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Ultrasound 1 > Aorta/IVC/PV > Flashcards

Aorta/IVC/PV Flashcards

1
Q

Which organ system is the first system to be functional in the embryo?

A

cardiovascular system

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2
Q

T or F: the embryonic heart and aorta form at different times

A

False.

The embryonic heart and aorta form at the same time.

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3
Q

When does the embryonic heart and aorta start beating?

A

22 days

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4
Q

What happens to the embryonic aorta during the 3rd week?

A

The embryonic aorta begins as 2 dorsal AOs that fuse into 1 AO

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5
Q

What is the vitelline artery complex?

A

It is made up of vitelline arteries that carry blood from the AO to the yolk sac

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6
Q

A tube that connects the yolk sac to the digestive tract of a developing embryo

A

vitelline duct/yolk stalk

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7
Q

What is another name for the vitelline duct?

A

yolk stalk

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8
Q

What are the 3 layers of blood vessels?

A
  1. tunica intima
  2. tunica media
  3. tunica adventitia
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9
Q

What is the name of the inner layer of a blood vessel?

A

tunica intima

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10
Q

What is the name of the middle layer of a blood vessel?

A

tunica media

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11
Q

What is the name of the outer layer of a blood vessel?

A

tunica adventitia

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12
Q

Which blood vessel layer consists of endothelial tissue?

A

tunica intima

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13
Q

Which blood vessel layer consists of elastin, smooth muscle fibers, collagenous tissue, and provides the strength of arteries?

A

tunica media

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14
Q

Which blood vessel layer consists of loose connective tissue and vast vasorum?

A

tunica adventitia

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15
Q

What is the vasa vasorum?

A

It is the tiny arteries and veins that supply the blood vessel walls

(It is the vessels of vessels)

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16
Q

List the order in which the blood flows into each of the blood vessels from the heart and back

A
  1. Aorta
  2. Arteries
  3. Arterioles
  4. Capillaries
  5. Venules
  6. Veins
  7. IVC
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17
Q

Which is larger in diameter: arteries or veins?

A

Veins

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18
Q

What carries blood away from the heart to other organs?

A

Arteries

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19
Q

Does abdominal AO pulsation change with respirations?

A

No

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20
Q

What is the largest artery of the body?

A

Aorta

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21
Q

List the sections of the aorta

A
  1. aortic root
  2. ascending AO
  3. aortic arch
  4. descending AO
  5. abdominal AO
  6. iliac bifurcation
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22
Q

Which portion of the AO is inferior to the diaphragm?

A

abdominal AO

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23
Q

List the branches of the abdominal AO in descending order

A
  1. phrenic arteries
  2. CA
  3. SMA
  4. renal arteries
  5. RT/LT gonadal arteries
  6. IMA
  7. lumbar arteries
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24
Q

What branches are located laterally on the abdominal AO?

A

phrenic arteries, renal arteries

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25
Q

What branches are located anteriorly on the abdominal AO?

A

CA, SMA, IMA

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26
Q

What branch is located anteriolaterally on the abdominal AO?

A

RT/LT gonadal arteries

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27
Q

CA?

A

celiac axis

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28
Q

SMA?

A

superior mesenteric artery

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29
Q

IMA?

A

inferior mesenteric artery

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30
Q

What branch is located posteriolaterally on the abdominal AO?

A

lumbar arteries

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31
Q

What is the typical prox AO measurement?

A

3.0 cm

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32
Q

What is the typical mid AO measurement?

A

2.0 cm

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33
Q

What is the typical dist AO measurement?

A

1.2 cm

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34
Q

Where does the AO anatomically course?

A

courses slightly left of the vertebral column

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35
Q

What structures does the AO lie posterior to?

A
  • LT lobe of the liver
  • body of pancreas
  • the gastroesophageal junction (GEJ)
  • pylorus of the stomach
  • splenic vein
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36
Q

T or F: Arteries have valves

A

False.

Veins have valves to ensure blood flows in one direction towards the heart.

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37
Q

What arises from the LT ventricular outflow tract of the heart; has 3 semilunar cusps that prevent blood from flowing back into the heart?

A

aortic root

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38
Q

What arises a short distance from the ventricle and courses superiorly to form the aortic arch?

