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RVT > Anatomy Pt 1 > Flashcards

Anatomy Pt 1 Flashcards

1
Q

The posterior communicating artery connects the:

A. right and left sides of the circle of willis
B. right and left vertebral arteries
C. ECA to the ICA
D. anterior and posterior cerebral vessels

A

D

FeedBack:The posterior communicators connect the posterior cerebral system to the anterior cerebral system (PCA and the MCA).

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2
Q

If the systemic blood pressure rises but flow remains constant, what happened to the resistance in the vascular beds?

A. increases
B. unable to determine without knowing the flow velocity
C. no change
D. decreases

A

A

FeedBack:Resistance and pressure are directly related. If pressure goes up, resistance must go up to maintain a consistent amount of flow.

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3
Q

The innominate vein is formed by the junction of:

A. superior vena cava and inferior vena cava
B. subclavian vein and cephalic vein
C. internal jugular vein and superior vena cava
D. subclavian vein and internal jugular vein

A

D

FeedBack:The innominate vein is formed by the junction of subclavian vein and internal jugular vein.

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4
Q

Which of the following vessels does not drain into the IVC?

A. right gonadal vein
B. right renal vein
C. left hepatic vein
D. splenic vein

A

D

FeedBack:The left gonadal vein empties into the left renal vein while the right gonadal vein empties directly into the IVC. The splenic vein is part of the portal system.

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5
Q

Normal extremity venous flow will demonstrate all of the following Doppler characteristics, except:

A. Phasic flow
B. Spontaneous flow
C. Continuous flow
D. All of the above are normal venous flow characteristics

A

C

FeedBack:Continuous flow is a sign of abnormally decreased flexibility of the vein structure either due to thrombus formation on the wall or volume overload due to CHF.

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6
Q

Where is the marginal artery of Drummond located?

A. at the splenic hilum
B. part of the cerebrovascular circulatory system
C. connects the SMA and IMA through the mesentery
D. connect the dorsalis pedis artery to the posterior tibial artery in the foot

A

C

FeedBack:The marginal artery of Drummond connects the SMA and IMA through the mesentery and is a possible pathway for collateral flow.

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7
Q

All of the following are arteries supplied with blood from the ICA, except

A. posterior communicator artery
B. anterior choroidal artery
C. maxillary artery
D. ophthalmic artery

A

C

FeedBack:The maxillary artery is a branch of the ECA

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8
Q

Normal flow in the splenic artery:

A. is laminar.
B. demonstrates Reynold’s number >2000.
C. is hepatopetal.
D. is high resistant.

A

B

FeedBack:The splenic artery is the most tortuous artery in the body and carries very turbulent flow. A Reynolds number over 2000 indicates the point where turbulence is identified on color Doppler.

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9
Q

At what level in the neck does the common carotid artery normally bifurcate?

A. At the angle of the mandible
B. At the upper level of the thyrocervical trunk
C. At the lower border of the larynx
D. At the upper border of the thyroid cartilage

A

D

FeedBack:The common carotid artery normally bifurcates at the level of the upper border of the thyroid cartilage.

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10
Q

The ACA and its branches feed which of the following lobes of the brain?

A. occipital and frontal
B. occipital and parietal
C. frontal only
D. parietal and frontal

A

D

FeedBack:The ACA and its branches feed the parietal and frontal lobes.

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11
Q

Which of the following arteries does not usually have a pair of veins of the same name?

A. brachial artery
B. femoral artery
C. gastrocnemius artery
D. peroneal artery

A

B

FeedBack:Femoral veins can be duplicated but this not a common finding and is considered a variant. The brachial artery, forearm and calf arteries have paired veins of the same name.

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12
Q

Which of the following is not considered a “normal” cause of turbulence in a vessel?

A. bifurcation
B. tortuosity
C. eccentric change in vessel course
D. myointimal hyperplasia

A

D

FeedBack:Abnormal causes of turbulence are acquired. Myointimal hyperplasia occurs with stent or bypass graft placement. Atherosclerosis formation or bypass grafts are acquired causes of turbulent flow in a vessel.

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13
Q

The soleal plexus is located:

A. In the neck
B. In the calf
C. In the forearm
D. In the Circle of Willis of the brain

A

B

FeedBack:The soleal plexus is the venous drainage system/reservoir of the soleal muscle of the calf.

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14
Q

Which of the following is part of the deep venous system of the forearm?

A. antecubital vein
B. basilic vein
C. radial vein
D. cephalic vein

A

C

FeedBack:The basilic, cephalic and antecubital veins are superficial veins of the arm. The radial, ulnar, brachial and axillary veins are deep veins of the arm.

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15
Q

Normal venous flow in the deep veins of the thigh can be characterized by all of the following terms, except:

A. spontaneous
B. phasic
C. pulsatile
D. low velocity

A

C

FeedBack:The term pulsatile refers to arterial flow changes that occur with cardiac systole and diastole. Venous flow varies with respiration and normally has very low velocity. Spontaneous flow should also be present (without any augmentation maneuvers applied).

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16
Q

Which of the following veins does not normally contain any functioning valves?

