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Anatomy Pt 2 Flashcards

1
Q

The attached image is taken from a lower extremity venous Doppler exam. Which of the following veins would NOT normally demonstrate this flow pattern?

Image shows quick augmentation with no flow seen well before or after augment

A. popliteal vein
B. great saphenous vein
C. posterior tibial veins
D. anterior tibial veins

A

A

FeedBack:The deep calf veins and superficial veins do not normally exhibit spontaneous flow patterns. Augmentation is usually necessary to demonstrate patency of these veins. Lack of spontaneous flow in the popliteal vein is abnormal and a sign of flow stasis.

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2
Q

Which artery courses anteriorly along the calf and laterally through the interosseous membrane of the leg?

A. PER
B. SFA distal
C. ATA
D. PTA

A

C

FeedBack:The interosseous membrane connects the medial tibia and anterior fibula and separates the muscles of the calf. The ATA and ATV course just anterior to the membrane.

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3
Q

A branch of which artery joins the terminal ulnar artery to form the superficial palmar arch?

A. Ulnar
B. Brachial
C. Antecubital
D. Radial

A

D

FeedBack:A branch of the radial artery joins the terminal ulnar artery to form the superficial palmar arch. A branch of the ulnar artery joins the terminal radial artery to form the deep palmar arch.

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4
Q

The image is a transverse view of the right antecubital fossa. What vessel is indicated by letter B?

Image shows transverse image just superior to ac fossa with one vein(A)….one vein one art(C)……one vein(B)

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

A

D

FeedBack:If the image is of the right arm, the left side of the image corresponds with the lateral right arm. The veins of the arm listed from lateral to medial: cephalic, brachial, basilic

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5
Q

The superficial venous system of the lower extremities contains vessels that are located

A. on the lateral aspect of each leg
B. within the connective tissue between the muscle tissue
C. superficial to the deep muscular fascia
D. adjacent to an artery with the same name

A

C

FeedBack:The saphenous veins and their tributaries course within the subcutaneous tissue, between the fascial layers.

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6
Q

Normal perforator valves allow blood flow in the perforator to move:

A. from the femoral vein to the GSV
B. toward the ankle
C. toward the heart
D. from the GSV to femoral vein

A

D

FeedBack:Normal perforator valves allow blood flow in the perforator to move from the superficial system to the deep system. Dilated perforators will allow bidirectional blood blow.

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7
Q

Which of the following is unaffected by vasoconstriction and vasodilation in the arterioles?

A. the amount of diastolic flow in an artery
B. hydrostatic pressure
C. the number of phases of flow in the arterial waveform
D. peripheral resistance

A

B

FeedBack:Hydrostatic pressure is the weight of the column of blood in the vessels when standing. Vasoconstriction will increase peripheral resistance and increase resistance in the feeding arteries. Higher resistance flow will have less antegrade flow in diastole. Vasodilation will decrease peripheral resistance and decrease resistance in the feeding arteries. Lower resistance flow will have more antegrade flow in diastole. A biphasic waveform can become monophasic.

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8
Q

The transducer is placed in the longitudinal position slightly anterior to midline of the medial upper left calf. The beam is angled posterior until the image displayed appears. What vessel is indicated by letter B?

vein A
vein
vein B
vein C 
all join together proximal in the leg

A. peroneal vein
B. anterior tibial vein
C. posterior tibial vein
D. gastrocnemius vein

A

A

FeedBack:The image displays the confluence of the posterior tibial and peroneal veins. The peroneal veins are deeper on the image.

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9
Q

What venous valves are closed in the lower extremity during calf muscle relaxation?

A. All of the valves in the deep and superficial system
B. Calf veins
C. All of the valves in the deep system
D. Proximal thigh veins

A

D

FeedBack:During muscle contraction, the large blood volume residing in the deep calf veins and soleal sinuses is squeezed up and out of the calf. The proximal valves of the deep veins are forced open. The distal valves close to prevent caudal flow. The perforator valves close to prevent flow into the superficial venous system. During calf muscle relaxation, the proximal valves close due to the hydrostatic pressure forcing blood back down the veins to the level of the valve. During relaxation, the distal and perforator valves open, and blood flows into the calf deep veins.

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10
Q

The profunda artery courses ________________ to the superficial femoral artery.

A. posterior medial
B. posterior lateral
C. anterior medial
D. anterior lateral

A

B

FeedBack:The deep femoral artery courses posterior and lateral to the superficial femoral artery.

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11
Q

The most common congenital anomaly of the Circle of Willis is:

A. the duplication of one or both of the MCAs
B. the absence of one or both of the MCAs
C. the duplication of one or more communicating arteries
D. the absence of one or more communicating arteries

A

D

FeedBack:The most common congenital anomaly of the Circle of Willis is the absence of one or more communicating arteries.

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12
Q

Which of the following veins is located deep to the muscular fascia in the proximal arm and superficial to the fascia in the forearm?

A. brachial
B. basilic
C. median cubital
D. cephalic

A

B

FeedBack:The basilic vein penetrates the muscular fascia just above the elbow and courses cephalad to join the axillary vein

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13
Q

During inspiration the flow in the veins of the upper extremities _____________.

