Arteries Flashcards
How can you tell you’re imaging the IVC?
It will compress; it moves with the body
How can you tell you’re imaging the aorta?
It will pulse; it moves with the heart
Why is knowing the abdominal vessels important for scanning?
They provide landmarks for organ imaging
What does the circulatory system do?
It transports gases and nutrients to the tissue and transports waste products away from the tissue
In general, what does the network of vessels look like?
Arteries - arterioles - capillaries - venules - veins
How do you measure the blood flow in an artery?
Place the gate and the wings with an angle of less than 60°
Make sure it is swept to either side a bit
How do you measure blood flow in a vein?
Just place the gate
What happens to blood flow when you fast for an exam?
Being NPO will affect blood flow; not eating will resist blood flow
What are the 3 parts of a vessel wall?
Tunica intima, tunica media, tunica externa/adventitia
Do arteries or veins have a thicker muscle layer?
Arteries have a thicker muscle layer than veins
Describe 4 things about Tunica Intima…
Endothelial cells - lumen
Delicate connective tissue
Elastic tissue
Inner layer
Describe 3 things about the Tunica Media…
Smooth elastic muscle
Middle layer
Helps regulate flow by controlling diameter
Describe 3 things about the Tunica Externa/Adventitia…
Loose connective tissue
Smooth muscles and elastic tissue
Outer layer
What is the vasa vasorum?
Small blood vessels that supply the walls of the aorta and vena cava
List 5 things about arteries…
Blood away from heart Smaller in diameter Faster moving blood Elasticity No change in respiration
List 7 things about veins…
Blood to the heart Slower moving blood
Collapsible Little elasticity
Large diameter Changes with respiration
Has valves
What part of the body has the most valves?
The legs; makes sure blood flows the right way
What are capillaries?
Small vessels connecting the arterial and venous systems
What is passed through capillary walls?
Nutrients and waste
What are the 6 major arteries?
Aorta, celiac axis, SMA, renal, IMA, common illiacs
What is the name of the arteries and veins that lead to the lungs?
Pulmonary arteries and veins
Describe 3 things about the aorta…
Trunk artery
Largest principle artery
Arises from the left ventricle
What does the aorta do?
Distributes blood to organs and limbs
How are arterial branches named?
Usually after the organ it is feeding
What are the 5 different parts of the aorta?
Root of the aorta - LVOT Ascending aorta Aortic arch Thoracic descending aorta Abdominal descending aorta - retroperitoneum
Describe 3 things about the root of the aorta…
Leaves the left ventricle
Three cusps on the aortic valve
Coronary arteries arise from the cusps
What happens if cusps are damaged?
A heart attack could occur
Describe the ascending aorta…
Arches to form the aortic arch
What arteries branch out from the aortic arch?
Brachiocephalic
Left common carotid
Left subclavian
What 2 arteries branch off the brachiocephalic?
Right subclavian
Right common carotid
Describe the descending aorta…
Enters the abdomen through the opening of the diaphragm
Describe 3 things about the ascending aorta…
Largest artery in the body
Slightly left of the vertebral column
Diaphragmatic crura surround the aorta through the diaphragm
What is the diaphragmatic crura?
Tendinous structures that extend inferiorly from the diaphragm to attach to the vertebral column
Form a tether for muscular contraction; name is from their leg shaped appearance (crus is Latin for leg)
What can the crus of the diaphragm be confused with?
The right renal artery
What is the normal measurement of the abdominal aorta?
2-3 cm in diameter
Describe 3 thing about the aorta from a scanning aspect…
Best anatomic landmark
Patient lays in a supine position
Longitudinally - it’s a hallow tube anterior to the spine
What might you need to do when scanning the aorta to get by air or gas?
Apply pressure and angle the transducer
What techniques might you use to get a better image of the aorta?
Breathing or extend abdomen techniques
Too high of gain might create what when scanning the aorta? What should the aorta look like?
Artifactual internal echoes
Anechoic
What symptoms might lead to an aortic scan?
Abdominal pain, pulsatile mass, AAA on film, F/U AAA, trauma, abdominal bruit
What is the other position a patient can be in for an aortic scan?
Decubed; on side
Describe 3 things about the aorta in transverse…
Circular structure
Gradual tapering
Becomes more anterior distally
What is the measurement of the proximal aorta?
2.0-2.6 cm
What is the measurement of the middle aorta?
1.6-2.4 cm
What is the measurement of the distal aorta?
1.1-2.0 cm
What is the measurement of the iliacs?
0.6-1.4 cm
What are the aorta branches?
Phrenic arteries - lateral branch by diaphragm Celiac - 1st anterior branch SMA - 2nd anterior branch Renal arteries - lateral branch IMA - anterior near bifurcation
Name the 5 paired arteries branches of the aorta…
Suprarenal Renal Gonadal Lumbar Common iliacs
Name the 3 unpaired branches of the aorta…
Celiac axis
SMA
IMA
Name 3 anterior branches of the aorta…
Celiac axis
SMA
IMA
Name 2 lateral branches of the aorta…
Renal
Common iliacs
What does the phrenic arteries supply?
