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A_arterial duplex and indirect > abdomen duplex > Flashcards

abdomen duplex Flashcards

1
Q

What anatomy is interrogated by abd doppler

A 
Ao - Iliac vessels 
renal artery
kidney 
mesenteric arteries  
liver
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2
Q

What anatomy is interrogated by abd doppler

A 
Ao - Iliac vessels 
renal artery
kidney 
mesenteric arteries  
liver
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3
Q

Ao iliac Doppler purpose

A

stenosis
bypass graft f/u
aneurysms

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4
Q

Renal artery

Kidney

A

> 60% diameter reduction
presence of disease (nephrosclerotic)
patient renal vessels in Tx

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5
Q

Mesenteric arteries

A

stenosis

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6
Q

liver

A

r/o portal HTN
patient liver vessels s/p liver Tx
pre op for liver transplant

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7
Q

Limitation

A

the usual obvious reasons + SOB and rapid respiration

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8
Q

parameter for

a. Ao-Iliac artery stenosis
b. aneurysm

A

a. 2:1 velocity increase (same as LE)
b. > 3 in aorta

*note that parameter for iliac is x 1.5 cm size increase from adjacent segment -
just like any other vessel outside of the Ao

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9
Q

most AAA are caused by what and occur mostly where

A

atherosclerotic disease

infrarenal

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10
Q

what is the most common type of aneurysm

A

true

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11
Q

what types of true aneurysm is most common

A

fusiform , saccular

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12
Q

what is the most frequent complication of aortic aneurysm?

peripheral aneurysm ?

A

Rupture for Aortic aneurysm

embolization from peripheral aneurysm

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13
Q

what 3 conditions can cause renovascular HTN

A

atherosclerosis
Fibromuscular dysplasia
occlusion

anything that would result in decreased profusion to kidney paranchyma

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14
Q

what is the mechanism for hypertension

A

Renin (when kidney parenchyma perfusion is suboptimal- renin production is increased
Renin stimulates angiotensinogen to be converted into angiotensin which causes increase in systemic HTN

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15
Q

what is the landmark for identifying the left renal artery

A

left renal vein

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16
Q

Describe the teq for RA interpretation

A

celiac artery and SMA velocity data

obtain aorta PSV near SMA level

turn trans- find renal arteries

image the kids and measure them + survey for cortex thinning and abnormal findings

Obtain PSV and EDV bilaterally @
renal artery :P, M, D

Upper/ Lower pole of the kidney in segmental arteries

OBSERVE FOR SECONDARY RENAL ARTERIES

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17
Q

what abdominal arteries should show low resistance on Doppler

A

renal
celiac
hepatic
splenic

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18
Q

what abdominal organs are typically high resistant

A

fasting SMA & IMA

Aorta

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19
Q

what is being referred to as splanchnic circulation ?