A. Innominate vein
B. Axillary vein
C. Peroneal veins
D. Small saphenous

A

A

FeedBack:Lower extremity veins that do NOT contain valves = IVC, iliac veins and soleal sinuses; Upper extremity veins that do NOT contain valves = SVC and innominate veins.

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17
Q

What is the first branch of the ascending aorta?

A. coronary arteries
B. subclavian artery
C. left carotid artery
D. innominate artery

A

A

FeedBack:Keep in mind that the question asks for the first branch of the ascending aorta, not the arch. The coronary arteries originate just above the aortic valve in the heart.

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18
Q

Which of the following is not a branch of the ECA?

A. Ophthalmic
B. Superior thyroidal
C. Temporal
D. Lingual

A

A

FeedBack:The ophthalmic artery feeds the eye and surrounding structures. This is the only branch of the ICA before it enters the Circle of Willis. The ECA is responsible for feeding extracranial structures including the face, portions of the throat and neck, tongue and scalp.

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19
Q

Which of the following vessels supply the majority of blood to the cerebellum?

A. ECA and Basilar
B. ICA and Vertebral
C. ICA and ECA
D. Vertebral and Basilar

A

D

FeedBack:The cerebellum is located in the posterior fossa of the skull. The vertebral arteries course between the vertebral pedicles to converge into the basilar artery. Branches from the vertebral and basilar arteries feed the cerebellum and portions of the brain stem.

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20
Q

The ECA is normally ______________ to the ICA.

A. Medial
B. Lateral
C. Inferior
D. Superior

A

A

FeedBack:The ECA usually courses anteriorly and medially in the neck to feed structures including the face, tongue and scalp. The ICA usually courses posteriorly and laterally to enter the skull and feed the cerebral tissues.

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21
Q

. _________________________ carry(s) the blood from the GSV in the distal thigh into the distal femoral vein.

A. Lateral perforators
B. Thigh perforators
C. Paratibial perforators
D. Posterior venous arch

A

B

FeedBack:The distal thigh perforators, formerly known as Dodd’s perforators, drain blood from the GSV in the distal thigh into the distal femoral vein.

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22
Q

Know calf vein images

A

When imaging the posterior leg, the notch on the transducer should be placed toward the right side of the patient, just like imaging the anterior leg. The right side of the image is lateral and the left side of the image is medial in both imaging views.

A- small saphenous
B- lateral gastroc
C- medial gastroc
D- pop veins

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23
Q

Poiseuille’s Law states that the ___________________ has most drastic effect on the blood flow in a vessel.

A. pressure gradient
B. fluid viscosity
C. vessel radius
D. vessel length

A

C

FeedBack:A small change in vessel radius causes a dramatic change in the blood flow within

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24
Q

Which abdominal vessel arises from the anterior surface of the aorta approximately 2 cm distal to the celiac axis?

A. inferior mesenteric artery
B. superior mesenteric artery
C. gastroduodenal artery
D. common hepatic artery

A

B

FeedBack:The SMA arises from the anterior surface of the aorta approximately 2 cm distal to the celiac axis.

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25
Q

The radial and ulnar veins merge to form the _______________________ at the ________________________ fossa.

A. brachial vein, antecubital
B. brachial vein, popliteal
C. axillary vein, antecubital
D. axillary vein, axillary

A

A

FeedBack:The radial and ulnar veins merge to form the brachial vein at the antecubital fossa.

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26
Q

In the Circle of Willis there is/are:

A. 2 ACA communicator arteries and 1 PCA communicator artery
B. 2 ACA communicator arteries and 1 MCA communicator artery
C. 1 ACA communicator artery and 2 PCA communicator arteries
D. 1 ACA communicator artery and 2 MCA communicator arteries

A

C

FeedBack:In the Circle of Willis there is 1 ACA communicator artery and 2 PCA communicator arteries.

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27
Q

The hepatic artery carries _______ of the blood entering the liver.

A. 20-30%
B. 50-60%
C. 80-90%
D. 100%

A

A

FeedBack:The portal vein carries 70-80% of the blood entering the liver, but it is lower in oxygen saturation at 85%. The hepatic artery carries 20-30% of the blood into the liver and it has a 95% oxygen saturation. The portal venous system supplies just over half of the oxygen to the liver tissue because of the high volume of flow. The hepatic artery supplies just under half of the oxygen to the liver tissues.

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28
Q

The left and right innominate veins merge to form the ____________________.

A. Right atrium
B. superior vena cava (SVC)
C. Brachiocephalic vein
D. inferior vena cava (IVC)

A

B

FeedBack:The right and left innominate veins merge to form the SVC.

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29
Q

Using the suboccipital window, the normal basilar and vertebral arteries ______________________.

A. will demonstrate bidirectional flow
B. cannot be evaluated using this transcranial window
C. will demonstrate flow toward the probe
D. will demonstrate flow away from the probe

A

D

FeedBack:The suboccipital window is performed by placing the transducer at the base of the skull and Cephalad into the cranium. The normal basilar and vertebral arteries will demonstrate flow away from the probe.