A. increases
B. decreases
C. remains unchanged
D. reverses direction

A

A

FeedBack:During inspiration the pressure within the chest cavity decreases allowing venous flow from the upper extremities to increase. During expiration, the pressure within the chest cavity increases causing the venous flow from the upper extremities to decrease. THE OPPOSITE IS TRUE WITH THE FLOW FROM THE LOWER EXTREMITIES.
During inspiration the pressure within the abdominal cavity increases causing venous flow from the lower extremities to decrease. During expiration, the pressure within the abdominal cavity decreases allowing the venous flow from the lower extremities to increase.

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14
Q

Be able to identify these waveforms

A

A. monophasic, high resistance
B. biphasic
C. Triphasic
D. monophasic, low resistance

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15
Q

The lateral plantar artery originates:

A. at the popliteal artery
B. at the ATA
C. at the PTA
D. at the peroneal artery

A

C

FeedBack:The lateral plantar artery originates at the PTA.

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16
Q

Which arteries supply the forearm and hand with blood?

A. 2 Radial and 2 Ulnar Arteries
B. 1 Radial Artery and 1 Ulnar Artery
C. 1 Cephalic Artery and 1 Basilic Artery
D. 2 Radial and 1 Ulnar arteries

A

B

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17
Q

The distal femoral artery becomes the popliteal artery:

A. at the level of the medial quadricep tendon
B. at the level of the adductor canal
C. at the level of the heads of the gastrocnemius muscles
D. in the popliteal fossa

A

B

FeedBack:The distal femoral artery becomes the popliteal artery at the level of the adductor canal (Hunter’s canal).

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18
Q

The inguinal ligament:

A. connects the greater tuberosity to the superior edge of the iliac crest
B. connects the greater and lesser tuberosities of the femur
C. connects the superior edge of the iliac crest with the anterior pubic bone
D. connects the ischial tuberosity to the anterior pubic bone

A

C

FeedBack:The inguinal ligament connects the superior edge of the iliac crest to the anterior pubic bone.

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19
Q

Normally, what changes occur in the waveform of the SMA postprandially?

A. resistance decreases
B. resistance increases
C. diastolic flow decreases
D. resistance and diastolic flow decreases

A

A

FeedBack:When digestion starts, the digestive organs require an increase in blood flow. The resistance in the SMA blood flow will decrease and diastolic flow will decrease. If stenosis is present, there will be an increase in systolic velocity (>2.75m/s)with no change in the resistance to the flow.

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20
Q

Which vessel courses posterior to the anterior scalene muscle?

A. brachial artery
B. axillary artery
C. subclavian artery
D. aorta

A

C

FeedBack:The subclavian artery courses posterior to the anterior scalene muscle.

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21
Q

Know angio of subclavian artery branches

Specifically this image is tested on the right subclavian artery. 1st-4th is labeled from medial to lateral

A

A. Internal thoracic artery - 4th
B. Vertebral artery -2nd
C. Thyrocervical trunk - 3rd
D. Right CCA -1st

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22
Q

In most patients, the first branch of the ECA is:

A. the superficial temporal artery
B. the internal thoracic artery
C. the ophthalmic artery
D. the superior thyroidal artery

A

D

FeedBack:In most patients, the first branch of the ECA is the superior thyroidal artery. The internal thoracic artery is a branch of the subclavian artery. The superficial temporal artery is a branch of the ECA but more distally. The ophthalmic artery is a branch of the ICA.

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23
Q

Which of the following explains the increased incidence of DVT in the left leg when compared to the right leg?

A. The left iliac vein is usually smaller than the right.
B. There are more valves present in the left iliac vein which can lead to increased venous stasis.
C. Left iliac vein is a common location for DVT formation with pregnancy
D. The anatomic course of the left iliac vein leads to increased risk of extrinsic compression.

A

D

FeedBack:Left iliac vein courses beneath the right iliac artery at the aortic bifurcation. Extrinsic compression has been linked to increased incidence of left leg DVT. This condition is called May Thurner syndrome.

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24
Q

Diastolic flow reversal is normal in which of the following vessels?

A. renal arteries
B. internal carotid artery
C. celiac artery
D. common iliac artery

A

D

FeedBack:The lower extremities are normally a high resistance vascular bed. This leads to diastolic flow reversal and a triphasic or biphasic waveform. Any low resistance vessel with a monophasic waveform has no flow reversal during diastole.