A

ascending aorta

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39
Q

Three arterial branches arise from the superior border of the aorta to supply the head, neck, and upper extremities

A

aortic arch

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40
Q

From the aortic arch, the AO descends posterior to the heart through the thoracic cavity

A

descending aorta

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41
Q

After the AO pierces the diaphragm, the thoracic AO becomes known as what?

A

abdominal AO

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42
Q

What is the typical measurement for the iliacs?

A

1.0 cm

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43
Q

Where does the AO bifurcate into the right and left iliacs?

A

At the 4th lumbar vertebrae near the umbilicus

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44
Q

Where is the diaphragmatic crura located?

A

it surrounds the prox abdominal AO as it projects through the diaphragm into the abdomen

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45
Q

What is the diaphragmatic crura?

A

the tendinous structures that attach/anchor the diaphragm to the vertebral column.

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46
Q

T or F: the abdominal AO pierces the diaphragm and courses between the RT and LT crura

A

True.

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47
Q

What is the first anterior branch of the AO?

A

CA

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48
Q

What originates approx. 2.0cm inferior to the diaphragm?

A

CA

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49
Q

What has been known to compress the CA?

A

median arcuate ligament

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50
Q

What is the CA responsible for?

A

supply oxygenated blood to the liver

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51
Q

What are the 3 branches of the CA?

A
  1. common hepatic artery
  2. splenic artery
  3. left gastric artery
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52
Q

On US: this vessel branches off the CA and courses to the RT of the abdomen at almost 90 degrees

A

common hepatic artery

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53
Q

On US: this vessel branches off the CA and takes a tortuous course horizontally to the left of the body as it forms the superior border of the tail of the pancreas

A

splenic artery

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54
Q

What is the largest vessel of the CA branches?

A

splenic artery

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55
Q

What vessel branches off the CA and is rarely seen by ultrasound?

A

left gastric artery

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56
Q

LGA

A

left gastric artery

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57
Q

CHA

A

common hepatic artery

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58
Q

What is the splenic artery responsible for?

A

supplies oxygenated blood to the spleen and tail of pancreas

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59
Q

What is the LGA responsible for?

A

supplies oxygenated blood to the esophagus and stomach

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60
Q

What does the CHA branch into?

A
  1. GDA
  2. PHA
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61
Q

GDA

A

gastroduodenal artery

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62
Q

PHA

A

proper hepatic artery

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63
Q

What does the PHA branch into?

A
  1. RHA
  2. RGA
  3. LHA
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64
Q

RGA

A

right gastric artery

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65
Q

RHA

A

right hepatic artery

66
Q

LHA

A

left hepatic artery

67
Q

What is the LHA responsible for?

A

supplies the caudate and left of the liver

68
Q

What does the RHA branch into?

A

cystic artery

69
Q

What is the RHA and cystic artery responsible for?

A

supplies GB and liver

70
Q

What is the GDA responsible for?

A

supplies duodenum and parts of the stomach

71
Q

What comes off anteriorly of the AO approx. 1.0cm inferior to the CA?

A

SMA

72
Q

What does the SMA feed?

A
  1. small intestine
  2. cecum
  3. ascending colon
  4. transverse colon
73
Q

What pathology should be considered if the distance of the SMA to the AO is severe or > 11mm?

A

lymphadenopathy

74
Q

Where does the SMA run?

A

The SMA runs posterior to the neck of the pancreas and anterior to the uncinate process

75
Q

This vessel has 5 branches and each of those branches consists of 10-16 branches all of which supply the small bowel

A

SMA

76
Q

What do the renal arteries feed?

A

kidneys

77
Q

What vessels arise laterally from the AO at the 3rd lumbar vertebrae, just inferior to the SMA?

A

renal arteries

78
Q

T or F: The left renal artery is longer than the right renal artery

A

False.

The right renal artery is longer than the left renal artery.

79
Q

What vessel courses posterior to the IVC, anterior to the spine, and posterior to the renal vein?

A

RRA

80
Q

RRA

A

right renal artery

81
Q

LRA

A

left renal artery

82
Q

What vessel courses from the AO directly into the LT kidney?

A

LRA

83
Q

What vessel arises anteriorly off the abdominal AO at about the 4th lumbar vertebrae, and very difficult to identify on US?

