Ch. 12,14,16 Flashcards by Destiny S

The portal vein is formed by the confluence of which two veins?

a. Splenic, superior mesenteric vein
b. Celiac, duodenal
c. Hepatic, IVC
d. Inferior mesenteric, renal

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The celiac and hepatic arteries should normally exhibit a __________ waveform pattern.

a. High resistance
b. Low resistance
c. Monophasic
d. Respiratory

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What relationship does the right renal artery (RRA) have to the inferior vena cava (IVC)?

a. RRA passes transverse to the IVC
b. RRA passes anterior to the IVC
c. RRA passes superior to the IVC
d. RRA passes posterior to the IVC

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Flow direction into the liver is called:

a. Hepatopetal flow
b. Hepatofugal flow
c. High resistant flow
d. Collateral flow

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Which of the following is the first branch off the abdominal aorta?

a. Celiac axis
b. Renal artery
c. Superior mesenteric artery
d. Common iliac artery

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Which of the following is the threshold for an abnormal renal artery to aortic ratio (RAR)?

a. 1.5
b. 2.0
c. 2.5
d. 3.5

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What happens to the Doppler waveform in the celiac axis when the patient eats?

a. Remains the same
b. Demonstrates a decrease in systolic velocity
c. Demonstrates an increase in systolic velocity
d. Demonstrates a decrease in diastolic velocity

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Abdominal pain that develops 15-30 minutes after eating is sometimes called “fear of food” syndrome. Which of the following is a possible cause?

a. Cardiac angina
b. Nutcracker syndrome
c. Mesenteric ischemia
d. Budd Chiari syndrome

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A tardus parvus waveform in a segmental renal artery suggests what condition?

a. Renal parenchymal disease
b. Coarctation of the aorta
c. Stenosis or occlusion of the main renal artery
d. Renal vein thrombosis

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Renal fibromuscular dysplasia (FMD) usually occurs in what vessel segment?

a. At the origin if the main renal arteries
b. In the segmental arteries
c. In the interlobar arteries
d. In the mid to distal main renal artery

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Which of the items below describes the course of the left renal vein.

a. Posterior to the celiac axis and anterior to the aorta to enter the IVC

b. Anterior to the SMA and inferior tothe aorta to enter the IVC

c. Posterior to the SMA and anterior to the aorta to enter the IVC

d. Lateral to the SMA and medial to the aorta to enter the IVC

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A normal Doppler signal in the SMA postprandial should be:

a. A low resistance waveform

b. A high resistance waveform with a peak systolic velocity of 220 cm/sec

c. A low resistance waveform with a peak systolic velocity of 250 cm/sec

d. A high resistance waveform

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Which of the following is not a cause of portal hypertension?

a. Thrombosis of the portal vein
b. Hepatic artery stenosis
c. IVC obstruction
d. Hepatic fibrosis

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What is the criteria threshold for an SMA > 70% stenosis?

a. PSV of 180 cm/sec
b. EDV of 50 cm/sec
c. PSV of 220 cm/sec
d. PSV of 275 cm/sec

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At what dimension point does the portal vein size become abnormal?

a. 5 mm
b. 8 mm
c. 13 mm
d. 16 mm

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Budd-Chiari Syndrome is a set of clinical symptoms caused by which of the following?

a. Renal artery occlusion
b. Thrombosis of the portal vein
c. Compression of the celiac artery
d. Thrombosed hepatic vein

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The lie of the aorta within the body is
a) midsagittal
b) superior to inferior
c) transverse oblique
d) transverse

superior to inferior

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the long axis of the aorta is visualized best in a
a) sagittal or coronal scanning plane
b) transverse scanning plane
c) axial section
d) right lateral decubitus position

sagittal or coronal scanning plane

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longitudinal views of the splenic artery and common hepatic artery are seen in a
a) sagittal or coronal scanning plane
b) transverse scanning plane
c) sagittal scanning plane
d) coronal section

transverse scanning plane

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axial views of the SMA are seen in a
a) sagittal or coronal scanning plane
b) transverse scanning plane
c) sagittal scanning plane
d) longitudinal section

transverse scanning plane

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longitudinal views of the renal arteries are seen in a
a) sagittal or coronal scanning plane
b) transverse scanning plane
c) sagittal scanning plane
d) sagittal section

transverse scanning plane

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the size of the aorta is normal up to