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25
Which of the following normally demonstrates a high resistance Doppler flow profile? A. external carotid artery B. post-prandial superior mesenteric artery C. renal artery D. hepatic artery
A FeedBack:The post prandial SMA will be lower resistance with increased diastolic flow. The MCA, renal and hepatic arteries will also have low resistance flow with increased diastolic flow.
26
What blood vessels are located at letter A? Image is cross section of calf- know this pic Paired veins anterior - A paired veins back left - C paired veins back right -D A. 2 PTA and 1 PTV B. 2 ATA and 1 ATV C. 1 PTA and 2 PTV D. 1 ATA and 2 ATV
D
27
Put the following terms in order from largest to smallest in size. capillary, aorta, femoral artery, arteriole, tibial artery A. capillary, arteriole, tibial artery, femoral artery, aorta B. aorta, femoral artery, tibial artery, arteriole, capillary C. aorta, capillary, femoral artery, tibial artery, arteriole D. capillary, aorta, femoral artery, tibial artery, arteriole
B FeedBack:From largest to smallest: aorta, femoral artery, tibial artery, arteriole, capillary. Capillaries are the smallest blood vessels in the body.
28
Where do the plantar arteries originate? A. from the PTA posterior to the medial malleolus B. from the ATA posterior to the medial malleolus C. from the ATA anterior to the medial malleolus D. from the peroneal artery just past the Achilles tendon attachment at the heel
A FeedBack:The plantar arteries originate from the PTA posterior to the medial malleolus.
29
During a color evaluation of the common femoral vein, the patient is asked to perform the Valsalva maneuver. The cephalic flow indicated by the blue color in the CFV immediately disappears until the patient releases their muscles. The blue color returns and completely fills the vessel. What do these color Doppler findings indicate? A. The response described is a normal result for the CFV. B. Superficial venous insufficiency is present. C. There is most likely an occlusive DVT in the superficial femoral vein causing the venous turbulence proximally. D. A significant level of insufficiency is present and should be further evaluated with PW or CW Doppler techniques.
A FeedBack:When the valsalva maneuver is applied, flow within the lower extremities should decrease significantly and/or stop completely. The loss of color flow during the Valsalva maneuver is a normal response of cessation of flow.
30
Branches of the ___________________ connect to branches of the vertebral arteries to allow collateral flow from the anterior circulation to the posterior circulation. A. ophthalmic artery B. subclavian artery C. occipital artery D. basilar artery
C FeedBack:The occipital artery is a branch of the ECA. Branches of the occipital artery meet branches of the vertebral artery. This is a possible collateral pathway for obstruction in the vertebral system or the ICA system on the same side.
31
The external iliac artery: A. courses along the medial side of the psoas muscle B. supplies the pelvic organs C. courses medially through adductor hiatus D. begins at the level of the inguinal ligament
A FeedBack:The external iliac artery travels laterally to the inguinal ligament and becomes the common femoral artery as it crosses under the ligament. It also courses along the medial side of the psoas muscle to supply the lower extremities with blood
32
All of the following are located adjacent to the inguinal ligament, except: A. common femoral artery B. common femoral vein C. saphenofemoral junction D. saphenopopliteal junction
D FeedBack:The CFA and CFV course under the inguinal ligament. The GSV joins the CFV near the ligament. The FV and PFV join to form the CF just distal to the ligament. The saphenopopliteal junction is located in the upper calf or popliteal fossa in most patients
33
A common anatomic variant of the mesenteric arterial anatomy is: A. the celiac artery is absent and the liver, stomach and spleen are supplied with blood from the inferior mesenteric artery B. the celiac artery and SMA originate from the posterior aorta C. The SMA and IMA share a common trunk D. the celiac axis and SMA share a common trunk
D FeedBack:A common anatomic variant of the mesenteric arterial anatomy is the celiac axis and SMA share a common trunk. Other known variants include the hepatic artery originates from the SMA or the hepatic artery originates directly from the aorta.
34
The inner most layer of an arterial wall is called ____________________, while the outermost layer of an arterial wall is called _______________________. A. tunica intima, vasa vasorum B. vasa vasorum, tunica adventitia C. tunica adventitia, tunica intima D. tunica intima, tunica adventitia
D FeedBack:The inner most layer of an arterial wall is called tunica intima, while the outermost layer of an arterial wall is called tunica adventitia.
35
The transducer is placed in the longitudinal position slightly anterior to midline of the medial upper left calf. The beam is angled posterior until the image displayed appears. What vessel is indicated by letter C? ``` Image longitudinal veins in calf anterior - a vein not labeled medial- b posterior c ``` A. posterior tibial vein B. gastrocnemius vein C. peroneal vein D. anterior tibial vein
C FeedBack:The image displays the confluence of the posterior tibial and peroneal veins. The peroneal veins are deeper on the image.
36
Which of the following correctly describes the venous system of the upper extremity? A. The superficial venous system of the arm is the primary drainage system of the extremity B. The veins of the upper extremity have nearly twice the number of valves compared to the lower extremity C. Effort thrombosis refers to clot in the veins of the hand caused by repetitive wrist motion D. Patients with May Thurner syndrome have an increased risk of developing upper extremity thrombosis
A FeedBack:The superficial venous system of the arm is the primary drainage system of the extremity. The deep system is the primary drainage system in the legs. The veins of the upper extremity have far fewer valves than the lower extremity. They do not need as many because the arm is closer to the heart and experiences lower hydrostatic pressures. May Thurner syndrome affects the left common iliac vein. Effort thrombosis refers to thrombus formation at the shoulder caused by repetitive shoulder movement that compresses the vein in the thoracic outlet.
