal ligament corresponding to transducer position 2 shows spermatic cord (C), external iliac artery (A), inferior epigastric artery (E), femoral vein (V), and superior pubic ramus (curved arrow).
Indirect inguinal hernia is the most common type of groin hernia
.testis descends from the abd to scrotum through ing canal,which can resul in delayed or incomplete closure of processus vaginalis.=
In the first decade of life, it is more common on the right side in the male b/c:
- F ailure of closure of processus vaginalis
later descend of R testis
=In indirect inguinal hernia - herniated structures enter the inguinal canal lateral to the inferior epigastric artery and superior to the inguinal ligament, and extend for a variable distance through the inguinal canal. It travels down the canal on the outer (lateral and anterior) side of the spermatic cord.
NECK LIES WITHIN DEEP RING,FUNDUS LIES WITHIN INH CANAL.
Its neck is lateral to the inferior epigastric vessels
most common form of hernia(young)
In adult males, 65% of inguinal hernias are indirect and 55% are Rt sided.
Direct inguinal hernia …..weakened area is just lateral to the conjoint tendon and medial to the inferior epigastric artery
30-year-old man with sonogram of right indirect inguinal hernia with transducer positioned parallel to and cranial to inguinal ligament corresponding to transducer position 2.
Pre-Valsalva maneuver sonogram (hernia not visible) shows external iliac artery (A), inferior epigastric artery (E), and superior pubic ramus (curved arrow).
Indirect inguinal hernia.
Long-axis view shows that neck
of the hernia lies in the internal inguinal ring (IIR),
which lies superior and lateral to the proximal inferior epigastric artery (IEA).Hernia sac then courses horizontally in an inferomedial direction within the inguinal canal (IC).Indirect inguinal hernias always pass superficial to the IEA.
Left, Drawing shows that indirect inguinal hernia sac tends to lie anterior to spermatic cord, whereas direct inguinal hernia sac lies posterior to the cord.
Center, Short-axis view shows fat-containing direct inguinal hernia (H)posterior and medial to the spermatic cord (SC).
Right, Short-axis view shows fat-containing indirect inguinal hernia (H)lying anterior and lateral to the spermatic cord (SC).
indirect inguinal hernia displacing and compressing the hyperechoic spermatic
cord posteriorly.
direct inguinal hernia displacing and compressing the hyperechoic spermatic cord anteriorly and laterally
Almost all spigelian hernias arise from the inferior end of the spigelian fascia just lateral to where
it is penetrated by the inferior epigastric vessels, lateral to the lateral edge of the rectus abdominis muscle.
25-year-old man with right spigelian hernia. Pre-Valsalva maneuve over linea semilunaris in axial plane corresponding to transducer position 1 in Figure 4 (hernia not visible) showing right rectus abdominis muscle (R), inferior epigastric artery (curved arrow), peritoneal fat stripe (straight arrows), and lateral abdominal muscles (M).
Post-Valsalva maneuver sonogram in same location showing peritoneal fat stripe distorted by fat-containing spigelian hernia (arrows) at linea semilunaris.
Note rectus abdominis muscle (R) and lateral abdominal muscles (M).
The spigelian fascia is composed of several different layers of loosely apposed aponeurotic tendons.
From external to internal lie the aponeurosis of the external oblique, internal oblique, and transverse abdominis muscle.
Internal to the aponeurosis lie the transversalis fascia and peritoneum.
In spigelian hernias the transverse abdominis tendon is always torn. In most cases the internal oblique aponeurosis is also torn
The external oblique tendon is always intact and usually forces the hernia sac to extend either medially over the anterior aspect of the rectus abdominis muscle or laterally over the external oblique muscle, forcing it into the shape of an anvil or mushroom.
Small, spigelian hernia in which the aponeuroses of both the transverse
abdominis and internal oblique muscles are torn, but in which the external oblique aponeurosis, is intact.
The saphenofemoral junction, similar to the origin of the inferior epigastric artery for inguinal hernias, is the key landmark for identifying the femoral hernia.
Unlike inguinal hernias, femoral hernias are more common in women than men.
It is thought that the increased intrapelvic pressure that occurs during the third trimester of pregnancy together with the hormone induced
Softening of tissues, predisposes to the development of femoral hernias.
Femoral hernias arise within the femoral canal inferior to the inguinal canal and ilioinguinal crease. The femoral canal lies just medial to the common femoral vein (CFV) and just superior to the saphenofemoral junction
The testes are a paired organ in the scrotum,
The testicles have a strong organ capsule (tunica albuginea testis).
The testicular parenchyma is composed of 250–350 lobules, which drain through the mediastinum testis to the epididymis.
The lobules are separated by connective tissue septa (Septula testis) originating from the mediastinum testis. A lobule of the testis consists of one or several seminiferous tubules, which end and start at the rete testis [fig. cross section of the testis and epididymis].
Normal tunica albuginea. Longitudinal gray-scale US image of a normal testis depicts a thin
echogenic line (arrow) around the testis.
