Aorta & IVC - A&P Flashcards
Normal AO measurement
less than 3 cm diameter
1st branch of abd. AO
Celiac axis/trunk
Celiac axis branches
splenic, L.gastric, common hepatic arteries
2nd branch of abd. AO
SMA (superior mesenteric artery)
Function of SMA
delivers blood to large seg. of intestines
3rd branch
L & R renal distal to SMA
Bifurcation
L & R iliac arteries @ umbilicus
AO function
arteries (red) deliver O2 rich blood to body stores potential energy & converts to kinetic energy
AO originates from
L. Ventricle through aortic arch
IVC function
veins (blue) delivers O2 depleted blood back to heart from lower limbs
low pressure
IVC location
anatomic right side of AO
AO location
anatomic left side of IVC
IVC diameter characteristics
Generally 2.5 cm but varies Should decrease as descending inferiorly
Inspiratory collapse
quick sniff of air, causes IVC to collapse
Valsalva maneuver
causes decrease in IVC diameter patient holds breath and tech bears down - increasing intrathoracic pressure
Hepatic branches
right, middle, left hepatic train hepatic (liver) blood into IVC
Portal vein function and formation
returns O2 depleted blood to IVC formed by junction of splenic & sup. mes. veins
3 layers of AO and IVC
Tunica intima = inner most
Tunica media = middle, thicker in AO
Tunica adventitia = outer
Normal Abdominal AO
Normal AO has bright echogenetic walls
Pulsates
Anterior to anatomic left of spine
Commonly seen in AO scan
Celiac Axis/ trunk
SMA
Renal arteries
Common Iliac Arteries
Artery landmark segments
Prox - segment immediatly inferior to diaphram and superior to celiac axis
Mid - between celiac axis & caudally positioned SMA
Dist - between SMA & AO bifurcation
AO Prox landmarks
inferior to diaphragm and superior to celiac axis
AO Mid Trans
Between celiac axis superiorly and SMA inferiorly
Celiac axis = seagull
Anatomic right is Hepatic artery
Anatomic left is Splenic artery
Splenic Vein
Crawling over SMA on its way to form portal vein of liver
Landmark to ID pancrease - located anteriorly
Locaiton of AO
Anatomic left of spine
Location of IVC
Anatomic right of spine
IVC Characteristics
Large variations in diameter
Relates to patient’s breathing
Push belly out and press down to see better
Any condition with right heart (R.Vent.) issues will apear plethoric (fluid filled)
Due to hepatic vein draining into IVC
IVC segments
Prox - extends from R.Atrium, includes hepatic vein
Mid - level of renal veins, posterior to head of pancreas
Dist - common illiac veins
Transducer selection for AO and IVC
curved array
3-5 MHz
Doppler effect
a change (doppler shift) in frequency of waves when the wave source is moving
Color Doppler instruments
information on presence, direction, speed and blood flow characteristics
Spectral Doppler
Looks at flow at one site
and details of waveform, characteristics, velocities and indices
The vessel demarcated by the indicator in this accompanying short-axis image of the abdominal aorta delivers blood to which of the following organs?
Intestines
Left Kidney
Spleen
All above
A & C
Intestines
Which of the following represents the structure demarcated by the indicator?
Duodenum
Portal Vein
AO
IVC
CBD (common bile duct)
IVC
The structures supplied by the vessel demarcated by the indicator in this long-axis view of the abdominal aorta include the __________.
Intestines
Left kidney
Liver
Stomach
Spleen
Intestines
Which of the following sonographic characteristics helps distinguish the IVC from the aorta?
A. The IVC has an intrahepatic course prior to emptying into the right atrium.
B. The IVC has characteristic hepatic vein tributaries several centimeters prior to joining the right atrium.
C. The IVC tends to flatten as it courses distally and is more compressible compared to the aorta.
D. All of the above
E. None of the above
All of the above
Which of the following can often be seen when scanning the proximal IVC in short axis (transverse imaging plane)?
A. Hepatic veins
B. Liver
C. Common iliac veins
D. A and B
E. B and C
A & B
Which of the following can often be seen when scanning the proximal IVC in short axis (transverse imaging plane)?