37
Letter A indicates which of the following structures? ``` Image of angio rt subclavian with branches medial - lateral 1st - D 2nd - B 3rd- C 4th- A ``` A. Internal thoracic artery B. Vertebral artery C. Superficial temporal artery D. Thyrocervical trunk
A ``` FeedBack: A. Internal thoracic artery B. Vertebral artery C. Thyrocervical trunk D. Right CCA ```
38
Which of the following are branches of the distal ICA? A. MCA, ACA and posterior communicating artery B. MCA and anterior communicating artery C. MCA, ACA and PCA D. supraorbital artery and PCA
A FeedBack:Ophthalmic artery is the first branch from siphon area inside the cranium and branches into nasal, frontal & supraorbital arteries. The anterior choroidal artery and posterior communicating artery are the other two main intracranial branches of the distal ICA before it terminates at the bifurcation into the ACA and MCA once it reaches the circle of willis.
39
Assuming proper transducer orientation, which of the following normal vessels could be displayed on the image? blue superficial vein merging with red colored vein A. right axillary vein and cephalic vein B. left common femoral vein and greater saphenous vein C. superior vena cava and right innominate vein D. left subclavian vein and cephalic vein
A FeedBack:The flow in the blue vessel is moving into the red vessel. The flow in the red vessel is moving toward the right side of the image. This is a transverse image of the right shoulder. The left side of the image is the lateral arm. The right side of the image is the medial arm. The vessels would be reversed on the image of this was a left shoulder image. If this were a longitudinal view of the groin it would demonstrate the greater saphenous vein extending upward on the left side of the image.
40
The most common normal variant in the ECA/ICA anatomy is: A. the ECA branches directly from the ICA at the level of the angle of the mandible B. the ECA is absent and the ICA has branches that feed the extracranial structures C. the ECA lies posterior and medial to the ICA D. the ECA lies posterior and lateral to the ICA
D FeedBack:In most patients the ECA is the anterior medial branch of CCA . There are several normal variants in ECA/ICA position, with the most common being the ECA lies posterior and lateral to the ICA
41
The profunda artery: A. supplies blood to the prostate and pelvic organs in a male patient B. courses posterior and lateral to the femoral artery C. demonstrates low resistance flow compared to the femoral artery D. courses posterior and medial to the femoral artery
B FeedBack:The profunda artery courses posterior and lateral to the femoral artery.
42
The image is a transverse view of the right antecubital fossa. What vessel is indicated by letter A? transverse AC fossa image left on image - vein (A) Middle of image vein and art (C) right on image- vein (B) A. cephalic vein B. antecubital vein C. basilic vein D. brachial vein
A FeedBack:If the image is of the right arm, the left side of the image corresponds with the lateral right arm. The veins of the arm listed from lateral to medial: cephalic, brachial, basilic
43
During inspiration the flow in the veins of the lower extremities _____________. A. increases B. decreases C. remains unchanged D. reverses direction
B FeedBack:During inspiration the pressure within the chest cavity decreases allowing venous flow from the upper extremities to increase. During expiration, the pressure within the chest cavity increases causing the venous flow from the upper extremities to decrease. THE OPPOSITE IS TRUE WITH THE FLOW FROM THE LOWER EXTREMITIES. During inspiration the pressure within the abdominal cavity increases causing venous flow from the lower extremities to decrease. During expiration, the pressure within the abdominal cavity decreases allowing the venous flow from the lower extremities to increase.
44
What blood vessels are located at letter B? cross section of calf veins top of image - A bottom left - C bottom right - B A. 2 peroneal arteries and 1 peroneal vein B. 1 ATA and 2 ATV C. 1 PTA and 2 PTV D. 2 peroneal veins and 1 peroneal artery
D
45
Vasoconstriction will cause ________________ , while vasodilation will cause ______________. A. increased heart rate, increased blood pressure B. increased flow volume, decreased flow volume C. increased flow rate, decreased flow rate D. increased resistance to flow, decreased resistance to flow
D FeedBack:Vasoconstriction in the arterioles will cause increased resistance to flow in the feeding vessels, while vasodilation will cause reduced resistance.
46
What are the direct branches of the popliteal artery? A. ATA and Tibioperoneal trunk B. PTA and Tibioperoneal trunk C. PTA and ATA D. Peroneal and PTA
A FeedBack:The ATA branches off the popliteal artery first, to leave the tibioperoneal trunk that splits into the peroneal and PTA slightly more distally in the calf.
47
A pulsatility index of > 5.0 in the extremities indicates: A. normal resistance B. mildly decreased resistance C. moderately decreased resistance D. severely decreased resistance
A FeedBack:The pulsatility index describes the resistance of the blood flow. The higher the PI, the greater the resistance. Normal PI in the extremities is >5.0 and in most organs normal values are <1.5
48
The image is a transverse view of the right antecubital fossa. What vessel is indicated by letter C? image of the AC fossa vein on left of image - (A) middle - vein and art (C) right of image vein (B) A. basilic vein B. brachial vein C. brachial artery D. cephalic vein
C FeedBack:If the image is of the right arm, the left side of the image corresponds with the lateral right arm. The veins of the arm listed from lateral to medial: cephalic, brachial, basilic. The red color in the vessel labeled C indicates flow in the opposite direction of the other vessels on the screen. Letter C is the brachial artery.
49