A

IMA

84
Q

What does the IMA feed?

A
  1. LT transverse colon
  2. descending colon
  3. sigmoid colon
  4. rectum
85
Q

What do the common iliacs branch into?

A

external and internal iliacs

86
Q

What does the internal iliac supply?

A
  1. pelvic viscera
  2. peritoneum
  3. buttocks
  4. sacral canal
87
Q

What does the external iliac become?

A

common femoral artery

88
Q

What does the external iliac supply?

A

ipsilateral lower extremity

89
Q

What vessels arise from the lateral AO walls and feed the diaphragm?

A

phrenic arteries

90
Q

What vessels arise anterolateral inferior to the renal arteries and course along the psoas muscle until they reach the designated gonadal destination?

A

RT and LT gonadal arteries

91
Q

What do the RT and LT gonadal arteries feed?

A

Testicles or ovaries

92
Q

What vessels are usually 4 arteries that are present on each side of the AO and travel posterolateral?

A

lumbar arteries

93
Q

What do the lumbar arteries feed?

A
  1. muscle
  2. skin
  3. bone
  4. spinal cord
94
Q

What type of transducer do we use for aortic ultrasound?

A

2-4 MHz curvilinear transducer

95
Q

What is a typical pt prep for aortic ultrasound?

A

NPO for 8 hours

96
Q

What lab values are indicative of an aortic ultrasound?

A
  1. increased WBCs
  2. decrease in hematocrit (rupture)
97
Q

What occurs when the arterial vascular system becomes stiff and thickened, and results in higher blood pressure?

A

arteriosclerosis

98
Q

What is a condition in which the aortic wall becomes irregular with plaque build-up?

A

atherosclerosis

99
Q

AAA

A

abdominal aortic aneurysm

100
Q

T or F: true aneurysms can involve 1, 2, or all 3 layers of the vessel wall

A

False.

True aneurysms involve all 3 layers of the vessel wall.

101
Q

What is an abdominal aortic aneurysm?

A

it is a localized dilation of the abdominal AO, usually greater than 3 cm in diameter, that involves all 3 layers of the wall

102
Q

What is a localized dilation of the abdominal AO, usually greater than 3 cm in diameter, that involves all 3 layers of the wall

A

AAA

103
Q

How does a AAA occur?

A

the force of blood pushing against the walls combined with wall injury/damage causes weakness and the walls aneurysm

104
Q

What is more common for an aneurysm: abdominal AO or thoracic AO?

A

abdominal AO

105
Q

Where does the majority of aneurysms occur?

A

below the renal arteries

106
Q

What is Marfan syndrome?

A

an inherited disorder that affects connective tissue that support and anchor your organs and other structures in your body

107
Q

What is Ehlers-Danlos syndrome?

A

a group of disorders that affect connective tissues that support organs, structures, and other tissues

108
Q

An abdominal aneurysm located below the renal vessels?

A

infrarenal

109
Q

An abdominal aneurysm located above the renal vessels?

A

suprarenal

110
Q

An abdominal aneurysm located between the renal vessels?

A

pararenal

111
Q

What and where is the most common AAA?

A

infrarenal, fusiform in the dist AO

112
Q

What are the two possible shapes of aneurysms?

A

saccular or fusiform

113
Q

What aneurysm shape is connected with a mouth, more of a sudden transition, and may or may not contain thrombus

A

saccular

114
Q

What aneurysm shape is football-like, more of a smooth transition, and more common?

A

fusiform

115
Q

How can AAA’s be fixed?

A

grafts

116
Q

How are AAA grafts placed?

A

endovascularly or open surgery

117
Q

What is a mild, diffusely enlargement of the AO?

A

ectatic AO

118
Q

What is it when blood escapes through a hole in the vessel wall, but is contained within adjacent tissue?

A

pseudoaneurysm

119
Q

How is a pseudoaneurysm treated?

A
  • physical compression for 20 minutes
  • solution injection to clot it off
120
Q

What is the sonographic appearance of a pseudoaneurysm?

A

a “feeding vessel” to a heterogeneous mass and a to-fro spectral tracing

121
Q

What kinds of trauma can cause a pseudoaneurysm?