A

celiac trunk, SMA , IMA

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20
Q

what is RAR

A

highest RA PSV
////////////////////////////////////////
highest Ao PSV

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21
Q

what two conditions render the RAR insignificant

A

AAA
abnormal Ao PSV :
>90 cm/s
<40 cm/s

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22
Q

with abnormal aortic PSV what criteria is used instead of RAR

A

renal artery PSV of
> 180-200 cm/s

+ post stenotic turbulence

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23
Q

RAR parameters

A

normal <3.5

abnormal > 3.5 = greater than 60% diameter reduction

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24
Q

normal pole to pole length of a kidney

A

10-12 cm

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25
what ratio's are used to interpret renal artery study
EDR end diastolic ratio (parenchymal reisitance ratio) & Resistivity Index
26
what is the resistivity index formula
PSV - EDV ////////////// PSV
27
Normal velocity for RI of renal artery or parenchymal vessels
28
what is parenchymal resistance ratio
EDV ///////////////////////// PSV
29
what is normal parenchymal resistance ratio value
>.2 anything below that is abnormal
30
what is considered abnormal AT time for renal waveform indicating >60% stenosis somewhere along the vessel
>100 m/sec
31
what is normal value of renal doppler AT time ?
70 m/sec
32
mesenteric artery patient history
dull achy or crampy abdominal pain 15-30 minutes after meals mesenteric angina
33
explain technique for mesenteric study
``` Obtain PSV and EDV on following areas celiac artery SMA : P,M, D IMA AORTA ```
34
what is the "food challenge test"
Pt ingest high caloric meal (document how much was consumed) exam is repeated 20-30 minutes after or sooner with symptoms (document when sx started or duration of time between ingestion and beginning the exam) PSV and EDV measurements obtained at areas of fasting test (hyperemic response begins after about 10 -30min after eatin
35
Doppler characteristics and velocities: | SMA
``` High resistance (pre-prandial) converts to lower resistance post prandal ``` normal 110-177 cm/sec abnormal PSV >275 = >70% stenosis
36
Doppler characteristics and velocities: | CA
unaffected by eating can be taken in TRV Normal velocities 50-160 cm/sec >70% stenosis = PSV >200cm/sec
37
what predicts distal mesenteric disease?
high resistant waveform persists after eating
38
name the two collaterals that exist between the sma and the ima
marginal artery of drummond | arc of riolan
39
what is criteria for chronic mesenteric ischemia
2-3 mesenteric vessels have problems
40
what is celiac band syndrome
extrinsic compression via the median arcuate ligament of the diaphragm reversible CA stenosis expiration- breath out = stenosis inhilation-breath in = normal flow
41
what is clinical indication for celiac band syndrome
bruie | or can be asymptomatic
42
what might indicate acute rejection of renal transplant regarding doppler ?
increased arterial resistance
43
Ao iliac Doppler purpose
stenosis bypass graft f/u aneurysms
44
Renal artery | Kidney
>60% diameter reduction presence of disease (nephrosclerotic) patient renal vessels in Tx
45
Mesenteric arteries
stenosis
46
liver
r/o portal HTN patient liver vessels s/p liver Tx pre op for liver transplant
47
Limitation
the usual obvious reasons + SOB and rapid respiration
48
parameter for a. Ao-Iliac artery stenosis b. aneurysm
a. 2:1 velocity increase (same as LE) b. > 3 in aorta *note that parameter for iliac is x 1.5 cm size increase from adjacent segment - just like any other vessel outside of the Ao
49
most AAA are caused by what and occur mostly where
atherosclerotic disease | infrarenal
50
what is the most common type of aneurysm
true
51
what types of true aneurysm is most common
fusiform , saccular
52
what is the most frequent complication of aortic aneurysm? | peripheral aneurysm ?
Rupture for Aortic aneurysm embolization from peripheral aneurysm
53
what 3 conditions can cause renovascular HTN
atherosclerosis Fibromuscular dysplasia occlusion anything that would result in decreased profusion to kidney paranchyma
54
what is the mechanism for hypertension
Renin (when kidney parenchyma perfusion is suboptimal- renin production is increased Renin stimulates angiotensinogen to be converted into angiotensin which causes increase in systemic HTN
55
what is the landmark for identifying the left renal artery
left renal vein
56
Describe the teq for RA interpretation
celiac artery and SMA velocity data obtain aorta PSV near SMA level turn trans- find renal arteries image the kids and measure them + survey for cortex thinning and abnormal findings Obtain PSV and EDV bilaterally @ renal artery :P, M, D Upper/ Lower pole of the kidney in segmental arteries OBSERVE FOR SECONDARY RENAL ARTERIES
57
what abdominal arteries should show low resistance on Doppler
renal celiac hepatic splenic
58
what abdominal organs are typically high resistant
fasting SMA & IMA | Aorta
59
what is being referred to as splanchnic circulation ?
celiac trunk, SMA , IMA
60
what is RAR
highest RA PSV //////////////////////////////////////// highest Ao PSV
61
what two conditions render the RAR insignificant
AAA abnormal Ao PSV : >90 cm/s <40 cm/s
62
with abnormal aortic PSV what criteria is used instead of RAR
renal artery PSV of > 180-200 cm/s + post stenotic turbulence
63
RAR parameters
normal <3.5 abnormal > 3.5 = greater than 60% diameter reduction
64
normal pole to pole length of a kidney
10-12 cm
65
what ratio's are used to interpret renal artery study
EDR end diastolic ratio (parenchymal reisitance ratio) & Resistivity Index
66
what is the resistivity index formula
PSV - EDV ////////////// PSV
67
Normal velocity for RI of renal artery or parenchymal vessels
68
what is parenchymal resistance ratio
EDV ///////////////////////// PSV
69
what is normal parenchymal resistance ratio value
>.2 anything below that is abnormal
70
what is considered abnormal AT time for renal waveform indicating >60% stenosis somewhere along the vessel
>100 m/sec
71
what is normal value of renal doppler AT time ?
70 m/sec
72
mesenteric artery patient history
dull achy or crampy abdominal pain 15-30 minutes after meals mesenteric angina
73
explain technique for mesenteric study
``` Obtain PSV and EDV on following areas celiac artery SMA : P,M, D IMA AORTA ```
74
what is the "food challenge test"
Pt ingest high caloric meal (document how much was consumed) exam is repeated 20-30 minutes after or sooner with symptoms (document when sx started or duration of time between ingestion and beginning the exam) PSV and EDV measurements obtained at areas of fasting test (hyperemic response begins after about 10 -30min after eatin
75
Doppler characteristics and velocities: | SMA
``` High resistance (pre-prandial) converts to lower resistance post prandal ``` normal 110-177 cm/sec abnormal PSV >275 = >70% stenosis
76
Doppler characteristics and velocities: | CA
unaffected by eating can be taken in TRV Normal velocities 50-160 cm/sec >70% stenosis = PSV >200cm/sec
77
what predicts distal mesenteric disease?
high resistant waveform persists after eating
78
name the two collaterals that exist between the sma and the ima
marginal artery of drummond | arc of riolan
79
what is criteria for chronic mesenteric ischemia
2-3 mesenteric vessels have problems
80
what is celiac band syndrome
extrinsic compression via the median arcuate ligament of the diaphragm reversible CA stenosis expiration- breath out = stenosis inhilation-breath in = normal flow
81
what is clinical indication for celiac band syndrome
bruie | or can be asymptomatic
82
what might indicate acute rejection of renal transplant regarding doppler ?
increased arterial resistance

A_arterial duplex and indirect (13 decks)

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