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30
Q

The angular artery is the terminal branch of the

A. Ophthalmic artery
B. Nasal artery
C. Facial artery
D. Anterior cerebral artery

A

C

FeedBack:The angular artery is a terminal branch of the facial artery.

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31
Q

Where is the arc of Riolan found?

A. within the kidney
B. at the popliteal fossa
C. within the brain
D. within the mesentery

A

D

FeedBack:The arc of Riolan and the marginal artery of Drummond connect the SMA and IMA through the mesentery. They offer potential for collateral flow if a mesenteric obstruction occurs.

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32
Q

An ineffective calf muscle pump causes:

A. the pressure in the deep calf veins to drop
B. the pressure in the superficial veins to drop
C. flow to move through the perforators into the deep system
D. the pressure in the deep calf veins to increase

A

D

FeedBack:Effective calf pump reduces blood stasis/pooling, decreases venous pressure. Ineffective calf pump leads to increased stasis, venous volume and pressure; reflux is a contributing factor

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33
Q

The _______________________ is described as the segment of the vessel located between the distal ICA and the origin of the anterior communicating artery.

A. M3 segment of the MCA
B. A2 segment of the ACA
C. A1 segment of the ACA
D. M1 segment of the MCA

A

C

FeedBack:The A1 segment is located between the distal ICA and the origin of the anterior communicator artery. The A2 segment is located distal to the origin of the anterior communicator artery.

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34
Q

The ICA terminates into which two branches of the Circle of Willis?

A. MCA and ACA
B. PCA and ACA
C. MCA and posterior communicator arteries
D. Vertebral and basilar arteries

A

A

FeedBack:Bilateral ICAs course superiorly to join the Circle of Willis on the lateral aspect of each side of the brain. In most patients, they terminate at the origination of the MCA and ACA. The PCoA is branch of the distal ICA.

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35
Q

The great saphenous vein originates _____________________

A. at the dorsum of the foot and courses anterior to the lateral malleolus.
B. at the dorsum of the foot and courses anterior to the medial malleolus.
C. at the great toe and courses along the ventral aspect of the foot to reach the medial ankle and extend up the leg.
D. at the great toe and courses along the ventral aspect of the foot to reach the lateral ankle and extend up the leg.

A

B

FeedBack:The great saphenous vein originates at the dorsum of the foot and courses anterior to the medial malleolus.

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36
Q

The seagull sign refers to which of the following vessels?

A. common femoral bifurcation
B. celiac axis
C. bilateral renal origins
D. three hepatic veins

A

B

FeedBack:The celiac axis and the two branches visible on US form the seagull sign. The CHA and Splenic artery form the wings of the bird.

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37
Q

Which of the following statements does NOT describe a normal ICA and its Doppler waveform?

A. Carries majority of the blood to cerebrum
B. Has no extracranial branches
C. Is often a prime site for plaque formation
D. Has a high resistance waveform

A

D

FeedBack:The brain requires constant blood flow throughout the cardiac cycle. The cerebral structures normally offer very little resistance to the incoming flow of blood. The ICA has no extracranial branches and does deliver the majority of the blood flow to the brain. The ICA also has an increased prevalence for atherosclerotic changes, when compared to the CCA and ECA.

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38
Q

Know extracranial ICA vessel’s waveform image

A

The ICA is normally low resistance, monophasic flow with good amounts of antegrade diastolic flow. The flow in the MCA would be similar to this waveform but it is an intracranial vessel.

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39
Q

Which of the following flow characteristics is/are seen in a normal hepatic vein Doppler tracing?

A. cardiac pulsatility and respiratory phasicity
B. respiratory phasicity only
C. monophasic flow and respiratory phasicity
D. cardiac pulsatility only

A

A

FeedBack:Cardiac pulsatility is normal seen in the hepatic veins and the upper abdominal portion IVC. The motion of the heart causes vibrations within the chest that are carried throughout the adjacent structures. The flexibility of the IVC and hepatic veins allow the vibrations to affect the flow inside causing pulsatility.
As the diaphragm moves up and down with respiration, the intra-abdominal pressure is affected. Inspiration causes the diaphragm to move down which increases the intra-abdominal pressure. This causes flow in the abdomen and lower extremities to decrease or cease movement. The diaphragm moves upward with expiration and the intra-abdominal pressure decreases allowing flow to move toward the heart again.

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40
Q

Ohm’s Law of electrical current is also used to describe:

A. arterial blood flow volumes
B. arterial phasicity related to vessel recoil
C. the appearance of flow vortices distal to a stenosis
D. venous capacitance

A

A

FeedBack:Ohm’s Law of electrical current is also used to describe arterial blood flow volumes. current = voltage / resistance which equates to flow volume = pressure / resistance

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41
Q

Which superficial vein listed forms a connection at the elbow between the two main upper extremity superficial veins?

A. basilic vein
B. radial vein
C. cephalic vein
D. antecubital vein

A

D

FeedBack:The antecubital vein (AKA median cubital vein) forms a connection at the elbow between the basilic and cephalic veins.