Which calf vessel can be identified between the medial malleolus and the distal portion of the Achilles tendon? A. anterior tibial artery B. posterior tibial artery C. peroneal artery D. posterior venous arch
B FeedBack:The PTA and PTVs can be identified between the medial malleolus and the distal portion of the Achilles tendon.
50
Which of the following veins normally do not demonstrate spontaneous flow on Doppler evaluation? A. posterior tibial and popliteal veins B. peroneal and femoral veins C. posterior tibial, peroneal and great saphenous vein D. All lower extremity veins should normally demonstrate spontaneous flow on Doppler evaluation. Loss of spontaneity indicates flow stasis.
C FeedBack:Calf veins and superficial veins do not normally demonstrate flow without augmentation. (Lack spontaneity) Normally the flow is very low velocity and not easily detected without augmentation.
51
The lateral plantar arch artery originates at the _____________________. A. peroneal artery B. popliteal artery C. posterior tibial artery D. anterior tibial artery
C FeedBack:The lateral plantar arch originates at the PTA
52
When evaluating the GSV for use as a bypass graft, what is the preferred diameter for the vein? A. >5mm B. >7mm C. >10mm D. >3mm
D FeedBack:When evaluating a vein for use as a bypass graft, a 3mm diameter or greater is preferred.
53
Which of the following veins receives blood from the superficial and deep venous systems? A. popliteal vein and inferior vena cava B. brachial vein and small saphenous vein C. femoral vein and great saphenous vein D. subclavian and popliteal vein
D FeedBack:The subclavian vein receives blood from the cephalic vein and the axillary vein. The popliteal vein receives blood from the lesser saphenous and deep calf veins.
54
The profunda femoral artery supplies blood to which of the following structures? A. Psoas muscle B. Quadriceps muscle C. Bicep muscle D. Pelvic organs
B FeedBack:The profunda artery branches from the common femoral artery and mainly supplies blood to the muscles/structures of the thigh and hip.
55
Where is the eustachian valve found? A. near the junction of the IVC with the right atrium B. thoracic outlet C. popliteal fossa D. antecubital fossa
A FeedBack:A Eustachian valve is a single flap of tissue at the junction of the IVC with the right atrium that is necessary for fetal circulation. The Eustachian valve may persist in some adults, but it has no effect on circulation. It is not a TRUE venous valve in an adult and the IVC is described as having no valves.
56
The innominate veins lie ____________ to the innominate artery. A. inferior and posterior B. posterior and medial C. posterior and lateral D. anterior and lateral
D FeedBack:The innominate veins lie anterior and lateral to the innominate artery.
57
Which of the following veins does not normally contain any functioning valves? A. small saphenous vein B. deep femoral vein C. inferior vena cava D. common femoral vein
C 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. It is important to note that the Eustachian valve may be identified in the IVC at the junction with the right atrium. It is a remnant of fetal circulation and does not function as a valve in an adult.
58
Normal brachial pressures should not differ more than ____________ mmHg between arms. A. 5 B. 10 C. 30 D. 20
D FeedBack:If the brachial pressures differ by more than 20mmHg, a subclavian steal should be suspected.
59
The supraorbital artery originates from the ophthalmic artery and joins what branch of the ECA? A. posterior auricular artery B. lingual artery C. superficial temporal artery D. vertebral artery
C FeedBack:The supraorbital artery originates from the ophthalmic artery and joins the superficial temporal artery(branch of the ECA). This arrangement allows for collateral flow to occur on the same side of the body if the ICA is obstructed.
60
The normal brachial artery waveform will normally resemble the flow in the normal ______________artery A. hepatic artery B. superior mesenteric artery C. peroneal artery D. vertebral artery
C FeedBack:The normal brachial artery waveform will normally resemble the flow in the normal peroneal artery. Extremity flow will demonstrate a high resistance, triphasic waveform.
61
The waveform displayed would be normally found in all of the following vessels, except? below baseline phasic flow 0.45 m/s A. main portal vein B. mid renal vein C. proximal renal vein D. proximal hepatic vein
D FeedBack:The renal veins and main portal veins normally demonstrate flow with respiratory phasicity and mild pulsatility. The hepatic veins normally demonstrate a triphasic pattern, especially in the proximal portion that is adjacent to the heart.
62
The image demonstrates a venous perforator connected to the greater saphenous vein. Which of the following is true regarding the image and venous perforators? red superficial vessel A. Perforators are normally identified in most venous exams. B. The flow within the perforator is moving in the normal direction. C. Flow within the perforator system is normally bidirectional. D. Compression techniques are non-diagnostic for thrombus formation in the perforator system because it is not possible thrombus to form within them due to their small size.
B FeedBack:The flow demonstrated is moving away from the probe, according to the color map. This indicates normal flow direction from the superficial to the deep system.
63
Which of the following is a potential collateral pathway for extracranial to intracranial blood flow? A. Superficial temporal artery branches connect to small branches of the ascending pharyngeal artery B. Ascending pharyngeal branches connect to small branches of the superior thyroidal artery C. Facial and maxillary artery branches connect to small branches of the orbital artery D. Ascending pharyngeal branches connect to small branches of the lingual artery
C FeedBack:ECA branches provide collateral pathways when stenosis is present in the intracranial system Superficial temporal artery branches connect to small branches of the ophthalamic artery. Facial and maxillary artery branches connect to small branches of the orbital artery. Ascending pharyngeal branches connect to small branches of the vertebral artery. The other answer choices given describe connection of two vessels in the extracranial system.
