Clinical Applications of Sonography
Exam Answer Key
Course Introduction
This course explores the practical use of sonographic imaging in clinical settings, emphasizing the role of ultrasound technology in the diagnosis and management of medical conditions. Students will gain in-depth knowledge of sonographic procedures across multiple body systems, including abdominal, obstetric, gynecological, vascular, and musculoskeletal applications. The course integrates case studies and image interpretation to enhance clinical decision-making skills and prepares students to work collaboratively with healthcare teams in delivering patient care through effective use of sonographic modalities.
Recommended Textbook
Sonography Introduction to Normal Structure and Function 3rd Edition by Reva Arnez Curry
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31 Chapters
845 Verified Questions
845 Flashcards
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Chapter 1: Before and After the Ultrasound Examination
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30 Verified Questions
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Sample Questions
Q1) Using self-sheathing needles is a strategy for reducing exposure to blood-borne pathogens. ____
A)True
B)False
Answer: True
Q2) A living will can be found in the patient's chart. ____
A)True
B)False
Answer: True
Q3) The ultrasound request form contains the patient's identification number. ____ A)True
B)False
Answer: True
Q4) HBV and HIV can transmitted through _____________ _______________ caused by contaminated sharp objects.
Answer: accidental injuries
Diseases can be transmitted in many ways. Accidental injuries from contaminated sharp objects (e.g., needles, scalpels, broken glass, and exposed dental wires) are the most common means of transmission.
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Chapter 2: Ultrasound Instrumentation: Knobology, Imaging Processing,
and Storage
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Sample Questions
Q1) When the focal zone indicator is set too deep for the organ being examined
A) the echogenicity is too bright.
B) the resolution is suboptimal.
C) the light output is inadequate.
D) the organ needs to be repositioned.
Answer: B
Q2) Doppler can be added to the image by which control?
A) M mode
B) Brightness and contrast
C) Power Doppler
D) Trackball
Answer: C
Q3) The posterior border of the gallbladder cannot be seen on sagittal view; it appears to be cut off. Which control is most likely to correct this?
A) Depth
B) Frequency
C) TGC
D) Cine loop
Answer: A
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Chapter 3: General Patient Care
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Sample Questions
Q1) If patients ask about the ultrasound findings, they should be told that sonographers _____________________; rather, sonographers
Answer: do not provide a diagnosis; provide the ultrasound images to an interpreting physician, who provides an interpretive report to the referring physician Patients should be told that sonographers do not provide a diagnosis; rather, they provide the sonographic images to an interpreting physician, who sends an interpretive report to the patient's referring physician.
Q2) Patients have been known to answer to the wrong name; therefore, the sonographer should always _____________________________________________.
Answer: check the patient's identification bracelet (or identification number) against the patient chart; or, ask outpatients to repeat their name back to the sonographer Prior to an exam, sonographers must make sure they have the correct patient. Patients have been known to answer to the wrong name. The sonographer should check the patient's identification bracelet or number against the patient chart and request form; they should ask outpatients to repeat back their names.
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Chapter 4: First Scanning Experience
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Sample Questions
Q1) Normal muscle echo texture appears _______ with ______ echogenicity.
Q2) Longitudinal views show a structure's depth and ___________.
Q3) Documented areas of interest
A) are represented in a single scanning plane.
B) cover approximately every 2 cm of a structure.
C) must be represented in at least two scanning planes.
D) must include survey images.
Q4) With regard to echo texture characteristics, a disease can be described as _________ or __________.
Q5) When an organ is described as hypoechoic to another organ, this means that
A) one organ is brighter relative to the other.
B) one organ is less echogenic relative to the other.
C) one organ is visualized inferior to the other.
D) one organ is visualized posterior to the other.
Q6) Which of the following terms would NOT be used to describe a true cyst?
A) Anechoic
B) Irregular margins
C) Posterior enhancement
D) Refractive shadows
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Q7) Transverse planes divide the body into unequal ______ and _________ sections.
Chapter 5: Interdependent Body Systems
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Sample Questions
Q1) The peripheral nervous system connects the central nervous system with muscles, glands, and sensory organs. ____
A)True
B)False
Q2) Which organ allows free mixing of oxygenated and deoxygenated blood within the sinusoids?
