Anatomy Pt 1 Flashcards
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
D
FeedBack:The posterior communicators connect the posterior cerebral system to the anterior cerebral system (PCA and the MCA).
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
FeedBack:Resistance and pressure are directly related. If pressure goes up, resistance must go up to maintain a consistent amount of flow.
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
D
FeedBack:The innominate vein is formed by the junction of subclavian vein and internal jugular vein.
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
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.
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
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.
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
C
FeedBack:The marginal artery of Drummond connects the SMA and IMA through the mesentery and is a possible pathway for collateral flow.
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
C
FeedBack:The maxillary artery is a branch of the ECA
Normal flow in the splenic artery:
A. is laminar.
B. demonstrates Reynold’s number >2000.
C. is hepatopetal.
D. is high resistant.
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.
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
D
FeedBack:The common carotid artery normally bifurcates at the level of the upper border of the thyroid cartilage.
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
D
FeedBack:The ACA and its branches feed the parietal and frontal lobes.
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
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.
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
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.
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
B
FeedBack:The soleal plexus is the venous drainage system/reservoir of the soleal muscle of the calf.
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
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.
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
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).
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
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.
What is the first branch of the ascending aorta?
A. coronary arteries
B. subclavian artery
C. left carotid artery
D. innominate artery
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.
Which of the following is not a branch of the ECA?
A. Ophthalmic
B. Superior thyroidal
C. Temporal
D. Lingual
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.
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
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.
The ECA is normally ______________ to the ICA.
A. Medial
B. Lateral
C. Inferior
D. Superior
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.
. _________________________ 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
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.
Know calf vein images
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
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
C
FeedBack:A small change in vessel radius causes a dramatic change in the blood flow within
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
B
FeedBack:The SMA arises from the anterior surface of the aorta approximately 2 cm distal to the celiac axis.
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
FeedBack:The radial and ulnar veins merge to form the brachial vein at the antecubital fossa.
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
C
FeedBack:In the Circle of Willis there is 1 ACA communicator artery and 2 PCA communicator arteries.
The hepatic artery carries _______ of the blood entering the liver.
A. 20-30%
B. 50-60%
C. 80-90%
D. 100%
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.
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)
B
FeedBack:The right and left innominate veins merge to form the SVC.
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
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.
The angular artery is the terminal branch of the
A. Ophthalmic artery
B. Nasal artery
C. Facial artery
D. Anterior cerebral artery
C
FeedBack:The angular artery is a terminal branch of the facial artery.
Where is the arc of Riolan found?
A. within the kidney
B. at the popliteal fossa
C. within the brain
D. within the mesentery
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.
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
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
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
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.
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
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.
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.
B
FeedBack:The great saphenous vein originates at the dorsum of the foot and courses anterior to the medial malleolus.
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
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.
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
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.
Know extracranial ICA vessel’s waveform image
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.
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
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.
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
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
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
D
FeedBack:The antecubital vein (AKA median cubital vein) forms a connection at the elbow between the basilic and cephalic veins.
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
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.
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
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.
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
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.