3cm

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the proximal abdominal aorta is the portion
a) between the diaphragm and the CA trunk
b) between the diaphragm and the caudate lobe of the liver
c) just inferior to the CA trunk
d) that ascends from the heart

between the diaphragm and CA trunk

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the mid portion of the abdominal aorta is
A) between the diaphragm and CA trunk
B) inferior to the celiac trunk and along the length of the SMA
C) between the CA trunk and IMA
D) between the CA trunk and SMA trunk

inferior to the celiac trunk and along the length of the SMA

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Beginning posteriorly, and in correct order by the location in the body, the abdominal aorta is a) to the left of the spine, posterior to the splenic and common hepatic arteries, the SMA, splenic vein, the tail of the pancreas, left lobe of the liver b) anterior and just to the left of the spine, posterior to the gastroesophageal junction, CA, SMA, splenic vein, the body of the pancreas, a portion of the stomach, left lobe of the liver c)Anterior to the spine, posterior to the gastroesophageal junction, splenic vein, body of the pancreas, portion of the stomach, lefft lobe of the liver d) anterior to the spine and kidneys, posterior to the gastroesphageal junction, splenic vein, body of the pancreas, portion of the stomach, left lobe of the liver

anterior and just to the left of the spine , posterior to the gastroesophageal junction, CA, SMA, splenic vein, body of the pancreas, portion of the stomach, left lobe of the liver

the distal abdominal aorta is the portion a) that lies between the renal arteries ad the IMA b) inferior to the SMA trunk and superior to the bifurcation c) posterior to the head of the pancreas d) the bifurcation

inferior to the SMA trunk and superior to the bifurcation

the aorta is posterior to all of the following except the a) left renal vein b) SMA c) esophageal gastric junction d) pancreas head

pancreas head

a(n) __________ section of the RRA is seen_____________ a) axial, in transverse scanning plane between axial sections of the SMA and IVC b) longitudinal, in a transverse scanning plane posterior to an axial section of the IVC and longitudinal section of the right renal vein c) axial, in a sagittal scanning plane between axial sections of the SMA and aorta d) longitudinal, in a transverse scanning plane posterior to the SMA

longitudinal, in transverse scanning plane posterior to an axial section of the IVC and longitudinal section of the right renal vein.

which of the following is not a direct branch of the abdominal aorta a) celiac trunk b) renal artery c) mesenteric artery d) external iliac artery

external iliac artery

what is the most common location of an abdominal aortic aneurysm

infrarenal

the biggest risk factor for rupture of an abdominal aortic aneurysm is

size

The lie of the IVC within the body is a) midsagittal. b) superior to inferior. c) oblique. d) transverse

superior to inferior

The long axis of the IVC is seen from a a) sagittal or coronal scanning plane. b) transverse scanning plane. c) axial section. d) left lateral decubitus position.

sagittal or coronal scanning plane

Longitudinal views of the renal vein tributaries are seen in a a) sagittal or coronal scanning plane. b) transverse scanning plane. c) midsagittal plane. d) longitudinal section

transverse scanning plane

Axial views of the renal vein tributaries are seen in a a) sagittal or coronal scanning plane. b) transverse scanning plane. c) midsagittal plane. d) longitudinal section.

sagittal or coronal scanning plane

The IVC a) tributaries include the splenic vein. b) tributaries include the splenic vein and superior mesenteric vein. c) passes through a deep fossa on the inferior surface of the liver at the level where it is anterior to the left renal artery. d) passes through a deep fossa on the posterior surface of the liver between the caudate lobe and bare area.

passes through a deep fossa on the posterior surface of the liver between the caudate lobe and bare area

The size of the IVC is normal up to

4 cm

The proximal IVC is the portion a) that extends superiorly from the common iliac veins to just below the level of the renal veins. b) adjacent to the diaphragm and posterior to the body of the liver. c) posterior to the head of the pancreas at the level of the renal veins. d) that enters the heart.

that extends superiorly from the common iliac veins to just below the level of the renal veins

The mid portion of the IVC is a) the portion that extends superiorly from the common iliac veins to just below the level of the renal veins b) adjacent to the diaphragm and posterior to the body of the liver. c) posterior to the head of the pancreas at the level of the renal veins. d) the portion that enters the heart.

posterior to the head of the pancreas at the level of the renal veins

The distal IVC is the portion a) that extends superiorly from the common iliac veins to just below the level of the renal veins. b) that extends superior to the renal veins to the right atrium of the heart. c) posterior to the head of the pancreas at the level of the renal veins. d) just superior to the common iliac veins.

that extends superior to the renal to the right atrium of the heart

Beginning posteriorly, and in correct order by location in the body, the IVC is a) just to the right of and at the same level as the spine, posterior to the splenic and common hepatic arteries, body of the pancreas, right lobe of the liver. b) anterior and just to the right of the spine, anterior to the right renal artery, posterior to the head of the pancreas, gastroduodenal artery, portal splenic confluence, and the liver. c) anterior to the spine, posterior to the gastroesophageal junction, splenic vein, head of the pancreas, portion of the duodenum, right lobe of the liver. d) anterior to the spine and kidneys, posterior to the gastroesophageal junction, splenic vein, head of the pancreas, portion of the duodenum, right lobe of the liver. b) anterior and just to the right of the spine, anterior to the right renal artery, posterior to the head of the pancreas, gastroduodenal artery, portal splenic confluence, and the liver.

