Ch. 9 Abdominal Vasculature Flashcards
1
Q
The largest artery in the body originating at the left ventricle of the heart
A
aorta
2
Q
Where does the aorta originate?
A
left ventricle of the heart
3
Q
The subdivision of the aorta within the chest is referred to as
A
thoracic aorta
4
Q
the Aorta retroperitoneal (True or False)
A
True
5
Q
The innermost layer of the aorta closest to the flowing of blood
A
tunica intima
6
Q
The middle, muscular layer of the aorta
A
tunica media
7
Q
The outermost layer of the aorta also called tunica externa
A
tunica adventitia or tunica externa
8
Q
Arteries have a thicker
A
middle layer, tunica media
9
Q
What is the function of the abdominal aorta?
A
Supply blood to abdominal organs, pelvis, and lower extremities
10
Q
Most abdominal aortas have what kind of flow pattern
A
low resistance flow (some have high resistance)
11
Q
The first main visceral branch of the abdominal aorta also
A
celiac trunk (celiac artery/axis)
12
Q
The celiac trunk branches in three arteries
A
splenic artery, common hepatic artery, left gastric artery
13
Q
The common hepatic artery (rt of pt, lt of screen) and splenic artery (lt of pt, rt of screen) combine with the celiac trunk and created what sign
A
seagull sign
14
Q
Normal splenic artery flow
A
low resistance
15
Q
The common hepatic artery branches into what artery at the level of the pancreatic head
A
gastroduodenal artery
16
Q
The flow pattern characterized by persistent forward flow throughout the cardiac cycle
A
low resistance flow
17
Q
the flow pattern that results from small arteries or arterioles that are contracted, which produces an increase in the resistance to blood flow to the structure that is being supplied
A
high resistance flow
18
Q
Most abdominal arteries are considered to have low-resistance flow. True or False?
A
True
19
Q
The __________ artery arises from the anterior aspect of the abdominal aorta, between the crura of the diaphragm.
A
Celiac
20
Q
The second main branch of the abdominal aorta is the:
A
superior mesenteric artery
21
Q
The _______ _______ ______ typically originates along the anterior aspect of the abdominal aorta, just distal to the origin of the celiac trunk
A
Superior mesenteric artery
22
Q
The superior mesenteric artery supplies blood to where?
A
Small intestines, some of the colon, and the pancreas
23
Q
A significant branch of the hepatic artery that supplies blood to the gallbladder
A
cystic artery
24
Q
The SMA will exhibit high resistance flow in fasting, 30-90 mins after meal will have what kind of flow
A
low resistance
25
The third visceral branches of the abdominal aorta are the
paired renal arteries
26
What is the normal flow pattern of suprarenal aorta?
Low resistance flow
27
What is the normal flow pattern in infrarenal aorta?
High resistance flow
28
What is the normal flow pattern for celiac artery?
Low resistance flow
29
What is the normal flow pattern for common hepatic artery? Is it Hepatofugal or Hepatopedal
Low resistance flow; Hepatopedal
30
What is the normal flow pattern for common iliac artery?
High resistance flow
31
What is the normal flow pattern for the splenic artery?
Low resistance flow
32
Renal arteries have what type of flow pattern?
Low resistance flow
33
What is the normal flow pattern of SMA?
Fasting patient = high resistance flow
Postpranial (30-90 min) = low resistance flow
34
The _______ _______ ______ will exhibit high-resistance flow in the fasting patient.
Superior mesenteric artery
35
The SMA will yield to a low-resistance waveform in what condition?
30-90 minutes postprandial
36
What is the third main branch of the abdominal aorta?
Paired renal arteries
37
Which renal artery is longer and why?
RRA, because the aorta is located on the left side of the abdomen
38
The right renal artery originates from the...
Right anterolateral aspect of the aorta and travels posterior to the IVC on its way to the tight renal hilum
39
The left renal artery originates from the...
Left anterolateral aspect of the aorta and travels posterior to the left renal vein as it progresses to the left renal hilum
40
In the sagittal plane, the ________ _______ artery may be identified as an anechoic circle posterior to the IVC
Right renal artery
41
The fourth main branch of the abdominal aorta is
Gonadal arteries
42
__________ arteries arise from the anterior surface of the abdominal aorta, just below the renal artery level
Gonadal arteries
43
What artery supplies blood to the transverse colon, descending colon, and rectum
Inferior Mesenteric Artery (IMA)
44
The ________ _______ artery arises from the anterior surface of the abdominal aorta
Inferior mesenteric artery
45
Normal aorta will be larger in diameter just below the diaphragm and progressively ___ as it approaches the umbilicus
tapers
46
What does the distal aorta bifurcate to?
