Abdominal Doppler

Question 1

Celiac Trunk

Answer 1

1st major branch of abd aorta

Splenic artery
Hepatic artery
Left gastric artery

Seagull sign: splenic & hepatic artery

Variation: celiac trunk may arise from SMA

Question 2

Hepatic artery

Answer 2

Gives rise to gastroduodenal artery (seen in panic head)

Common hepatic artery->proper hepatic artery, divides into right and left hepatic in liver.

Question 3

SMA

Answer 3

2nd major branch of abd aorta

Pre prandial: high resistance
Post prandial: low resistance

Supplies bowel

Question 4

Renal arteries

Answer 4

Branches below SMA

Rt renal artery branches anterolateral, post to IVC

Left renal artery branches posterolateral of aorta.

May have multiple renal arteries.

Renal artery->segmental->interlobar->arcuate->interlobular

Low resistant

Question 5

Porto venous system

Answer 5

Splenic vein + IMV + SMV = Portal splenic confluence

-> MPV -> Rt & Lt PV

Portal veins:
Hepatopedal flow
Echogenic walls 
Diameter < 13mm
Phasic waveform. Non pulsatile

Question 6

IVC

Answer 6

Terminates at Rt atrium

Enlarge with heart failure
Pulsatile

Variation: may cross over to left of aorta. May have 2 IVC.

Expands with inspiration due to intra abdominal pressure. Decreases with expiration.

Valsalva causes dilatation

Question 7

Renal veins

Answer 7

Left: receives left suprarrenal vein and left gonadal vein (testicular or ovarian)
Left longer than right.
Courses anterior to aorta and posterior to SMA.

Right: no tributaries.

Question 8

Hepatic veins

Answer 8

Rt middle left
Drain liver to IVC
Hepatofugal flow. Away from liver.
Pulsatile flow

Question 9

Causes for IVC dilatation

Answer 9

Congestive heart failure and pulmonary hypertension

Question 10

IVC

Answer 10

Formed by confluence of common iliacs below aortic bifurcation at L5

Anterior to aorta above umbilicus, posterior to aorta below umbilicus

Question 11

Eustachian Valve

Answer 11

Flap of tissue at junction or IVC with Rt atrium necessary for fetal circulation. May persist in some adults.

Question 12

Budd Chiari

Answer 12

Obstruction of hepatic veins via thrombosis (#1), stenosis, membrane compression, or tumor.

Causes: oral contraceptives, liver/kidney/adrenal cancer

Pain, jaundice, hematemesis, ascites, hepatomegaly, portal HTN

Question 13

Nutcracker syndrome

Answer 13

SMA compresses left renal vein against aorta. Can lead to left renal vein thrombosis.

Question 14

Renal cell carcinoma is MC cancer to mets to

Answer 14

Renal vein and IVC causing mass and thrombosis within.

Obstruction in IVC will cause flow in the iliac veins to become continuous.