A
  • accident
  • surgery
  • heart cath
  • angiography
122
Q

What is it when the intimal wall of the AO separates and appears as a flap in the lumen of the AO?

A

aortic dissection

123
Q

T or F: Aortic dissections do not have a true lumen, only a false lumen

A

False.

Aortic dissections have a true lumen and a false lumen.

124
Q

What is the mortality rate of an aortic rupture?

A

50%

125
Q

What are the clinical indications and lab values for an aortic rupture?

A
  • excruciating back pain
  • shock
  • expanding abdominal mass
  • decrease in hematocrit
126
Q

Is US used for aortic ruptures?

A

No, because time is so essential CT is the gold standard

127
Q

The aneurysm is thickened and surrounded by fibrosis and adhesions?

A

inflammatory AO aneurysm

128
Q

aneurysm caused by infection?

A

mycotic aneurysm

129
Q

abnormal connection from an artery to a vein?

A

arteriovenous fistula

130
Q

presents clinically as HTN, from renal artery plaque or fibromuscular dysplasia; looks like a string of pearls on CT?

A

renal artery stenosis

131
Q

Where the exchange of materials between blood and tissue take place?

A

capillaries

132
Q

T or F: capillaries have multiple layers

A

False.

Capillaries only have 1 layer

133
Q

What aides venous blood return?

A
  • muscle contraction
  • respiration
134
Q

T or F: blood pressure is higher in the IVC

A

False.

Blood pressure is higher in the arterial system.

135
Q

Where does the IVC form?

A

at the 4th lumbar vertebrae where the common iliac veins come together

136
Q

On US, when does the IVC get bigger, when the pt is breathing normally or when they take a deep breath and hold it?

A

deep breath and hold it

137
Q

Where are the hepatic veins located?

A

They originate between the segments of the liver and drain posteriorly into the IVC at the level of the diaphragm

138
Q

T or F: hepatic veins are surrounded by echogenic reflectors

A

False.

Hepatic veins are NOT surrounded by echogenic reflectors; portal veins ARE.

139
Q

Which one is longer: the right renal vein or left renal vein?

A

left renal vein

140
Q

T or F: pts with RT-sided heart failure will have decreased pulsatility?

A

False.

pts with right-sided heart failure will have increased pulsatility

141
Q

Where does the RT gonadal vein drain into?

A

IVC

142
Q

Where does the LT gonadal vein drain into?

A

LRV

143
Q

LRV

A

left renal vein

144
Q

RRV

A

right renal vein

145
Q

(On US) This kind of pathology appears as solid material of varying echogenicity within the IVC lumen and may be partially filling or completely filling the IVC

A

IVC thrombosis

146
Q

What is thrombosis of the hepatic veins in the liver?

A

Budd Chiari syndrome

147
Q

What kind of pathology do these clinical findings suggest:
- RUQ pain
- ascites
- hepatomegaly

A

Budd Chiari syndrome

148
Q

Formation of a clot in the vein that drains blood from the kidney

A

Renal vein thrombosis

149
Q

What does an IVC filter do?

A

traps emboli from migrating to the heart and lungs

150
Q

What is the entrance/gateway of major veins, arteries, and ducts going into and out of the liver?

A

Porta hepatis

151
Q

Flow directed away from the liver

A

hepatofugal

152
Q

Flow directed toward the liver

A

hepatopetal

153
Q

What 3 vessels come together to form the main portal vein?

A
  1. splenic vein
  2. IMV
  3. SMV
154
Q

IMV

A

inferior mesenteric vein

155
Q

SMV

A

superior mesenteric vein

156
Q

What does the MPV branch into?

A

RPV and LPV

157
Q

What does the RPV branch into?

A

anterior and posterior right portal veins

158
Q

What does the LPV branch into?

A

medial and lateral left portal veins

159
Q

Formation of venous collaterals around a portal vein thrombosis?

A

Cavernous transformation of the portal vein

160
Q

Increased venous resistance throughout the liver due to liver disease

A

portal venous HTN

161
Q

What supplies blood to the liver?

A
  • portal veins
  • hepatic arteries
162
Q

What vessels and ducts form the portal triad?

A
  1. hepatic artery
  2. portal vein
  3. common bile duct

Ultrasound 1 (8 decks)

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