64
The great saphenous vein is attached to the _______ aspect of the common femoral vein. A. medial B. lateral C. anterior D. posterior
A FeedBack:The great saphenous vein is attached to the medial aspect of the common femoral vein.
65
The image is a transverse view of right shoulder. What vessel is indicated by letter B? blue superficial vein joining red vessel A. subclavian vein B. axillary vein C. cephalic vein D. basilic vein
C FeedBack:The cephalic vein joins the axillary vein to form the subclavian vein.
66
The subclavian artery becomes the axillary artery: A. when it crosses over the deltoid muscle B. at the level of the fourth rib C. when it crosses anterior to the clavicle D. at the level of the first rib
D FeedBack:The subclavian artery extends from the innominate artery to the axillary artery. It courses posterior to the anterior scalene muscle and clavicle. It becomes the axillary artery at the level of the first rib.
67
The posterior tibial artery courses along: A. the medial aspect of the thigh. B. the medial aspect of the calf. C. the lateral aspect of the calf. D. the posterior aspect of the knee
B FeedBack:The posterior tibial artery courses along the medial aspect of the calf.
68
In cases of interrupted IVC, how does the blood from the distal IVC and lower extremities reach the right atrium? A. an AV malformation of the pelvis must be present for the patient to survive after birth B. azygos vein serves as a collateral pathway and empties into the SVC C. umbilical vein serves as a collateral pathway and empties into the portal system D. iliac veins empty directly into the renal veins
B FeedBack:Interrupted IVC: the intrahepatic segment of the IVC does not develop; the azygos vein drains the flow from the pelvis and lower extremities into the SVC; hepatic veins empty directly into the right atrium
69
All of the following are concomitant veins, except: A. PTV B. gastrocnemius C. peroneal D. soleal veins
D FeedBack:Concomitant veins - refers to a vein that is usually paired, with a vein lying on either side of a single artery. Radial, ulnar, PTV, ATV, peroneal and gastrocnemius veins are example of concomitant veins. The soleal veins/sinuses have no accompanying artery.
70
What is the arrow pointing to on the image of the right groin? image is of common femoral junction in long view pointing to echogenic material in the most superficial vein seen on image A. superficial femoral artery B. superficial femoral vein C. great saphenous vein D. common femoral vein
C
71
In most patients the right CCA: A. bifurcates at a lower level in the neck than the left CCA B. is nearly twice the diameter of the left CCA C. originates directly from the aortic arch D. bifurcates at the level if the clavicle
A FeedBack:Right CCA originates from the innominate artery. Left CCA originates from the aortic arch (second branch from arch). In most patients the right CCA bifurcates at a lower level than the left CCA.
72
Which of the following occurs during calf muscle relaxation? A. blood flows through the perforators from the superficial to the deep veins B. The gastrocnemius veins fill with blood from the popliteal vein C. blood flows through the perforators from the deep to the superficial veins D. the superficial veins fill with blood
A FeedBack:When the muscle contracts, flow moves from the deep calf veins into the popliteal and femoral vein. As the muscle relaxes, blood is essentially sucked through the perforators from the superficial system into the deep system to refill the vessels.
73
The _____________________ supplies arterial blood to the small intestine and proximal colon, while the __________________ supplies blood to the distal colon. A. gastroduodenal artery, SMA B. SMA, IMA C. left gastric artery, IMA D. celiac axis, SMA
B FeedBack:The proximal colon and small intestine are supplied by the SMA. The distal colon is supplied by the IMA.
74
Which of the following veins courses anterior to the tibial bone in the calf? A. great saphenous vein and anterior tibial vein B. great saphenous vein C. anterior tibial vein D. peroneal vein
C FeedBack:The anterior tibial veins course anterior to the tibial bone in the calf.
75
All of the following are deep venous structures of the lower extremity, except: A. peroneal veins B. vein of Giacomini C. sural sinuses D. gastrocnemius veins
B FeedBack:The vein of Giacomini is a superficial communicator vein connecting the GSV and SSV. The gastrocnemius veins and sural sinus are located deep in the calf muscle. The peroneal veins are deep veins of the calf.
76
Which of the following is not a branch of the subclavian artery? A. internal thoracic artery B. costocervical trunk C. posterior auricular artery D. thyrocervical trunk
C FeedBack:Branches from subclavian artery: Vertebral artery, Internal mammary artery (AKA internal thoracic artery), Thyrocervical trunk, Costocervical trunk
77
Bank tellers, teachers, cashiers and assembly line workers have an increased risk of all of the following, except: A. jugular vein thrombosis B. varicose veins C. thrombus formation in the soleal sinuses D. venous hypertension
A FeedBack:Bank tellers, teachers, cashiers and assembly line workers are on their feet, standing still for several hours of the day. This will cause venous blood to pool in the legs and increase pressure in the veins (venous hypertension). Stasis of venous flow can lead to thrombus formation. Flow in the jugular veins would flow easily into the vena cava with no stasis or increased risk of thrombus formation.
78
What blood vessels are located at letter C? cross section of calf top of image - A Left bottom - C right bottom B A. 2 peroneal veins and 1 peroneal artery B. 2 peroneal arteries and 1 peroneal vein C. 1 ATA and 2 ATV D. 1 PTA and 2 PTV
D
79
The term for the most common anatomic variant of the aortic arch anatomy is the: A. Bovine arch B. Talbot arch C. Bifurcating arch D. Simpson arch
A FeedBack:A Bovine arch indicates that there are two branches originating from the aortic arch, instead of 3. The the innominate artery and left CCA origin are combined and the left subclavian artery is the second branch. Although "bovine" indicates a cow, this arch formation is NOT related to the arch formation in cattle.