A) Liver
B) Kidneys
C) Pancreas
D) Spleen
Q3) The nervous system assists the endocrine system through the hypothalamus, which controls the pineal gland; the pineal gland in turn controls the other endocrine glands.
A)True
B)False
Q4) Endocrine glands release hormones via ducts into the bloodstream. ____
A)True
B)False
Q5) The _______________ system monitors and controls almost every organ in the body.
Page 7
Q6) Homeostasis is defined as
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Chapter 6: Anatomy Layering and Sectional Anatomy
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Sample Questions
Q1) Which structure is NOT oriented horizontally in the body?
A) Renal artery
B) Splenic vein
C) Common bile duct
D) Thyroid isthmus
Q2) In gross anatomy, the abdominal aorta is located ___________ to the left kidney.
A) medial
B) lateral
C) inferior
D) anterior
Q3) The lesser sac
A) extends from the diaphragm to the pelvis and covers the width of the abdomen.
B) is a diverticulum of the greater sac located posterior to the stomach.
C) is a double layer of peritoneum that extends from the stomach to adjacent abdominal organs.
D) attaches to the anterior surface of the transverse colon.
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Chapter 7: Embryology
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Sample Questions
Q1) The primitive gut forms during embryologic week 4 and is composed of a foregut, a midgut and a hindgut. ____
A)True
B)False
Q2) Peristalsis begins at
A) 12 weeks.
B) 11 weeks.
C) 7 weeks.
D) 20 weeks.
Q3) The vitelline veins carry oxygenated blood from the embryo to the placenta. ____
A)True
B)False
Q4) The foregut forms
A) the distal duodenum, small bowel, and proximal part of the colon.
B) the distal part of the colon.
C) part of the mouth, as well as the pharynx, esophagus, stomach, and proximal part of the duodenum.
Q5) The embryologic heart begins beating at approximately embryologic week 3. ____
A)True
B)False
10
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Chapter 8: The Abdominal Aorta
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Sample Questions
Q1) Splenic vein ____
Q2) Sonographically, in a longitudinal section, the abdominal aorta appears as a
A) pulsatile, tubular, anechoic lumen with bright, echogenic walls.
B) pulsatile, axial, anechoic lumen with bright, echogenic walls.
C) non-pulsatile axial, anechoic lumen with anechoic walls.
D) none of the above
Q3) Body of the pancreas ____
Q4) The common hepatic artery branches into the
A) celiac and gastroduodenal arteries.
B) celiac and splenic arteries.
C) gastroduodenal and proper hepatic arteries.
D) proper hepatic and celiac arteries.
Q5) The median sacral artery is superior to the A) renal arteries.
B) adrenal arteries.
C) gonadal arteries.
D) common iliac arteries.
Q6) Psoas major muscle ____
Q7) Left lobe of the liver ____
Q8) Splenic artery ____
Page 11
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Chapter 9: The Inferior Vena Cava
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Sample Questions
Q1) The left common iliac vein is easily seen on ultrasound. ____
A)True
B)False
Q2) The gonadal veins are easily seen on ultrasound. ____
A)True
B)False
Q3) Echoes thought to be associated with blood flow sometimes can be seen in the IVC.
A)True
B)False
Q4) The IVC can be divided into the following sections:
A) Suprahepatic, infrahepatic, and midhepatic
B) Hepatic, prerenal, renal, and postrenal
C) Hepatic, lumbar, renal, and gonadal
D) All of the above
Q5) In a sagittal scanning plane, the right renal artery can be seen as a(n)
A) longitudinal, curvilinear structure anterior to the axial IVC.
B) straight structure posterior to the AO.
C) round, short axis structure posterior to the longitudinal IVC.
D) oval structure anterior to the longitudinal IVC.
Page 12
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Chapter 10: The Portal Venous System
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Sample Questions
Q1) The normal main portal vein measures up to
A) 5 cm in diameter and 3 to 4 cm long.
B) 5 cm in diameter and 5 to 6 cm long.
C) 13 mm in diameter and 5 to 6 cm long.
D) 10 cm in diameter and 3 to 4 cm long.
Q2) Hepatic artery walls ____
Q3) Tributaries of the portal vein include which vessels?