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42
Q

Which of the following veins is the gastrocnemius plexus connected to?

A. profunda vein
B. great saphenous vein
C. popliteal vein
D. superficial femoral vein

A

C

FeedBack:The gastrocnemius plexus is located in the calf muscle and drains into the popliteal veins. It acts as a reservoir for blood when sitting and standing etc.

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43
Q

As pressure increases, resistance must ______________________ to maintain constant flow volume.

A. resistance does not vary related to pressure and flow volume
B. decrease
C. increase
D. stay constant

A

C

FeedBack:As pressure increases, flow will increase if there is no change in resistance. In order to maintain a constant flow, when pressure increases, resistance must increase.

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44
Q

Which of the following terms can be used to describe the normal Doppler waveform in the portal vein?

A. continuous with mild pulsatility
B. continuous with minimal respiratory phasicity
C. prominent respiratory phasicity and mild pulsatility
D. blunted with respiratory phasicity

A

B

FeedBack:Venous flow in the portal system normally demonstrates no cardiac pulsatility with minimal respiratory phasicity due to the increased thickness of the vessel walls and location in the abdomen.

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45
Q

Which gonadal vein empties directly into the IVC?

A. Right gonadal vein
B. Left gonadal vein
C. Right and left gonadal veins
D. Neither gonadal vein empties directly into the IVC

A

A

FeedBack:The right gonadal vein empties into the IVC, while the left gonadal vein empties into the left renal vein.

46
Q

Is there change in the Celiac artery after eating?

A

FeedBack:The celiac artery waveform is usually unchanged after eating in the normal patient. The CA mainly supplies the liver and spleen with blood and these organs are low resistance vascular beds. The fasting waveform and peak velocity on this patient are well within normal limits which indicates a normal celiac axis.

47
Q

The primary mechanisms that control arterial flow volume changes during the cardiac cycle are:

A. vessel length, peripheral resistance
B. cardiac output, peripheral resistance
C. viscosity, vessel radius
D. cardiac output, viscosity

A

B

FeedBack:The primary mechanisms that control arterial flow volume changes during the cardiac cycle are cardiac output and peripheral resistance.

48
Q

_________________________ drain(s) blood from the GSV in the proximal thigh into the proximal and mid femoral vein.

A. Posterior tibial perforators
B. Paratibial perforators
C. Posterior venous arch
D. Thigh perforators

A

D

FeedBack:Hunterian’s perforators drain blood from the GSV in the proximal/mid-thigh into the femoral vein. They are also referred to as proximal thigh perforators.

49
Q

Which of the following terms can be used to describe the normal Doppler waveform in the proximal renal vein?

A. respiratory phasicity only
B. respiratory phasicity and mild pulsatility
C. mild pulsatility only
D. continuous only

A

B

FeedBack:Venous flow in the IVC, hepatic and proximal renal veins normally demonstrate respiratory phasicity and mild cardiac pulsatility. At the renal hilum, the flow is more continuous with minimal respiratory phasicity.

50
Q

In an image of the IVC is long, what vessel is just posterior to it and shown to be in a transverse view with the IVC still long?

A

Right renal artery

51
Q

Which intracranial artery courses within the sylvian fissure?

A. anterior cerebral artery
B. posterior cerebral artery
C. basilar artery
D. middle cerebral artery

A

D

FeedBack:The M2 segment courses within the sylvian fissure toward the lateral aspect of the cranium.

52
Q

Respiration and ____________________ are responsible for venous blood flow.

A. vessel recoil
B. valsalva maneuvers
C. the calf muscle pump
D. the tunica media layer of the wall

A

C

FeedBack:Respiration and the calf muscle pump are responsible for moving venous blood through the body.

53
Q

Blood within the pulmonary veins:

A. contains a high oxygen content and flows into the right atrium
B. contains a low oxygen content and flows into the left atrium
C. contains high oxygen content and flows into the left atrium
D. is normally high resistance

A

C

FeedBack:Blood within the pulmonary veins contains high oxygen content and flows into the left atrium.

54
Q

Which of the following is true regarding the superficial veins of the lower extremity?

A. They are located 1-2cm below skin surface
B. They are more difficult to compress than the deep system
C. They do not contain valves
D. The superficial veins course cephalad to meet the profunda vein to form the common femoral vein

A

A

FeedBack:The superficial system of the legs contains numerous valves and are very easy to compress.

55
Q

The ______________ course(s) between the tibial and fibular head to empty blood into the popliteal vein.

A. posterior tibial veins
B. peroneal veins
C. small saphenous vein
D. anterior tibial veins

A

D

FeedBack:ATVs course anterolaterally to the tibial bone across the interosseous membrane of the calf and through a space between the tibial and fibular head to empty into the popliteal vein.

56
Q

Which statement below is true regarding the normal CCA Doppler tracing?

A. The waveform is a combination of external and internal carotid characteristics. High resistance peaks with increased diastolic flow.
B. The waveform exhibits a sharp upstroke and minimal diastolic flow velocities.
C. The waveform exhibits a triphasic pattern of flow.
D. None of the above

A

A

FeedBack:The waveform is a combination of external and internal carotid characteristics. High resistance peaks with increased diastolic flow.

