Ch. 9 (Curry) Flashcards
Common iliac veins (right and left)
bilateral veins that empty the lower extremities and pelvis and converge at approx. the level of the umbilicus to form the IVC
Gonadal veins (right and left)
bilateral veins that empty either the testes or ovaries. Superior to the lumbar veins, the right gonadal vein courses parallel to the IVC and empties into its anterolateral aspect of the IVC; the left gonadal vein courses parallel and lateral to the IVC and empties into the left renal vein
Hepatic veins (right, middle, left)
normally three hepatic veins meet at the superior aspect of the liver and empty into the anterior aspect of the IVC. Generally, the right hepatic vein empties the right lobe of the liver, the middle hepatic vein empties the caudate lobe, and the left hepatic vein empties the left lobe of the liver
Inferior phrenic veins
veins that bilaterally drain the diaphragm and empty into the lateral aspect of the IVC. Course in a superior-to-inferior direction
Inferior vena cava (IVC)
a retroperitoneal, tubular structure coursing superiorly from the convergence of the common iliac veins in the lower abdomen, just to the right of the spine, through the abdomen and chest until it reaches the right atrium of the heart. Along its course, it receives multiple tributaries filled with deoxygenated blood from body structures
IVC sections (hepatic, prerenal, renal, postrenal)
the hepatic section is located directly posterior to the liver, where the hepatic veins empty into the IVC. The prerenal section extends from just inferior to the hepatic veins to slightly superior to the renal veins. The renal section includes the renal veins and multiple tributaries. This section terminates almost immediately after the branching of the renal veins. The postrenal section extends from just inferior to the renal veins to the convergence of the common iliac veins.
Suprarenal veins (right and left)
veins that bilaterally empty the adrenal glands. The left suprarenal vein follows a course similar to that of the left renal vein, into which it eventually empties. When the right suprarenal vein does not empty into the right renal vein, it empties directly into the IVC at a level slightly superior to the right renal vein
The IVC is
one of the two great abdominal vessels (the other being the aorta)
The IVC is formed by
the convergence of the common iliac veins
The IVC has ___ sections
4
Name the four sections of the IVC
Hepatic, prerenal, renal, postrenal
Sonographic appearance
anechoic lumen with thin, bright, echogenic walls. Small moving echoes are often noticed within the lumen of the IVC due to the flow of blood within the vessel
Hepatic veins appear
as anechoic linear structures. one often notices a characteristic “bunny ear” or “reindeer sign” pattern
The IVC and its visible branches are primarily evaluated sonographically….
to detect intraluminal thrombosis and tumor invasion
Interventional radiologist
specializes in identification, diagnosis, and endovascular treatment of vascular disorders
Vascular surgeons
specializes in the surgical and endovascular treatment of vascular disorders
Duplex doppler sonography
necessary to ensure at adequate examination. the abdominal venous system displays characteristic Doppler waveforms. A sonographer or vascular technologist performs this exam. A physician, usually a radiology or vascular surgeon, interpret the findings
Color flow doppler
color doppler can often assist in determining flow characteristics in the abdomin and extremities by quickly identifying flow and turbulence. Continuous wave doppler is also helpful in determining the status of extremity veins. The doppler signal is amplified by a loudspeaker, which allows the examiner to hear an audible signal.
Impedance flow plethysmography
Impedence flow plethysmography is the technique of measuring the blood volume change of an area
Venography
Considered by many the gold standard when detecting venous disease. Dye (contrast material) is injected into the target vein and serial radiographs are taken
Computed axial tomography (CT scan)
done to evaluate the abdominal venous system; however it is rarely used to determine the disease state of extremities. This exam consists of a series of sequential radiographs, which are computer-reconstructed to identify various structures. A radiologic tech performs this exam and a radiologist interprets the findings.
Magnetic resonance imaging (MRI)
infrequently called on to evaluate the venous system. Not used to assess the extremity veins. The images are similar in format to those of CT; however the images are generated using a strong magnetic field instead of radiation as in CT. A magnetic resonance imaging tech or radiologic tech performs this exam and a radiologist interprets the exam
Vasculature (Inferior to Superior)
Iliac veins Lumbar Veins Gonadal Veins Renal Veins Hepatic Veins Inferior Phrenic Veins
Renal Veins (Right and Left)
Veins that bilaterally empty the kidneys into the lateral aspect of the IVC. The right renal vein generally empties only the right kidney but sometimes assists the right adrenal gland via the right suprarenal vein. the left renal vein empties the left kidney and is subject to more tributaries than the right renal vein, such as the left gonadal vein, left suprarenal vein, and many smaller tributaries.