The diaphragm
What does the cystic artery supply?
The gallbladder
Th celiac axis originated how many cm below the what?
2 cm below the diaphragm
The celiac axis is superior to what organ?
The pancreas
What does the celiac axis spilt into?
Common hepatic artery
Splenic artery
Left gastric artery
What type of blood flow does the celiac axis have?
Low resistance
Is blood flow in the celiac axis affected by eating?
No
What does the common hepatic artery travels along?
The superior border of the head of the pancreas
What does the common hepatic artery branch into?
The proper hepatic artery (LT/RT hepatic arteries) and the gastroduodenal artery
What organ does the proper hepatic artery enter?
The liver
What organs does the gastroduodenal artery supply?
The pancreas and the duodenum
What is an easy way to find the gastroduodenal artery when scanning?
It is the anterior eye of the worm (pancreas)
What is the circular structure that creates the posterior eye of the worm (pancreas)?
Common bile duct
The common hepatic artery then divides again into what?
The left hepatic artery and right hepatic artery
What does the left hepatic artery supply?
Caudate and left lobe of liver
What does the right hepatic artery supply?
The right lobe and the gallbladder via the cystic artery
The splenic artery is the _________ branch of the celiac axis.
Largest
How does the splenic artery travel out from the celiac axis?
Tortuous course superior and posterior to the body and proximal tail of the pancreas
What does the splenic artery supply?
The spleen, pancreas, and fundus of the stomach
What kind of blood flow is in the splenic artery?
Low resistance
Left gastric artery is the ________ branch of the celiac axis.
Smallest
How does the left gastric artery travel?
Anterior and cephalad
What does the left gastric artery supply?
The stomach and the pylorus
What creates the “seagull” sign when scanning in transverse?
The celiac axis, splenic artery, and common hepatic artery
The superior mesenteric artery is about how far below the celiac axis?
1-2 cm
How does the superior mesenteric artery run?
Parallel to the aorta and posterior to the neck/body of the pancreas
What does the superior mesenteric artery supply?
The small intestine and the proximal colon
What does the superior mesenteric artery look like when scanning longitudinally?
Tubular structure coursing parallel to the anterior aorta
What does the superior mesenteric artery look like when scanning transversely?
Circular structure anterior to the aorta and posterior to the pancreas body
What can you easily see the superior mesenteric artery when scanning?
It has a halo surrounding it; highly reflective echoes
Superior mesenteric artery preprandial has what kind of blood flow?
High resistance flow
Superior mesenteric artery postprandial has what kind of blood flow?
Low resistance blood flow
What does high resistance blood flow look like spectrally?
It will sharply peak then beat back up
What does low resistance blood flow look like spectrally?
It will peak then on the way down it will create a hump
What does the internal carotid supply blood to? What kind of flow is present?
Feeds the brain
Low resistance flow
What does the external carotid supply blood to? What kind of flow is present?
Feeds the face
High resistance flow
What kind of blood flow is present when the stomach is full? How about empty?
Full = low
Empty = high
When dealing with the SMA/IMA, what is intestinal angina?
Medical condition in which lack of blood causes severe chest pains
The inferior mesenteric artery originates how far above the bifurcation?
3-4 cm
How does the inferior mesenteric artery travel and what does it supply?
Inferiorly to supply the descending colon, sigmoid colon, and rectum
What impedes on seeing the inferior mesenteric artery when scanning?
Gas artifacts impede visualization
What kind of blood flow does the inferior mesenteric artery have?
Low resistance
Renal arteries are how far inferior of the SMA?
1-3 cm
The right renal artery travels how?
Posterior to the IVC
Movie star artery
The left renal artery travels how?
Anterior to the psoas muscle
What do the renal arteries supply?
Kidneys, adrenals, ureters
Describe 3 things about the right renal artery…
Longer
Posterior to IVC
Posterior to the vein before entering the hilum
Describe 2 things about the left renal artery…
Shorter
Courses directly to the hilum
Which artery is shorter? Right or left renal artery?
Left renal artery
What is the best way to see the renal arteries?
In transverse and use color Doppler
What kind of blood flow does the renal arteries have?
Low resistance flow
What is stenosis?
Narrowing of the artery
Renal artery stenosis usually mean what?
Hypertension or renal tumor
What is a fistula?
A weird connection between and artery and a vein
Describe 3 things about a renal arteriovenous fistula…
Congenital or acquired
Cluster of tubular structures
Weird connection between an artery and vein
Common iliac arteries can be seen where?
At the bifurcation of the aorta
What is the measurement of the common iliac arteries in transverse?
Less than 1.2 cm
What does the common iliac arteries supply blood to?
Legs and pelvis
Internal iliac supplies?
The pelvis and buttocks
External iliac supplies?
The legs