57
Q

Paired veins that accompany an artery of the same name are called:

A. venae comitantes
B. posterior arch veins
C. Klippel Trenauney Weber syndrome
D. duplicated veins

A

A

58
Q

Which vein(s) originates at the ankle and courses along the medial border of the fibula to join the posterior tibial veins just distal to the popliteal fossa?

A. small saphenous vein (SSV)
B. great saphenous vein (GSV)
C. peroneal veins (PER)
D. deep femoral veins (DFV)

A

C

FeedBack:The peroneal vein originates at the ankle and courses along the medial border of the fibula to join the PTV just distal to the popliteal fossa.

59
Q

The release of norepinephrine into the blood steam has what effect on the arterioles?

A. vasoconstriction
B. vasodilation
C. decreased flow resistance
D. stenosis

A

A

FeedBack:Norepinephrine causes vasoconstriction and adrenaline causes vasodilation.

60
Q

Which vein below is usually the longest vein in the body?

A. inferior vena cava
B. femoral vein
C. great saphenous vein
D. small saphenous vein

A

C

FeedBack:The great saphenous vein originates at the ankle and courses cephalad to join the common femoral vein in the groin.

61
Q

Hydrostatic venous pressure ___________ when a patient goes from standing to the supine position.

A. decreases
B. will show little change
C. shows a quick decrease before returning to 100mmHg
D. increases

A

A

FeedBack:Hydrostatic pressure refers to the weight of the column of blood within the veins when a patient is standing. The pressure is 0mmHg at the level of the heart and increases more distally to a level of 100mmHg at the ankles. When a patient lies down, the pressure in the “column” is eliminated

62
Q

_________________________ receives the blood from the posterior tibial perforators and plays a major role in venous stasis of the lower extremity.

A. The posterior accessory saphenous vein
B. The anterior accessory saphenous vein
C. The posterior venous arch
D. The lateral perforator

A

C

FeedBack:Posterior arch vein extends superior from the ankle to the GSV in the mid-calf; plays a major role in venous stasis; connected to 3 ankle perforators called posterior tibial perforators (formerly Cockett’s Perforators.)

63
Q

When performing a lower extremity venous exam for insufficiency, you locate an incompetent vein connected to the GSV in the mid to upper calf by an incompetent perforator. Identify the vein.

A. Small saphenous vein
B. Vein of Giacomini
C. Posterior arch vein
D. Paratibial perforator

A

C

FeedBack:The posterior arch vein connects the posterior tibial perforators (Cockett’s perforators) to the GSV in the mid to upper calf. This vein usually plays a major role in disease caused by venous stasis.

64
Q

Which of the following statements can be used to describe a normal renal artery waveform?

A. monophasic with increased diastolic flow
B. increased diastolic flow reversal
C. tri- or biphasic with increased diastolic flow reversal
D. pulsus alternans

A

A

FeedBack:Blood flow into organs is normally continuous throughout the cardiac cycle. The flow is described as low resistance or monophasic and demonstrates increased antegrade flow in diastole.

65
Q

Which of the following locations has a direct connection between the deep and superficial veins of the leg?

A. adductor canal
B. groin
C. hunter’s canal
D. ankle

A

B

FeedBack:The greater saphenous vein joins the common femoral vein in the groin area, adjacent to the inguinal ligament.

66
Q

Which of the following factors are related to potential hemodynamic changes within a vessel?

A. vessel length and blood viscosity, but not vessel radius
B. blood viscosity and vessel radius, but not vessel length
C. vessel length and vessel radius, but not blood viscosity
D. vessel length, vessel radius and blood viscosity

A

D

FeedBack:Changes in vessel length, vessel radius and blood viscosity are related to potential hemodynamic changes within a vessel.

67
Q

How many segments are recognized in the middle cerebral artery?

A. 2
B. 3
C. 4
D. 1

A

B

FeedBack:M1, M2 and M3 are the three segments of the MCA.

68
Q

The posterior communicating arteries connect the:

A. PCA and MCA
B. ACA and PCA
C. basilar and PCA
D. vertebral and basilar

A

A

FeedBack:The posterior communicating arteries connect the ipsilateral PCA and MCA.

69
Q

All of the following are branches of the ophthalmic artery, except?

A. frontal artery
B. supraorbital artery
C. posterior auricular artery
D. nasal artery

A

C

FeedBack:The posterior auricular artery branches from the ECA and supplies the ear with oxygenated blood.

70
Q

Which of the following statements is true regarding the vertebral arteries?

A. The right vertebral artery is the first branch of the aortic arch.
B. The right vertebral artery is normally smaller than the left.
C. The right and left vertebral arteries empty their blood into the right and left basilar arteries.
D. Vertebral artery flow is normally biphasic due to turbulence at their junction with the basilar artery.

A

B

FeedBack:The right vertebral artery is normally smaller than the left vertebral artery.

71
Q

Where are the venous sinusoids in the lower extremity?