anterior and just to the right of the spine, anterior to the RRA, posterior to the head of the pancreas, gastroduodenal artery, portal splenic confluence, and the liver

The left renal vein has a ________________ course compared with the right renal vein. a) identical b) shorter c) wider d) longer

longer

All of the following are IVC tributaries except the a) hepatic veins. b) right renal vein. c) superior mesenteric vein. d) left renal vein.

superior mesenteric vein

The primary function of the IVC is to a) carry deoxygenated blood from the heart. b) serve as a lymph drainage channel. c) carry deoxygenated blood to the heart. d) regulate metabolism

carry deoxygenated blood to the heart

The right and left common iliac veins are ______________ the right and left common iliac arteries a) posterior to b) anterior to c) wider than d) longer than

posterior to

The IVC is medial to all of the following except the: a) right adrenal gland b) caudate lobe c) right kidney d) right ureter

caudate lobe

The IVC is anterior to all of the following except the: a) transverse duodenum b) right crus of the diaphragm c) right adrenal gland d) psoas major muscle

transverse duodenum

The IVC is right lateral to all of the following except the: a) aorta b) caudate lobe c) left renal vein d) portal splenic confluence

caudate lobe

The IVC is posterior to all of the following except the: a) uncinate process b) spine c) hepatic veins d) common bile duct

spine

The IVC passes through a deep fossa on the posterior surface of the liver between the ___________________ and _________________. a) caudate lobe and gallbladder fossa b) spine and right lateral lobe c) caudate lobe and bare area d) bare area and diaphragm

caudate lobe and bare area

Normally, the diameter of the IVC will _______________ during the Valsalva maneuver or inspiration. a) decrease b) increase c) collapse d) stay the same

increase

The orientation of the IVC within the body is a) vertical oblique. b) vertical. c) oblique. d) horizontal.

vertical

Which of the following vessels runs posterior to the IVC? a) left renal vein b) right hepatic artery c) right renal artery d) left renal artery

right renal artery

The IVC lies along the posterior surface of what lobe of the liver? a) left b) caudate c) quadrate d) anterior segment of the right

caudate

The long axis of the gallbladder is visualized in A) a transverse scanning plane B) either transverse, sagittal, or coronal scanning planes depending on its position C) a sagittal scanning plane D) longitudinal scanning planes

either transverse, sagittal, or coronal scanning planes depending of its position

What can help in the evaluation of the retroduodenal portion of the CBD? A) use water to displace the bowel gas B) glucagon C) intercostal, left lateral decubitus approach D) use a sharp transducer angle right laterally from the midline

use water to displace the bowel gas

In a sagittal plane at the level of the porta hepatis the portal vein will be A) seen in long axis B) seen in short axis C) anterior to the common duct D) anterior to the hepatic artery

seen in short axis

Different patient positions are used when evaluating the gallbladder because A) it distinguishes certain abnormalities from each other B) single position evaluation is not enough confirmation C) of the variability of the position of the gallbladder D) it unfolds the gallbladder

it distinguishes certain abnormalities from each other

______________ describes a folded gallbladder fundus. A) segmental contraction B) santorini's fold C) biliary bend D) phrygian cap

Phrygian cap

The long axis view of the common duct is seen A) in an oblique sagittal scanning plane B) in an oblique transverse scanning plane C) posterior to the long axis of the hepatic artery D) posterior to the axial sections of the portal vein

in an oblique sagittal scanning plane

The gallbladder tends to lie in the A) retroperitoneum B) midepigastrium C) area between the right medial angle of the ribs and the superior pole of the right kidney D) area just inferior to the level of the costal margin

area between the right medial angle of the ribs and the superior pole of the right kidney

The CBD is located to the hepatic artery A) left lateral B) right lateral C) inferomedially D) posterior

right lateral

The cystic duct connects the A) common hepatic and CBD's B) common duct and pancreatic duct C) common duct and gallbladder neck D) gallbladder neck and body

common duct and the gallbladder neck

The sprial valve A) closes when the gallbladder is full of bile B) regulates the flow of bile from the gallbladder C) is the tortuous connection of the gallbladder and cystic duct D) is the tortuous connection of the gallbladder and common duct

is the tortuous connection of the gallbladder and cystic duct

The proximal portion of the common duct is A) called the CBD B) appears traversed when viewed at the level of the porta hepatis in a sagittal plane C) called the CHD D) appears traversed when viewed at the level of the pancreas head in a sagittal scanning plane

the CHD

The distal portion of the common duct is A) called the CBD B) appears traversed when viewed at the level of the porta hepatis in a sagittal plane C) called the CHD D) appears traversed when viewed at the level of the pancreas head in a sagittal scanning plane

the CBD

The common duct usually lies at a right angle to the costal margin

True

The gallbladder serves as a storage site for bile and is variable in size according to the amount of bile it is storing.