80
The _______________ artery terminates at the external calcaneal artery. A. peroneal B. anterior tibial C. posterior tibial D. medial gastrocnemius
A FeedBack:The peroneal artery terminates at the external calcaneal artery.
81
Vasodilation: A. can cause a triphasic waveform to become biphasic B. can cause a monophasic waveform to become triphasic C. usually occurs with stress or anxiety D. usually occurs in response to cold stimuli
A FeedBack:Vasodilation causes reduced resistance to flow to meet the tissue demands. Exercise will cause vasodilation and a triphasic waveform can become biphasic with the reduced resistance to flow.
82
The blue arrow indicates which of the following structures? Angio image CCA. blue arrow is pointing to a medial branch coarsing down off of the ECA (1st branch of ECA) A. Thyrocervical trunk B. Superior thyroidal artery C. Ophthalmic D. Internal thoracic artery
B FeedBack:The superior thyroidal artery is the first branch of the ECA.
83
Which of the following correctly describes normal flow in the hepatic vessels? A. the hepatic veins demonstrate hepatopetal flow B. the portal veins demonstrate hepatofugal flow C. the hepatic artery demonstrates hepatopetal flow D. the hepatic artery demonstrates hepatofugal flow
C FeedBack:Hepatofugal flow is flow that is moving out of the liver. Hepatopetal flow is flow that is moving toward/into the liver. The normal HA and PV demonstrate hepatopetal flow. The hepatic veins demonstrate hepatofugal flow.
84
The image is a transverse view of right shoulder. What vessel is indicated by letter A? blue superficial vessel (B) joining red deeper vessel (A) A. superior vena cava B. axillary vein C. innominate vein D. subclavian vein
B
85
The dorsalis pedis artery is a branch of: A. the ATA B. the PTA C. the peroneal artery D. the gastrocnemius artery
A FeedBack:The DPA is a distal branch of the ATA
86
Which of the following statements refers to the internal pudendal artery? A. Most common location for stenosis causing vasculogenic impotence B. Branch of the external iliac artery C. Supplies the penis with blood through the penile artery and its branches. D. Is the injection site for papaverine
C FeedBack:The internal pudendal artery is a branch of the internal iliac artery and supplies the penis with blood through the penile artery and its branches. Papaverine is injected into the tissues at the lateral side of the base of the penis.
87
While performing a lower extremity venous exam, you identify a small pair of veins with an accompanying artery deep in the calf muscle, that connect to the popliteal vein. What veins are these? A. anterior tibial veins B. posterior arch veins C. sural veins D. veins of Giacomini
C FeedBack:Sural veins are also called the gastrocnemius veins. They are located deep in the calf muscle and course alongside their accompanying artery. The sural veins empty their blood into the popliteal vein.
88
The diameter of a normal portal vein should not exceed: A. 13mm B. 11mm C. 10mm D. 12mm
A FeedBack:The diameter of the portal vein should not exceed 13mm.
89
Which of the following statements regarding venous perforators is false? A. Perforator flow is normally unidirectional but becomes bidirectional with exercise. B. They each contain a single valve. C. Thrombosis can occur within the perforators, which can lead to the formation of varicosities. D. Flow in the perforators normally moves from the superficial to the deep system.
A FeedBack:Venous valves are designed to allow unidirectional flow. If the valves are damaged or the vein is dilated to prevent proper valve movement, flow reversal may occur. Flow in the perforators normally moves from the superficial to the deep system.
90
Which of the following anatomic variants of ICA anatomy is most often associated with symptoms of cerebral ischemia? A. duplication B. coiling C. tortuosity D. kinking
D FeedBack:Kinking - vessel takes a sharp turn of 90 degrees or less, mimics stenosis and is related to plaque/stenosis formation. It is the anatomic variant most commonly associated with symptoms of ischemia Coling - vessel forms a circle during its course Tortuosity - vessel forms an S-shaped curve
91
What vein contains blood with a very high oxygen content? A. hepatic veins B. portal veins C. IVC D. pulmonary veins
D FeedBack:The pulmonary veins are the only veins in the body that carry highly oxygenated blood. These veins drain the blood from the lungs into the left atrium for distribution to the body through the left ventricle/aorta. All other veins carry blood that have depleted levels of oxygen because the organs that they are draining require the oxygen to function.
92
What is the name of the tiny network of vessels that supply/drain blood to/from the vessel wall? A. arterioles B. vasa vasorum C. capillaries D. venules
B FeedBack:The tiny network of vessels that supply/drain blood to/from the vessel wall is called the vasa vasorum. The tiny vessels wrap around the larger vessel within the tunica externa. The arteries and veins penetrate the tunica media to deliver and drain blood from the wall.
93
_______________ reflux will be normally seen in the lower extremity superficial system. A. No (0s) B. Less than 0.5s C. Less than 1.5s D. Less than 3s
B FeedBack:A small of amount of reflux (Less than 0.5s) may be seen in normal vessels with flow normalization following augmentation.
94
Exercise causes ________________ which leads to _________________ in the lower extremities. A. vasodilation, decreased resistance B. vasodilation, increased resistance C. vasoconstriction, increased resistance D. vasoconstriction, decreased resistance
A FeedBack:Vasodilation and resistance drops to encourage more flow distally, as the muscles require more oxygen.
95
The paratibial perforators connect: A. the GSV and PTVs B. the SSV and PTVs C. the SSV and popliteal vein D. the GSV and the ATVs
A FeedBack:The paratibial perforators connect the GSV and the PTVs.
96