A. between the soleal and gastrocnemius muscle
B. within the quadriceps muscle
C. within the adductor canal
D. popliteal fossa

A

A

FeedBack:The venous sinusoids serve as blood reservoirs in the calf and are an important part of the calf pump mechanism.

72
Q

Which branch of the Circle of Willis supplies the corpus callosum and the cavum septum pellucidum with arterial blood?

A. ACA
B. PCA
C. MCA
D. basilar artery

A

A

FeedBack:The corpus callosum and the cavum septum pellucidum are located along the midline in the anterior brain. Both structures are fed by the anterior cerebral artery.

73
Q

What two veins converge to form the superior vena cava?

A. right and left innominate
B. right subclavian and innominate
C. right and left subclavian
D. axillary and cephalic

A

A

FeedBack:The right and left innominate veins converge to form the superior vena cava.

74
Q

An effective calf pump causes ________________________ in the pressure in the deep veins of the calf.

A. an increase in cardiac output and an increase
B. a decrease
C. an increase
D. little change

A

B

FeedBack:Effective calf pump reduces blood stasis/pooling, decreases venous volume and pressure in the calf veins. Ineffective calf pump leads to increased stasis, venous volume and pressure in the calf veins; reflux is a contributing factor

75
Q

The gastrocnemius veins empty into the __________________.

A. distal SFV
B. distal profunda vein
C. popliteal vein
D. great saphenous vein

A

C

FeedBack:The gastrocnemius veins are part of the venous system of the calf muscles. Together with the soleal sinuses, they provide a venous reservoir for extremity blood.

76
Q

Which vessels allow for the exchange of nutrients and waste products between blood and tissue?

A. capillaries
B. plantar and palmar arches
C. distal arteries
D. segmental arteries

A

A

FeedBack:Capillaries are the smallest vessels in the circulatory system and they allow for the exchange of nutrients and waste products between blood and tissue.

77
Q

Which of the following structures is supplied by branches of the internal carotid artery?

A. lateral nose only
B. parietal lobe only
C. eyes and lateral nose, but not the parietal lobe
D. eyes, lateral nose and parietal lobe

A

D

FeedBack:Branches of the internal carotid artery supply the eyes, lateral nose and parietal lobe.

78
Q

Which of the following statements about the IVC is false?

A. The IVC empties blood into the right atrium.
B. The IVC should normally change diameter with respiration.
C. Congestive heart failure and pulmonary HTN can cause IVC dilatation.
D. The IVC is the most posterior vessel in the abdomen.

A

D

FeedBack:The aorta is the most posterior vessel in the abdomen.

79
Q

All of the following are tributaries to the popliteal vein, except:

A. small saphenous vein
B. peroneal vein
C. posterior tibial vein
D. femoral vein

A

D

FeedBack:The popliteal vein courses cephalad to become the superficial femoral vein once it passes into the adductor canal.

80
Q

The supraorbital artery is a branch of the ___________________________. Branches for the supraorbital artery connect with branches of the _________________________, which is a branch of the ECA. This is a common collateral pathway from the ECA to the ICA.

A. ophthalmic artery, maxillary artery
B. ICA, facial artery
C. ICA, ophthalmic artery
D. ophthalmic artery, superficial temporal artery

A

D

FeedBack:The supraorbital artery is a branch of the ophthalmic artery. Branches for the supraorbital artery connect with branches of the superficial temporal artery, which is a branch of the ECA. This is a common collateral pathway from the ECA to the ICA

81
Q

The _______________________ is described as the segment of the vessel located between the distal basilar artery and the origin of the posterior communicator artery.

A. M3 segment of the MCA
B. P2 segment of the PCA
C. M1 segment of the MCA
D. P1 segment of the PCA

A

D

FeedBack:The P1 segment is located between the distal basilar artery and the origin of the posterior communicator artery. The P2 segment is located distal to the origin of the posterior communicator artery.

82
Q

Which of the following is a direct branch of the aortic arch?

A. left vertebral
B. right carotid
C. right vertebral
D. left carotid

A

D

FeedBack:The three main branches of the aortic arch are the innominate artery, left common carotid artery and left subclavian artery

83
Q

What is the primary factor that determines the resistance characteristics of the arterial signal displayed by PW Doppler?

A. Vessel course and location
B. Branch number
C. Origin of blood
D. Part it is supplying

A

D

FeedBack:EX: Renal artery is low resistance for a normal kidney. Organs need constant flow throughout the cardiac cycle. The femoral artery is high resistance for a normal leg. Extremities do not need constant flow throughout the cardiac cycle.

84
Q

The vessel wall layer that is composed of fibrous connective tissue is called:

A. tunica externa
B. tunica intima
C. vasa vasorum
D. tunica media

A

A

FeedBack:The external layer is composed of connective tissue and adheres to the surrounding structures. The tunica media refers to the muscle layer of the vessel wall. The inner layer is the tunica intima which is composed of epithelial cells and covered by the basement membrane.