True

The CHD is considered normal in size up to

4mm

What is the normal diameter of the gallbladder wall?

< 3mm

The gallbladder is described in three major sections:

neck, body, fundus

The biliary system has three main functions:

1) transport bile to the gallbladder 2) store bile 3) transport bile to aid in digestion of fat

The biliary ducts are subdivided into intrahepatic and extrahepatic ducts?

True

Intrahepatic bile ducts are not routinely visualized on ultrasoun?

True

The gallbladder is an intraperitoneal organ?

True

The most common vein used for "in situ" bypass grafts is: A. Small saphenous vein. B. Popliteal vein. C. Basilic vein. D. Great saphenous vein.

Which of the following is NOT a potential complication of a reversed femoro-popliteal vein graft? A. Neointimal hyperplasia B. Graft aneurysm C. Fistula via non-ligated perforator vein D. Graft kink

What is the minimum diameter of the great saphenous vein considered to be appropriate for a successful in situ bypass? A. 1.0 mm B. 1.5 mm C. 2.0 mm D. 2.5 mm

The radial artery terminates in which vessel? A. Palmar arch B. Ulnar artery C. Brachial artery D. Interosseous artery

In which bypass graft procedure is a valvulotome used? A. In situ vein bypass B. Radial artery harvest C. Reversed vein bypass D. Aorto-bifemoral

During arterial mapping of the radial artery, you should do all of the following except: A. Determine if there is a calcified wall. B. Measure the peak systolic velocities proximal and distal. C. Perform reactive hyperemia on the arm. D. Measure the diameter of the vessel.

A hyperemic waveform existing in the posterior tibial artery 3 weeks status-post a femoral to distal vein bypass is most likely due to which of these conditions? A. Graft occlusion. B. Vasoconstriction. C. Graft stenosis. D. Chronic vasodilation.

What is the most common cause of in situ vein bypass graft stenosis? A. Atherosclerosis. B. Intimal hyperplasia C. Collagen vascular disease. D. Arteritis.

A photoplethysmography (PPG) tracing on the 5th hand digit (small finger) that goes from normal to "flat-line" with radial artery compression indicates which of the following? A. Patient has ulnar artery perfusion dominance. B. Patient has radial artery dominance. C. Patient has a radial artery stenosis. D. Patient has disease in the digital arteries.

A potential complication of an endovascular aneurysm repair (EVAR) is back-bleeding into the aneurysm sac from the IMA or lumbar arteries. This endoleak is classified as which of the following types. A. Type I B. Type II C. Type III D. Type IV

which of the following best describes the Brescia-Cimino procedure? A. A brachial artery to median cubital vein fistula. B. A straight Teflon graft from radial artery to the basilic vein. C. A radial artery to cephalic vein fistula. D. An indwelling hemodialysis catheter.

a radial artery to cephalic vein fistula

in a patient with a hemodialysis access forearm loop graft, digital ischemia can result from which of the following conditions? A. Thrombosed hemodialysis access graft. B. Incomplete palmar arch. C. Pseudoaneurysm. D. Venous outflow obstruction.

incomplete palmar arch

which of the following veins does not have an accompanying artery

basilic

what is considered to be the lowest vein diameter suitable for an arterial to venous hemodialysis fistula? A. 1.5 mm B. 2.0 mm C. 2.5 mm D. 2.0 cm

2.5mm

which of he following grafts is impenetrable by ultrasound? A. Gore-tex B. Bovine C. Atrium D. Vectra

vectra

reversed flow detected in the distal radial artery of an ipsilateral radial artery to basilic vein graft indicates which of the following conditions? A. Impending graft failure. B. Occluded ulnar artery. C. Incompetent palmar arch. D. Patent palmar arch.

patent palmar arch

which of the following vessels is not usually used hemodialysis access grafts of fistulas? A. Cephalic vein B. Brachial vein C. Basilic vein D. Median cubital vein.

brachial vein

antegrade, traphasic flow in a radial artery distal to a brachilic artery to basilic vein loop hemodalysis access graft indicates which of the following ? A. Normal radial artery flow. B. Venous outflow obstruction. C. Pseudoaneurysm at anastomosis. D. Graft failure.

normal radial artery flow

which access graft does not require maturation time A. Vectra (polyurethane) B. Gore-tex C. Atrium D. Impra PTFE

vectra (polyurethane)

antaegrade, triphasic flow in a brachial artery proximal to a radial artery to basilic vein hemodialysis access graft indicates which of the following? A. Normal radial artery flow. B. Venous outflow obstruction. C. Pseudoaneurysm at anastomosis. D. Graft failure.

graft failure