A) Right and left gastric veins and pancreaticoduodenal veins
B) Splenic and superior and inferior mesenteric veins
C) Gastroepiploic and right and left gastric veins
D) All of the above
Q4) Head of the pancreas ____
Q5) Where does the portal vein form in the body?
A) At the tail of the pancreas
B) At the left lobe of the liver
C) Near the head of the pancreas
D) Where it first enters the liver
Q6) Superior mesenteric vein lumen ____
Q7) Hepatic artery lumen ____
Q8) Portal venous walls ____
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Chapter 11: Abdominal Vasculature
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Sample Questions
Q1) Which is NOT a tributary of the inferior vena cava?
A) Hepatic vein
B) Portal vein
C) Renal vein
D) Right suprarenal vein
Q2) Which does NOT affect portal venous flow?
A) Posture
B) Dietary state
C) Hematocrit
D) Exercise
Q3) The hepatic artery enters the porta hepatis along with the
A) right hepatic and splenic veins.
B) main portal vein and common bile duct.
C) right hepatic vein and common bile duct.
D) left portal vein and right branch of the hepatic artery.
Q4) Which statement is NOT true about the renal arteries?
A) The left renal artery lies superior to the left renal vein.
B) The proximal renal arteries follow the crus of the diaphragm.
C) The right renal artery courses posterior to the inferior vena cava.
D) The renal arteries originate from the lateral wall of the abdominal aorta.
Page 14
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Chapter 12: The Liver
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Sample Questions
Q1) Amino acids ______
Q2) The liver occupies a major portion of the _____________ region.
A) umbilical
B) right hypochondriac
C) hypogastric
D) epigastric
Q3) Prominent pulsatility of the Doppler waveform in the portal vein is
A) normal.
B) abnormal.
Q4) Proximal to the _____________, the left portal vein takes a C-shaped, superior course in the liver.
A) ligamentum venosum
B) left hepatic vein
C) coronary ligament
D) falciform ligament
Q5) The normal sonographic appearance of the liver is
A) homogeneous.
B) heterogeneous.
C) decreased in echogenicity relative to the kidney.
D) isoechoic compared to the kidney.
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Chapter 13: The Biliary System
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Sample Questions
Q1) In the transverse view, the order of structures, from midline to right, is:
A) portal vein, head of the pancreas, duodenum, liver, and gallbladder.
B) portal vein, duodenum, superior mesenteric vein, right kidney, and gallbladder.
C) portal vein, head of the pancreas, gallbladder, right kidney, and liver.
D) splenic vein, superior mesenteric vein, duodenum, gallbladder, portal and vein.
Q2) The hepatic artery is found slightly medial and anterior to the main portal vein.
A)True
B)False
Q3) The common bile duct enters the duodenum through the hepatopancreatic ampulla. ____
A)True
B)False
Q4) The left hepatic duct is routinely seen on ultrasound. ____
A)True
B)False
Q5) Diameter of the common bile duct ____
Q6) Length of the common hepatic duct ____
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Chapter 14: The Pancreas
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Sample Questions
Q1) Sagittal views of the pancreas show the gland in transverse sections. ____
A)True
B)False
Q2) The thickness of the pancreas is approximately
A) 2 cm.
B) 2.5 cm.
C) 3 cm.
D) 3.5 cm.
Q3) The exocrine function of the pancreas is carried out by the beta cells. ____
A)True
B)False
Q4) Sonographically, the pancreas appears isoechoic to the liver. ____
A)True B)False
Q5) The CBD and GDA appear circular in the long axis (transverse view) of the pancreas. ____
A)True B)False
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Chapter 15: The Urinary System
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Sample Questions
Q1) The adrenal medulla is the source of the hormones that produces the "flight or fight" response. ____
A)True
B)False
Q2) Where is erythropoietin produced?
A) Adrenal cortex
B) Kidney
C) Juxtaglomerular apparatus
D) Posterior pituitary gland
Q3) The structures anterior to the left kidney are the:
Q4) The renal pyramid is one component of the renal lobe. Two other components are the ________ and the ________.
Q5) The apex of the medullary pyramid sits within a __________.
Q6) List and explain the laboratory values that help measure renal function.
