abd vascular Flashcards
Portal vein
Low velocity continuous flow
hepatic blood flow
25% proper hepatic
75% pv
13mm diameter
hepatopetal
intrasegmental
hyperechoic walls
Hepatic vein
3(Right, middle and left) Blood flow towards the IVC phases above and below the baseline TRIPHASIC (rt artrial filling and relaxation) Intersegmental and interlobar Non echogenic walls
Created to lower portal pressure
placed between the RHV & RPV
demontrates hepatofugal flow
Transjugular Intrahepatic postosystemic shun (TIPS)
what does a TIPS velocity of
low velocity means lumen occlusion in the future
what does a TIPS velocity of >190cm/ sec mean
high velocity means there is a narrowing of the shunt
Hepatic artery
parallel to the MPV (anterior and left)
low resistance
Post op liver transplant what does a high resistance hepatic artery waveform suggest
venous congestion of the liver or possible organ rejection
a parvus tardus (hepatic/ renal ) waveform suggests
a proximal anastomosis stenosis
(>50%) “ small, low pulse”
name the renal vascular flow
main renal artery segmental interlobar arcuate interlobular
what does a high restistance renal artery waveform suggest?
Renal vein thrombosis acute tubular necrosis acute glomerulonephritis (GN) transplant rejection Hydronephrosis
A RI of ___ is suggestive of obstructive hydronephrosis
> 0.7
What is the normal RI
0.7
Renal artery demonstrates
continuous forward flow during diastole, typical of low resistance flow
what is the formula for RI
Peak systolic freq
what does a RI= 0.5 mean
diastole is 50% of systole
what does a RI= 0.7
diastole is 30% of systole
what does a RI =1.0
diastole is absent
what is the RI the is questionable for transplant dysfunction
0.7-0.8
what is the RI for transplant dysfunction
> 0.8
the testicular blood flow is supplied by the
deferential artery cremasteric (external spermatic) artery Testicular artery capsular centripetal( intratesticular)
how do you rule out complete torsion
by decreasing the PRF ( color scale) it will better optimize slow blood flow
Typically the arterial supply of the prostate with branches from the internal iliac arteries
Inferior vesical artery
What is the normal liver size
15.5 AP superior to inferior
what is the normal spleen size
12cm L
8cmW
4cm THick( AP)
what indicates splenomegaly
> 12cm or spleen inferior to left kidney
what will a splenic artery aneurysm show
calcified circle in LUQ (xray)
always seen at the hilum
the celiac axis is
low resistance
2-3cm long
superior to pancreas
what are the branches of the celiac axis
common hepatic proper hepatic GDA left gastric splenic artery
superior mesenteric artery
1cm below the celiac axis
inferior to the pancreas
high resistance = fastic
low resistance= postparandial
renal arteries arise from the _____ wall of the AO
lateral walls
right renal artery passes posterior to
IVC
the left renal artery is _______ than the right
shorter
arise from the distal AO and are rarely seen
Gonadal arteries
With SMA AND CA stenosis or occlusion is becomes enlarged
Inferior Mesenteric Artery
To the right of the AO
posterior to the pancreatic head and liver
IVC
what makes the IVC dilate
cardiac failure and fluid overload
what is the most common tumor to involve the IVC
Renal cell carcinoma
the right renal vein
short
The left renal vein passes
the SMA & AO
the right gonadal vein drains into the _________ and the left gonadal vein drains into the
IVC, left renal vein
the azygous is on the
right
the hemiazygous is on the
left
what arteries supply each adrenal gland
suprarenal branch of inferior phrenic
suprarenal branch of aorta
suprarenal branch of renal artery
the right suprarenal vein drains into the ____ and the left suprarenal vein drains into the ______
IVC and left renal vein
involves all three layers
typically fusiform
measured AP & trans from outer to outer wall
true aortic aneurysm
bidirectional waveforms seen at the stalk
false Pseudoaneurysm
separation of the intima from the media
Dissecting aortic aneurysm
what is the mesenteric artery stenosis criteria
SMA velocity >275cm/ sec
CA velocity >200cm/ sec
represents a >70%stenosis
an abnormal connection between a vein and artery
arteriovenous shunts
sono for AV shunts
High velocity, low resistance
color flow bruit (tissue vibration)
pulsatile venous flow
Low resistance arterial flow
thyroid arterial supply
superior thyroid arteries: branch of ECA
Inferior thyroid arteries : branch of thyrocervical trunk
thyroid veins drain into the __________ via the superior and middle thyroid veins
and the inferior thyroid vein drains into the
Internal jugular veins
innominate veins
The ICA is
Lateral and posterior
low resistance
first branch is the Opthalmic artery
The ECA is
medial and anterior
High resistance
first branch is the superior thyroid artery
the Internal Jugular vein is
Lateral to the CCA
IJV and the subclavian vein drain into the innominate vein
the external jugular vein is
located superficially on the lateral aspect of the neck