Right and left common iliac artery
47
In the midabdomen, the aorta will measure _____cm or less
2.0cm
48
Upper limit of abdominal aorta just below the diaphragm
2.5cm in diameter
49
Upper limit of the distal abdominal aorta should not exceed
1.8cm
50
The common iliac arteries should measure typically between ___ to ___mm
8 to 10mm
51
The common iliac artery is considered aneurysmal if it exceeds ___cm
2cm
52
Normally, the spectral waveform of the proximal aorta superior to the abdominal visceral branches is considered _____ _________
Low resistance
53
What type of normal flow does the distal abdominal aorta have?
Typically high resistance
54
Normal spectral waveform in the distal abdominal aorta (infrarenal)
triphasic, high resistant
55
Any dilation of a blood vessel, whether focal or diffuse, is referred to as
Aneurysm
56
An aneurysm can result from the ______ of the vessel wall
Weakening
57
An abdominal aortic aneurysm is present when the diameter of the aorta exceeds in ____cm
3cm
58
What is the most common shape of abdominal aortic aneurysm?
Fusiform aneurysm
59
Enlargement of a vessel that involves all three layers
true aneurysm
60
Most AAAs are what kind of aneurysm
true aneurysm
61
Sudden dilation of a vessel, a sac like dilation of a vessel often spherical and large
saccular aneurysm
62
The most common location of an AAA
distal aorta (infrarenal)
63
What is the most common cause of abdominal aneurysm in the United States?
Atherosclerosis (accumulation of plaque within the walls of the artery)
64
an aneurysm caused by infection
mycotic aneurysm
65
Treatment for an AAA includes open surgery and ___.
endovascular aortic stent graft repair (EVAR) - nonsurgical method for treating AAA
66
___ of the abdominal aorta occurs when there is a separation of the layers of the arterial wall, disturbing the intima.
dissection
67
Those who have ___ are at increased risk for dissection.
Marfan syndrome (disorder of the connective tissue characterized by tall stature and aortic and mitral valve insufficiency)
68
Sonographic visualization of an ___ is indicative of aortic dissection.
intimal flap
69
Rupture of the abdominal aorta has a high
mortality, morbidity rate
70
Aneurysms that measure greater than ___ in diameter are prone to rupture.
7cm
71
Aneurysms in the abdominal aorta have been associated with:
1. Marfan syndrome
2. Syphilis
3. Familial inheritance
4. Infection l
72
Clinical findings of an ________:
1. pulsatile abdominal mass
2. abdominal bruit
3. back pain
4. abdominal pain
5. lower extremity pain
Abdominal Aortic Aneurysm
73
Sonographic findings of an ______:
1. Diameter of the abdominal aorta measures greater than 3 cm
2. Thrombus within the lumen of the aorta
3. Calcifications, along with the thrombus, may produce acoustic shadowing
Abdominal Aortic Aneurysm
74
An abdominal aneurysm with an adjacent ___ is diagnostic for aortic rupture
hematoma
75
This occurs when there is a separation of the layers of the arterial wall, predominantly disturbing the intima
Dissection of the abdominal aorta
76
The sonographic visualization of an _______ _____ is indicative of aortic dissection.
Intimal flap
77
Clinical findings of an ______:
1. intense back pain
2. hypertension
3. abdominal pain
4. lower back pain
5. neurologic symptoms
6. marfan syndrome
Aortic Dissection
78
Sonographic findings of an ______:
1. possible AAA
2. intimal flap may be noted within the aortic lumen
Aortic Dissection
79
Clinical findings of an _______:
1. decreased hematocrit
2. hypotension
3. pulsatile abdominal mass
4. abdominal bruit
5. back pain
6. abdominal pain
7. lower extremity pain
Aortic Rupture
80
Sonographic findings of an ______:
1. abdominal aneurysm with an adjacent hematoma
Aortic Rupture
81
Another term for false aneurysm
Pseudoaneurysm
82
a contained rupture of a blood vessel that is most likely secondary to the disruption of one or more layers of that vessel's wall
false aneurysm (pseudoaneurysm)
83
Pseudoaneurysms may be associated with
infection
84
What is a common site for pseudoaneurysm development?
within groin at level of femoral artery following a heart catherization
85
Sonographic findings of a pseudoaneurysm include a perivascular hematoma that contains swirling blood, producing a ___ sign and has a neck connecting it to the vessel.