Flow through venous perforators is: A. normally unidirectional from the superficial to the deep venous system B. normally unidirectional from the deep venous to the superficial system C. normally bidirectional to help equalize pressures in the deep and superficial systems D. normally absent unless the deep system becomes overloaded and forces the excess blood into the superficial system
A FeedBack:Flow through venous perforators is normally unidirectional from the superficial to the deep venous system.
97
The dorsalis pedis artery is a branch of the: A. anterior tibial artery B. popliteal artery C. posterior tibial artery D. peroneal artery
A FeedBack:The dorsalis pedis artery is a branch of the ATA.
98
Which normal variant of ICA anatomy is most commonly associated with symptomatic cerebral ischemia? A. kinking B. bifurcating C. coiling D. tortuosity
A FeedBack: Normal variants in the ICA anatomy: Tortuosity - S-shaped curve Kinking - takes a sharp turn, most commonly associated with symptomatic cerebral ischemia Coiling - vessel forms a circle during its course
99
The internal iliac artery: A. branches into the superficial and deep femoral arteries B. supplies the bladder, prostate and testicles in a male patient. C. courses lateral to the external iliac artery to reach the pelvis. D. demonstrates lower resistance flow than the external iliac artery.
D FeedBack:The gonadal arteries originate from the aorta not the internal iliac artery. Flow in the internal iliac artery is less resistant that the external branch because it supplies the pelvic organs with blood.
100
The pulsatility index (PI) in a normal aorta should be ______________ the PI in the normal popliteal artery. A. very similar to B. PI not measured in extremity vessels C. higher than D. lower than
D FeedBack:The pulsatility index (PI) in a normal aorta should be lower than the PI in the normal popliteal artery. The aorta flow is lower resistance than the popliteal artery, therefore there is a greater amount of pulsatility in the popliteal artery. The PI increases from the central arteries to the peripheral extremity arteries. A PI <5.0 in a lower extremity artery indicates proximal obstruction.
101
Which of the following lists the most common anatomic variation in aortic arch anatomy? A. Two branches originate from the arch: a shared innominate/left CCA trunk and the left subclavian artery B. Double aortic arch C. The coronary arteries originate from the innominate artery or the right CCA D. Pulmonary sling
A FeedBack:The most common anatomic variant of the arch branches is only two direct branches of the arch: 1. The innominate and left CCA originate as one short segment and then split 2. Left subclavian artery
102
Which vessel(s) supplies the majority of the blood to the hand? A. metatarsal arteries B. radial artery C. digital veins D. ulnar artery
D FeedBack:The ulnar artery supplies the majority of the blood to the hand.
103
The hypogastric artery is another name for what vessel? A. splenic artery B. internal iliac artery C. superior mesenteric artery D. inferior mesenteric artery
B FeedBack:The hypogastric artery is another name for the internal iliac artery.
104
All of the following arteries can normally be seen extracranially, except: A. superficial temporal artery B. internal carotid artery C. basilar artery D. vertebral artery
C FeedBack:The basilar artery is formed by the convergence of the left and right vertebral arteries inside the posterior aspect of the base of the skull.
105
The _________________ is formed by the junction of the splenic vein and the superior mesenteric vein. A. main portal vein B. left hepatic vein C. right hepatic vein D. inferior mesenteric vein
A FeedBack:The MPV is formed by the junction of the splenic vein and the superior mesenteric vein.
106
There are normally _______________ perforator veins in each leg. A. about 25-30 B. about 100 C. about 300 D. over 500
B FeedBack:There are normally about 100 perforator veins in each leg.
107
Normal extremity arterial flow should demonstrate a _________________acceleration time. A. rapid B. prolonged C. variable D. blunted
A FeedBack:Normal extremity arterial flow should demonstrate a rapid acceleration time
108
What is the most common normal variant in renal artery anatomy? A. absence of the right renal artery B. absence of the left renal artery C. right renal artery courses anterior to the IVC D. duplicated renal arteries
D FeedBack:1/3 patients have duplicated renal artery (most common anatomic variant).
109
The popliteal artery ___________ the popliteal vein. A. courses anterior to B. is more tortuous than C. is larger than D. courses posterior to
A FeedBack:The popliteal artery courses anterior to the popliteal vein.
110
Which of the following principles produces an equation that relates pressure gradient to flow and resistance within the circulatory system? A. Poiseuille's Law B. Bernoulli Principle C. Doppler Principle D. Raynaud's Phenomenon
A FeedBack:Poiseuille's Law states the pressure gradient in a vessel is equal to the flow volume multiplied by the resistance. Bernoulli's equation uses flow velocity to determine the pressure gradient at a specific location within the circulatory system.
111
Increased pressure in the venous system results in: A. an increased risk of stroke B. Baker's cyst formation C. decreased arterial pressure D. edema
D FeedBack:Increased pressure in the venous system results in edema as fluid is forced into surrounding tissues.
112
All of the following are correct regarding the brachiocephalic veins, except: A. Cardiac pulsatility is a normal Doppler finding in the brachiocephalic veins B. Formed by the junction of the internal jugular and subclavian veins C. Right and left brachiocephalic veins merge to form the superior vena cava D. Right and left brachiocephalic veins course anterior and medial to the right and left brachiocephalic arteries
D FeedBack:There is no brachiocephalic artery on the left side.
113
Which of the following normally demonstrates a low resistance Doppler flow profile? A. external carotid artery B. hepatic artery and renal artery C. renal artery and internal iliac artery D. external carotid artery, renal and hepatic arteries
B FeedBack:All vessels that feed organs will have low resistance vascular beds which lead to a low resistance waveform.

RVT (5 decks)

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