85
Q

Venous valve leaflets:

A. are composed of muscle cells.
B. are extensions of the vessel’s intimal layer.
C. are small flaps of connective tissue within the veins.
D. are muscular flaps that control backflow within the venous lumen

A

B

FeedBack:Venous valve leaflets are extensions of the vessel’s intimal layer

86
Q

Which vessel wall layer is thicker in arteries than in veins?

A. vasa vasorum
B. tunica media
C. tunica externa
D. tunica intima

A

B

FeedBack:The muscular layer is thicker in arteries to help maintain their shape and to handle the higher pressure blood flow within.

87
Q

Pressure in the venules does not normally exceed ________________.

A. 20mmHg
B. 0mmHg
C. 50mmHg
D. 80mmHg

A

A

FeedBack:Pressure in the venules does not normally exceed 20mmHg

88
Q

Which calf vessel’s anatomic course has been referred to as a “stocking seam”?

A. posterior tibial vein (PTV)
B. great saphenous vein (GSV)
C. superficial femoral vein (SFV)
D. small saphenous vein (SSV)

A

D

FeedBack:The small saphenous vein originates very superficially in the distal posterior calf. It courses midline up the calf to reach the popliteal vein at or near the popliteal fossa. Its course has been said to resemble the seam of a type of pantyhose or stockings.

89
Q

Resistance to flow ______________ as blood travels distally through the abdominal aorta.

A. decreases by 50%
B. remains constant
C. decreases slightly
D. increases

A

D

FeedBack:The proximal portion of the aorta demonstrates lower resistance, when compared with the distal portion. The branches of the upper and mid aorta feed low resistance capillary beds in the organs which affects the aortic flow causing it to be biphasic. The distal aorta branches into vessels that supply muscles and supporting structures of the legs. These tissues provide a much higher resistance to flow than the abdominal organs, causing triphasic flow in the distal aorta.

90
Q

Which of the following normal vessels will collapse when you ask the patient to sniff quickly with moderate exertion?

A. common femoral vein
B. basilic vein
C. subclavian vein
D. cephalic vein

A

C

FeedBack:The quick change in intrathoracic pressure with a sniff should cause the normal subclavian vein to collapse quickly due to the increased outflow into the innominate vein.

91
Q

Once the pressure in the deep venous system consistently exceeds the pressure in the superficial system,

A. perforators will dilate leading to bi-directional flow
B. perforators will constrict forcing flow reversal into the superficial system
C. perforators will exhibit stasis of flow and thrombus formation
D. perforators will dilate and allow flow to only move into the deep system

A

A

FeedBack:Once the pressure in the deep venous system consistently exceeds the pressure in the superficial system, perforators will dilate leading to bi-directional flow.

92
Q

What term refers to the capability of the vascular beds to alter the resistance to flow to maintain the levels of flow needed for normal function?

A. autoregulation
B. vasoconstriction
C. laminar flow
D. vasodilation

A

A

FeedBack:Vasoconstriction and vasodilation are ways the vascular beds autoregulate the flow.

93
Q

A mesenteric to aortic ratio is considered normal when it is ________________.

A. >1.0
B. 1.0 or less
C. >3.0
D. <3.0

A

B

FeedBack:The mesenteric velocity should be similar to the aortic velocity, which would yield a ratio of around 1.0. As the stenosis in the SMA increases, the velocity increases and the ratio increases. SMA/aorta ratio >3.0 indicates significant stenosis.

94
Q

Which of the following describes a cardiovascular application of the Bernoulli Principle?

A. explains the turbulence and layers of flow separation within the carotid bulb
B. explains the reason for increased resistance to flow at an area of focal stenosis
C. explains the relationship of vessel radius and flow volume
D. explains the reason for aliasing of the Doppler signal at high velocities

A

A

FeedBack:Bernoulli Principle explains the turbulence and layers of flow separation within the carotid bulb.

95
Q

The carotid siphon:

A. supplies blood to the ophthalmic artery.
B. is an area of flow separation due to the increase in vessel diameter at the bulb.
C. causes an area of decreased resistance to flow in the distal ICA.
D. usually forms a complete circle around the distal ECA before joining the circle of willis

A

A

FeedBack:ICA Siphon Area - distal ICA courses anteriorly then medially, then posteriorly forming an “S”; reduces flow, increases resistance to flow, causes turbulence and has increased risk for flow reducing lesions such as atheroma and thrombus

96
Q

Venous perforators connect the deep and superficial systems of the leg at many locations including:

A. groin only
B. groin and knee only
C. groin and ankle only
D. groin, knee, ankle

A

D

97
Q

The normal flow profile within the aorta is termed:

A. Phasic flow
B. Plug flow
C. Recoil flow
D. Continuous flow

A

B

FeedBack:The layers of blood flow in the aorta move at relatively the same speed and this is called plug flow. Laminar flow patterns occur in smaller vessels. The velocity of the layers of blood flow in these vessels vary slightly by decreasing as they near the vessel wall.

98
Q

Which of the following veins is not part of the deep venous system in the lower extremity?

A. small saphenous vein and peroneal veins
B. posterior tibial vein
C. great saphenous vein and femoral vein
D. great and small saphenous veins

A

D

FeedBack:The great and small saphenous veins make up the superficial venous drainage system of the lower extremity.