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Chapter 16: The Spleen
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Sample Questions
Q1) The longest axis of the spleen is along the eighth rib. ____
A)True
B)False
Q2) The average volume of the adult spleen is about
A) 50 ml.
B) 200 ml.
C) 400 ml.
D) 600 ml.
Q3) Left renal cortex ____
Q4) The spleen is anterior to the diaphragm and stomach. ____
A)True
B)False
Q5) Spleen ____
Q6) In an adult, the spleen is composed primarily of red blood cells. ____
A)True
B)False
Q7) Splenic artery lumen ____
Q8) Liver ____
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Chapter 17: The Gastrointestinal System
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Sample Questions
Q1) The lesser curvature of the stomach marks the _____ border of the organ.
A) right
B) left
C) anterior
D) posterior
Q2) The greater curvature of the stomach marks the _____ border of the organ.
A) right
B) left
C) anterior
D) posterior
Q3) The esophageal wall normally measures _____ at the esophagogastric (EG) junction.
A) 2 cm
B) 3 mm
C) 5 mm
D) 10 mm
Q4) The stomach is a retroperitoneal structure. ____
A)True
B)False
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Chapter 18: The Prostate Gland and Seminal Vesicles
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Sample Questions
Q1) When imaging or describing the glandular prostate, the best technique to describe the prostate is to use
A) regions.
B) zones.
C) anterior and posterior terminology.
D) medial and lateral terminology.
Q2) Which statement is NOT true about the seminal vesicles?
A) They are paired glands.
B) They are posterior to the urinary bladder and inferior to the prostate.
C) Each gland empties into the distal ductus (vas) deferens.
D) They help form the ejaculatory duct.
Q3) The periurethral tissues can easily be differentiated from the anterior fibromuscular stroma. ______
A)True
B)False
Q4) Denonvilliers' fascia
A) is an interior covering for the prostate gland.
B) is the external coating for the seminal vesicles.
C) lies between the prostate and the rectum.
D) lines the external wall of the urinary bladder.
Page 21
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Chapter 19: The Female Pelvis
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Sample Questions
Q1) The portions of the large intestine contained within the true pelvis are the
A) ascending colon and rectum.
B) transverse colon and rectum.
C) ascending and descending colon.
D) sigmoid colon and rectum.
Q2) "A thin, reflective, midline stripe in the uterus" describes the sonographic appearance of the
A) endometrial canal.
B) basal layer of the endometrium.
C) inner layer of the myometrium.
D) functional zone of the endometrium.
Q3) The three descriptive regions of the pelvis are the ________, ________, and _______ regions.
Q4) The arteries in the uterus that penetrate the myometrium are the
A) spiral arteries.
B) arcuate arteries.
C) straight arteries.
D) radial arteries.
Q5) The peritoneal cavity space posterior to the broad ligaments is the ________.
Q6) The two descriptive compartments of the pelvis are the ________ and ________.
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Chapter 20: First Trimester Obstetrics 0 to 12 Weeks
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Sample Questions
Q1) A sonographic marker of the chorionic cavity is A) echogenic.
B) anechoic.
C) hyperechoic.
D) triple line.
Q2) Gestational age determined by the size of the gestational sac uses
A) two right angle measurements in a longitudinal section.
B) the mean sac diameter (MSD).
C) addition of the number 30 to the sac depth.
D) addition of the number 30 to the CRL.
Q3) Human chorionic gonadotropin (hCG) is secreted by the developing: A) ovary.
B) oviduct.
C) zygote.
D) placenta.
Q4) The gestational age in days is calculated by
A) dividing the mean sac diameter by 30.
B) dividing the largest sac dimension by 30.
C) volume measurement of the gestational sac.
D) adding 30 to the mean sac diameter.
Page 23
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Chapter 21: Second and Third Trimester Obstetrics 13 to 42
Weeks
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Sample Questions
Q1) Identification of the great arteries and outflow tracts in their usual positions confirms normal ___________________ connections.
Q2) A grade III placenta may have
A) anechoic areas.
B) calcifications.
C) indentations in the chorionic plate.
D) all of the above
Q3) The atrial septal opening is the
A) ductus venosus.
B) mitral valve.
