Anatomy Pt 2 Flashcards
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
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.
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
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.
A branch of which artery joins the terminal ulnar artery to form the superficial palmar arch?
A. Ulnar
B. Brachial
C. Antecubital
D. Radial
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.
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
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
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
C
FeedBack:The saphenous veins and their tributaries course within the subcutaneous tissue, between the fascial layers.
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
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.
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
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.
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
FeedBack:The image displays the confluence of the posterior tibial and peroneal veins. The peroneal veins are deeper on the image.
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
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.
The profunda artery courses ________________ to the superficial femoral artery.
A. posterior medial
B. posterior lateral
C. anterior medial
D. anterior lateral
B
FeedBack:The deep femoral artery courses posterior and lateral to the superficial femoral artery.
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
D
FeedBack:The most common congenital anomaly of the Circle of Willis is the absence of one or more communicating arteries.
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
B
FeedBack:The basilic vein penetrates the muscular fascia just above the elbow and courses cephalad to join the axillary vein
During inspiration the flow in the veins of the upper extremities _____________.
A. increases
B. decreases
C. remains unchanged
D. reverses direction
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.
Be able to identify these waveforms
A. monophasic, high resistance
B. biphasic
C. Triphasic
D. monophasic, low resistance
The lateral plantar artery originates:
A. at the popliteal artery
B. at the ATA
C. at the PTA
D. at the peroneal artery
C
FeedBack:The lateral plantar artery originates at the PTA.
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
B
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
B
FeedBack:The distal femoral artery becomes the popliteal artery at the level of the adductor canal (Hunter’s canal).
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
C
FeedBack:The inguinal ligament connects the superior edge of the iliac crest to the anterior pubic bone.
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
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.
Which vessel courses posterior to the anterior scalene muscle?
A. brachial artery
B. axillary artery
C. subclavian artery
D. aorta
C
FeedBack:The subclavian artery courses posterior to the anterior scalene muscle.
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. Internal thoracic artery - 4th
B. Vertebral artery -2nd
C. Thyrocervical trunk - 3rd
D. Right CCA -1st
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
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.
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.
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.
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
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.
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.
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
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.
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.
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.
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.
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
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
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.
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.
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.
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.
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
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.
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.
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
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.
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
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.
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
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.