A. Hepatic veins
B. Liver
C. Common iliac veins
D. A and B
E. B and C
A and B
Hepatic veins and liver
Which of the following statements regarding the abdominal aorta is correct?
A The aorta courses anteriorly as it extends caudally.
B. Imaging of the distal aorta is frequently complicated by overlying bowel gas and soft tissues.
C. The celiac axis is the first major branch vessel that comes off the abdominal aorta.
D. All of the above
E. None of the above
All of the above
Which of the following statements regarding aorta and IVC physiology is correct?
The aorta and IVC both contain tunica intima, tunica media, and tunica adventitial layers.
B. The aorta has a thicker tunica media layer that contains more muscle layers than the IVC.
C. The IVC has thinner walls compared to the aorta.
D. The diameter of the IVC is highly dynamic and varies in response to physiologic parameters.
E. All of the above
All of the above
Which of the following choices best identifies the indicators demarcated by the arrows in this accompanying transverse plane image of the upper abdomen?
A. Indicator 1 is the IVC
B. Indicator 2 is the aorta
C. Indicator 1 is the anterior vertebral body of the spine
D. Indicator 2 is the IVC
E. B and C
B and C
The __________ is responsible for the image artifact delineated by the indicator in this accompanying short-axis image of the mid-abdominal aorta.
A. Gallbladder
B. Liver
C. Stomach
D. Bladder
E. None of the above
Stomach
Which of the following statements regarding the abdominal aorta is correct?
A. It has bright echogenic walls and an anechoic internal lumen.
B. It demonstrates pulsatility when examined with ultrasound.
C. It has dark anechoic walls and a bright hyperechoic internal lumen.
D. It courses along the anterior and anatomic right side of the spine.
E. A and B
A and B
Which of the following statements regarding the image artifact demarcated by the indicator in this short-axis view of the abdominal aorta taken in a transverse imaging plane is correct?
A. The artifact is caused by a gallstone.
B. Drinking water may mitigate this artifact.
C. The artifact is caused by gas.
D. The artifact is caused by acoustic shadowing.
E. B and C
B and C
Which of the following correctly characterizes the sonographic appearance of the IVC?
A. The IVC has thin, highly echogenic walls that surround an anechoic lumen.
B. The IVC demonstrates minimal variation in diameter during a normal patient’s respiratory cycle.
C. The IVC tends to dilate during a Valsalva maneuver.
A. The IVC has thin, highly echogenic walls that surround an anechoic lumen.
Which of the following branch vessels of the abdominal aorta can be visualized with abdominal sonography?
A. Celiac axis
B. Superior mesenteric artery
C. Right and left common iliac arteries
D. Left and right renal arteries
E. All of the above
All of the above
Which of the following statements regarding aorta and IVC imaging is correct?
A. A curved-abdominal probe in the 3 to 5 MHz range is an ideal initial choice for aorta and IVC imaging.
B. A phased-array transducer in the 1 to 5 MHz range may be used for aorta and IVC imaging.
C. Patients will often need to be scanned in different body positions (e.g., lateral decubitus or oblique positions) to ensure optimal acquisition of aorta and/or IVC views.
D. Different breathing techniques (e.g., Valsalva maneuver) may assist IVC imaging.
E. All of the above
All of the above
Which of the following statements correctly characterizes the relationship between IVC diameter and intravascular volume status of patients?
A. The diameter of the IVC is solely influenced by retrograde transmission of cardiac pulsations.
B. The diameter of the IVC is solely influenced by intravascular volume status of a patient.
C. The exact relationship and contributing factors leading to variations in IVC diameter are complex, multifactorial, and remain an active area of study.
D. All of the above
E. None of the above
C. The exact relationship and contributing factors leading to variations in IVC diameter are complex, multifactorial, and remain an active area of study.
The blue signal demarcated by the indicator in this short-axis view represents __________.
A. Blood flow within the IVC towards the transducer
B. Blood flow within the aorta towards the transducer
C. Blood flow within the IVC away from the transducer
D. Blood flow within the aorta away from the transducer
E. None of the above
C. Blood flow within the IVC away from the transducer
What is the structure identified by the indicator in this accompanying image?
A. Portal vein
B. Common hepatic artery
C. Superior mesenteric artery
D. Common bile duct
E. None of the above
SMA