C) foramen ovale.
D) ductus arteriosus.
Q4) Sonographic identification of the fetal __________________is necessary to establish renal function.
A) urinary bladder
B) kidneys
C) renal sinus
D) urine-filled medullary pyramids
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Chapter 22: High-Risk Obstetric Sonography
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Sample Questions
Q1) ________________was developed as an early 1st trimester means of collecting tissue for genetic analysis using placental tissue buds.
A) Amniocentesis
B) Ultrasound exam
C) Chorionic villus sampling
D) Biophysical profile
Q2) Abnormal fetal aortic flow velocity waveforms have been associated with A) musculoskeletal abnormalities.
B) genitourinary dysfunctions.
C) neurologic dysfunctions.
D) cardiac dysfunctions.
Q3) __________________________ measures the degree of fetal lung development.
Q4) ________________was developed as a 2nd trimester means of collecting a sample of amniotic fluid, which is used for a variety of metabolic assays or for DNA extraction.
A) Amniocentesis
B) Ultrasound exam
C) Chorionic villus sampling
D) Biophysical profile
Page 25
Q5) Twin gestations result from fertilization of either _______ or a _______.
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Chapter 23: The Thyroid and Parathyroid Glands
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Q1) Which statement is NOT true about the size and shape of the thyroid gland?
A) The right lobe often is slightly larger than the left lobe.
B) Shorter, obese patients tend to have oval lateral lobes measuring less than 3.5 cm.
C) Tall, thin patients have elongated lateral lobes that can measure up to 7 to 8 cm in the longitudinal plane.
D) Thyroid gland measurements have a wide range of variability.
Q2) The thyroid gland is composed of follicles filled with a substance called A) thyrotropin.
B) parafollicular cells (C cells).
C) colloid.
D) none of the above
Q3) The thyroid is an endocrine gland that secretes three hormones, which are
A) triiodothyronine (T4), thyroxine (T5), and calcitonin.
B) triiodothyronine (T3), thyroxine (T4), and calcium oxide.
C) thyroxine (T4), triiodothyronine (T3), and calcitonin.
D) triiodothyronine (T3), thyroxine (T7), and iron.
Q4) Patients with secondary hyperparathyroidism develop hypercalcemia. ____
A)True
B)False
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Chapter 24: Breast Sonography
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Q1) The glandular layer of the breast atrophies after menopause. ____
A)True
B)False
Q2) Prolactin
A) aids breast development.
B) stimulates breast secretory system after childbirth.
C) acts on breast during pregnancy to prepare for nursing.
D) stimulates the release of milk during nursing.
Q3) The breast has the largest amount of fatty tissue during the reproductive years.
A)True
B)False
Q4) Lobules are subunits of lobes. ____
A)True
B)False
Q5) Estrogen
A) aids in breast development.
B) stimulates the breast's secretory system after childbirth.
C) acts on the breast during pregnancy to prepare for nursing.
D) stimulates the release of milk during nursing.
Page 27
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Chapter 25: Penile and Scrotal Ultrasound
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Q1) Convoluted seminiferous tubules connect to straight tubules, which empty into the A) mediastinum testis.
B) tunica albuginea.
C) spermatogenesis.
D) rete testis.
Q2) What is the echogenicity of the epididymis?
A) Low level echoes
B) Medium level echoes
C) High echogenicity
D) It cannot be identified on ultrasound.
Q3) What is the echogenicity of the tunica albuginea?
A) Low level echoes
B) Medium level echoes
C) High echogenicity
D) It cannot be identified on ultrasound.
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28
Chapter 26: The Neonatal Brain
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Q1) What is the echogenicity of the caudate nucleus?
A) Echogenic
B) Moderately echogenic
C) Low level echoes
D) Hypoechoic
Q2) What is the echogenicity of the posterior periventricular white matter?
A) Echogenic
B) Moderately echogenic
C) Low level echoes
D) Hypoechoic
Q3) The diencephalon rests superior to the brain stem. It consists of
A) the thalamus, hypothalamus, and epithalamus.
B) the pons, midbrain, and medulla oblongata.
C) none of the above
D) all of the above
Q4) What is the echogenicity of the cerebral parenchyma?