The scrotum consists of a thin layer of skin (2-8 mm) and underlying fascia. Each hemiscrotum contains a testis with its coverings, epididymis, and spermatic cord.
A normal testis measures 5 × 3 × 2 cm in size.
In healthy young men the ovoid testis measures 15 to 25 mL in volume.
The testicular parenchyma consists of multiple lobules, each of which is composed of many seminiferous tubules that lead via the tubuli recti to dilated spaces, called the rete testis within the mediastinum
2- 3c.m. in anterio posterior
Volume 12.5 – 19 gm in adults.
The size of the testicle varies with age, increasing in size from birth to puberty and then decreasing later in life
The epididymis is located in the posterolateral aspect of the testicle as a hypoechoic structure discretely heterogeneous. With high resolution, the head, body, and tail is visualized in the mayority of cases.
Sagittal view of the body of epididymis (left). Sagittal view of the head of epididymis (right).
The mediastinum of the testis is an echogenic band of variable thickness that extends across in a craniocaudal direction. If imaged at an angle, it may resemble a testicular tumor (1).
Pampiniform plexus
Transverse views of the testicle demonstrating anechoic structurescorresponding to the pampiniform plexus.
A small amount of intrascrotal fluid may be normally seen.
Testicular appendages.At the upper pole of the testis is the appendix testis, a small pedunculated or sessile body
similar in appearance to the appendix of the epididymis.
Visible when hydrocele is present.
Normal rete testis .seen in 20% of patients.
Hypoechoic striated appaerence of rete testis fingerlike projection into parenchyma adjacent to mediastinam testis.
TORSION REQUIRE IMMIDIATE SURGERY TO PRESERVE THE TESTIS.
80-90% SALVAGE IN <5 YRS
70% 6-12
20% >12HRS
A.Tuniva vaginalis does not completely surronds the testis n epididymis,normaly attaces to the post scrotal wall.
B.Complete surronding .causing free movement of testis.mostly occur in puberty.
C.Torsion occur and may compromise vascularity
d.Usually occou in newborn.
Tunina vaginALIS IS NORMALY ATTACHED BUT POOR OR ABSENT ATTACHMENT OF TESTIS WITH SCOTAL WALL.CAUSING ABNORMAL ROTATION.
Initially it becomes enlarged n nnormal echogenesity later it become hetreogenous and hypoechoic.
A hypoechoic or heterogenous denotes nonviability.
extratesticular sonographic findings typically occur in torsion and important to recocgnice torsion.
Spermatic chord immidietly cranial to testis is twisted causing torsion knot or whirpool pattern.
Epididimysis is enlarged.
Reactive hydrocele and scotal skin thickening seen.
Varicocele A varicocele is a collection of tortuous and dilated veins within the pampiniform plexus of the spermatic cord. They are found in approximately 15 % of adult males and can result in infertility secondary to decreased sperm motility and count. They are due to incompetent valves in the testicular vein. The vast majority of varicoceles are located on the left side and only 1 % are bilateral. The left sided predominance of varicoceles is thought to be due to the long course and angle of entry of the left testicular vein as it empties into the left renal vein. The right testicular vein is shorter and empties directly into the inferior vena cava. Varicoceles are much more apparent when the patient performs a Valsalva maneuver or is standing. Hence, ultrasound should be performed in both supine and standing positions. Sonographically, they appear as multiple anechoic serpiginous tubular or curvilinear structures of varying sizes (larger than 2 mm in diameter) in the region of the epididymis (Figure 4). Power Doppler should be used to confirm flow in the varicocele. (5,6,7)
Reversed flow lasting more than 1-2 sec.
Its very difficult to distinguish the various subtypes of nsgst on sonography.
Seminoma tend to occur in slightly older patient.peak incidence 4tth to 5th.
Mc tumor type in cryptorchis testes.
Macroscopically homogenously solid firm round or oval mass varying sizes from small nodule to large mass.
Embryonal cell carcinomas tend to distort the testicle and frequently invade the tunica albuginea
Welldefined markedly inhomogenous mass comtaining cystic and solid areas of varying sizes.dence echogenic foci are common resulting from calcification,cartilage,fibrosis,scarring.
Associated with cryporchism,klinefeltar down aids pul alv microlithiasis,radiotharapy patint,many GCT,.
NHL mc
Then laekamia
Nonlyphoma….lung prost mc.kidney stomach colon melanoma
Where cyst contain serous fluid,spermatocele contain spermatozoa,fat globules,lymphocyute,cellular debris giving thick and milky appearencs.
Sperm granuloma is seen in post vasectomy patint a extratesticular hypoechic area due to extravasasion of spermatozoa into the soft tissue and surrounding necrotisisng granulomatous disease.
Scrotal mesothelioma. (a) Transverse US image shows a hydrocele with several soft-tissue nodules
studding the tunica vaginalis (arrows). (b) Photograph of the resected scrotum demonstrates multiple soft-tissue
nodules (arrows).