ying yang
86
The largest vein in the body, created by union of common iliac veins
IVC
87
IVC is retroperitoneal (True or False)
True
88
Clinical findings of a ________:
1. recent catheterization, surgery or trauma
2. pulsatile mass in area of puncture location
Pseudoaneurysm
89
Sonographic findings of a _______:
1. perivascular hematoma containing swirling blood and has a neck connecting it to the vessel
2. color doppler demonstration of turbulent flow within the mass
Pseudoaneurysm
90
Pseudoaneurysm
The IVC has a smaller amount of smooth muscle within its tunica media compared to the abdominal aorta
91
This vein is considered retroperitoneal and located anterior to the spine and right lateral to the abdominal aorta
IVC
92
What is the primary function of the IVC?
Bring deoxygenated blood from the lower extremities, pelvis, and abdominal organs back to the heart
93
The IVC can be separated into four sections. Name them from superior to inferior:
1. Hepatic
2. Prerenal
3. Renal
4. Postrenal
94
The most superior portion of the IVC, the segment just below the diaphragm, courses posterior to the caudate lobe of the liver and through the bare area
Hepatic veins
95
Within the three hepatic veins (right, middle and left) fan be seen connecting to the _______.
IVC
96
With pulsed Doppler analysis, the hepatic veins will have what type of flow?
Pulsatile, triphasic blood flow pattern secondary association with the right atrium
97
The main venous connection to the IVC, next to the hepatic veins are called
Renal veins
98
______ ____ are derived from the termination of the smaller venous branches within the kidney and travel to the lateral aspect of the IVC.
Renal veins
99
True of False: the left renal vein is much longer than the right renal vein.
True
100
The ________ veins are referred to as the testicular veins for male and ovarian veins from the female
Gonadal veins
101
How is the IVC connected to the gonadal veins?
The right gonadal vein connects to the anterior aspect of the IVC.
102
The left gonadal vein drains to the ______ _____ _____, whereas the right renal vein drains directly to ______ _____ _____.
Left renal vein; inferior vena cava (IVC)
103
The right and left common iliac veins combine to form the _______ near the umbilicus
IVC
104
The diameter of the IVC should never exceed
2.5cm
105
Hepatic veins pulsed doppler
pulsatile, triphasic blood flow pattern
106
What is the most common findings of IVC thrombosis?
enlargement, absent flow, material noted within the lumen
107
With time, thrombus in the IVC would look like...
More echogenic and may even calcify and produce acoustic shadowing
108
Patients with the likelihood of having a pulmonary embolus often require what?
The placement of IVC filter
109
This filter is trap emboli that could be traveling upstream, potentially preventing a pulmonary embolus
IVC filter or Greenfield IVC filter
110
Tumor invasion of the IVC is often associated with
renal cell carcinoma
111
Besides renal cell carcinoma, what other conditions may attack the IVC?
Wilm's tumor and renal transitional cell carcinoma
112
What is the most common cause of IVC enlargement?
right sided heart failure
113
The normal flow pattern of the main portal vein is..
Hepatopetal and monophasic
114
The main portal vein shouldn't exceed in ____mm in diameter
13mm
115
The _______ _______ _____ is created by the union of the superior mesenteric vein and splenic vein
Main portal vein
116
The abnormal connection between arteries and veins is referred to as
Arteriovenous fistulas
117
_________ _____ may result from a simultaneous puncture of a vein and an artery
Arteriovenous fistulas
118
What vessel may attach to the splenic vein before reaching the portal confluence?
IMA
119
Occlusion of the hepatic veins describes
Budd-Chiari syndrome
120
Compression of the LRV between the SMA and the AO
Nutcracker syndrome (renal vein entrapment syndrome)
121
Which of the following section of the hepatic artery is located within the liver hilum?
proper
122
the residual channel of a vessel created by the accumulation of a clot within that vessel
false lumen
123
the true channel within a vessel
true lumen
124
The splenic artery travels superior to the pancreas and can be confused with
main pancreatic duct
125
False aneurysms typically result from
some type of injury or trauma
126
Normal spectral doppler characteristics within the graft (EVAR) are considered
triphasic
127
Most superior portion of the IVC
hepatic veins
128
The IVC terminates at the right
atrium of the heart
129
Blood flow toward the liver
Hepatopedal
130
What flow pattern would be the postprandial SMA yield in small bowel ishemia (interruption or reduction of the blood supply to the small intestines)?
high resistance