A) Echogenic
B) Moderately echogenic
C) Low level echoes
D) Hypoechoic
29
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Chapter 27: Pediatric Echocardiography
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Q1) In the normal infant heart, blood from the right atrium travels
A) across the foramen ovale into the left atrium, through the mitral valve and into the left ventricle.
B) through the tricuspid valve into the right ventricle, then continues to and through the pulmonary valve crossing into the pulmonary artery to the lungs.
C) across the foramen ovale into the left atrium, through the pulmonary veins to the lungs.
D) through the tricuspid valve into the right ventricle, across the aortic valve into the aorta.
Q2) On 2D, the heart has a soft, homogeneous, even textured appearance ranging from medium to low intensity. ____
A)True
B)False
Q3) The best view to image the coronary artery ostia is the
A) Parasternal Short Axis view aortic valve level (base)
B) Apical 4-chamber
C) Parasternal Long axis view
D) Parasternal Short axis view papillary muscle level
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Chapter 28: Adult Echocardiography
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Sample Questions
Q1) Three-dimensional echocardiography would be indicated in which patient?
A) A patient with a normal heart size and function on 2D examination
B) A patient with mild mitral valve regurgitation on Doppler
C) A patient with a small to moderate VSD on 2D examination
D) A patient with a reduced ejection fraction on 2D examination
Q2) Diastole and systole are the left ventricular relaxation and filling phase of the cardiac cycle. ____
A)True
B)False
Q3) In the parasternal short axis view, the great vessels cannot be identified. ____
A)True
B)False
Q4) The thickest layer of the heart is the myocardium. ____
A)True
B)False
Q5) Suspected aortic root dissection may be diagnosed with confidence with A) TTE.
B) a chest radiograph.
C) a fast CT scan.
D) TEE.
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Chapter 29: Vascular Technology
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30 Verified Questions
30 Flashcards
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Sample Questions
Q1) Which of the following is NOT an element of the Doppler equation?
A) Carrier Doppler frequency
B) Angle of insonation with respect to the path of blood flow
C) Constant for the speed of sound in blood
D) Velocity of red cell movement
Q2) Which change is NOT normally found in Doppler spectral waveforms from elderly patients?
A) Loss of the reverse diastolic flow component
B) A reduction in the peak diastolic forward velocity
C) A decrease in the peak systolic velocity
D) A decrease in vessel wall elasticity
Q3) Which is NOT a characteristic of a normal peripheral artery Doppler spectral waveform?
A) Narrow systolic Doppler spectral bandwidth
B) Reversed diastolic flow
C) Systolic window
D) Blunted systolic peak
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Chapter 30: Three-Dimensional Ultrasound
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32 Verified Questions
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Sample Questions
Q1) Volume acquisition can be done by
A) automatic and orthogonal acquisition.
B) orthogonal and 4D acquisition.
C) automatic or manual acquisition.
D) none of the above
Q2) Four-dimensional imaging can be done only with A) existing ultrasound systems with a 3D option.
B) 3D systems that use electromagnetic positioning sensors.
C) dedicated 3D transducers.
D) offline systems that attach to the ultrasound transducer.
Q3) The 4 in 4D ultrasound refers to A) a special algorithm.
B) space.
C) time.
D) velocity.
Q4) The most important step in acquiring 3D ultrasound images is A) volume acquisition.
B) reconstruction.
C) rendering.
D) movement of the transducer.
Page 33
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Chapter 31: Interventional and Intraoperative Ultrasound
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Sample Questions
Q1) During intraoperative ultrasound procedures, the transducer is A) placed on a sterile water path.
B) in direct contact with the skin surface.
C) in direct contact with organs and vessels.
D) only used laproscopically
Q2) The advantages of interventional and intraoperative ultrasound include:
a. ___________________________
b. ___________________________
c. ___________________________
d. ___________________________
e. ___________________________
Q3) Ultrasound-guided aspirations assist needle placement for A) fluid sampling.
B) small organ or stone extraction.
C) nephrostomies.
D) tissue sampling.
Q4) Intraoperative ultrasound is not limited by __________, __________, or __________.
Q5) A biopsy site is scanned before the biopsy to determine the best __________ with the shortest __________ and the __________ angle.
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