99
Q

The most cephalic branch of the abdominal aorta is:

A. Splenic artery
B. Common hepatic artery
C. SMA
D. celiac axis

A

D

FeedBack:The celiac axis is the first abdominal branch of the aorta followed by the origin of the SMA approximately 2cm more distal on the aorta. The renal arteries are the next distal branch followed by the IMA.

100
Q

The Achilles tendon is a landmark for which deep calf vein?

A. peroneal vein (PER)
B. posterior tibial vein (PTV)
C. anterior tibial vein (ATV)
D. small saphenous vein (SSV)

A

B

FeedBack:The Achilles tendon is identified at the area of the medial malleolus. The posterior tibial veins drain blood from the plantar arches and then course cephalad laying anterior to the tendon and posterior to the medial malleolus/tibial bone.

101
Q

Which of the following is supplied with arterial blood through branches of the ECA?

A. eyes only
B. lateral nose only
C. thyroid only
D. lateral nose and thyroid

A

C

FeedBack:The superior thyroidal artery is the first branch of the ECA. The other choices are supplied with blood through intracranial branches of the ICA.

102
Q

The small saphenous vein:

A. originates posterior to the medial malleolus and ascends along the midline aspect of posterior calf
B. originates posterior to the lateral malleolus and ascends along the midline aspect of posterior calf
C. originates anterior to the lateral malleolus and ascends along the midline aspect of posterior calf
D. originates immediately posterior to the Achilles’ tendon attachment at the heel and ascends along the midline aspect of posterior calf

A

B

FeedBack:The small saphenous vein originates posterior to the lateral malleolus and ascends along the midline aspect of posterior calf.

103
Q

Bradycardia is defined as a heart rate less than ________bpm.

A. 45
B. 50
C. 60
D. 65

A

C

FeedBack:Bradycardia is defined as a heart rate less than 60 bpm. Tachycardia is defined as a heart rate more than 100 bpm.

104
Q

Which artery supplies the brainstem with arterial blood?

A. posterior communicating artery
B. basilar artery
C. anterior cerebral artery
D. posterior cerebral artery

A

B

FeedBack:Branches from the vertebral and basilar arteries feed the cerebellum and portions of the brain stem.

105
Q

The femoral vein ______________________ the femoral artery.

A. is harder to compress than
B. is usually much longer than
C. courses anterior to
D. courses posterior to

A

D

106
Q

Which of the following veins originates at the medial wrist and courses up the medial arm to join the axillary vein?

A. Ulnar vein
B. Radial vein
C. Basilic vein
D. Cephalic vein

A

C

FeedBack:The radial veins join the ulnar veins at the elbow to form the brachial vein(s). The cephalic vein originates near the base of the wrist and travels up the lateral side of the arm to empty into the subclavian vein.

107
Q

Which blood vessel courses anterior to the aorta and posterior to the SMA?

A. left renal vein
B. inferior mesenteric vein
C. right renal vein
D. superior mesenteric vein

A

A

FeedBack:The left renal vein courses from the left kidney across the abdomen between the aorta and SMA to reach the IVC.

108
Q

Which of the following describes the normal appearance of a waveform obtained in the MCA?

A. low resistance flow that varies with patient respiration
B. low resistance, low velocity with small flow reversal component in diastole
C. low resistance, laminar flow with clear spectral window
D. low resistance with spectral broadening

A

D

FeedBack:The intracranial arteries normally demonstrate spectral broadening due to the small size of the vessels.

109
Q

The term used to describe the thickness of blood is:

A. resistance
B. viscosity
C. impedance
D. vasoconstriction

A

B

FeedBack:The higher the viscosity the thicker the fluid. Oil and honey have a higher viscosity than water.

110
Q

Which vein courses from the lateral aspect of the wrist extending up the lateral arm to the shoulder to join the axillary vein?

A. cephalic
B. basilic
C. axillary
D. brachial

A

A

FeedBack:The cephalic vein courses from the lateral aspect of the wrist extending up the lateral arm to the shoulder to join the axillary vein to form the subclavian vein.

111
Q

Which of the following statements regarding a Duplex exam of the upper extremity veins is false?

A. The cephalic vein is easily compressed with light probe pressure, which can be an exam limitation.
B. The subclavian and innominate veins normally demonstrate continuous flow.
C. Inspiration will cause an increase in flow within the larger upper extremity veins.
D. The internal jugular vein is usually part of the upper extremity evaluation

A

B

FeedBack:Proper compression of the subclavian vein is normally inhibited by the clavicle. The subclavian and innominate veins usually demonstrate pulsatile, phasic flow.

112
Q

The weight of the column of blood within the veins when standing is called?

A. Systemic Pressure
B. Hydrostatic Pressure
C. Pulmonary Pressure
D. Transmural Pressure

A

B

FeedBack:The systemic blood pressure is related to the arterial pressures within the body. The pulmonary pressure is related to the pressure within the pulmonary arteries.

RVT (5 decks)

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