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Ch. 9 Vascular System > Ch. 9 Vascular System > Flashcards

Ch. 9 Vascular System Flashcards

1
Q

Tiny arteries and veins that supply the walls of blood vessels

A

vasa vasorum

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2
Q

Inner layer of the vascular system

A

tunica intima

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3
Q

Minute vessels that connect the arterial and venous systems

A

capillaries

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4
Q

Communication between two blood vessels without any intervening capillary network

A

anastomosis

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5
Q

Outer layer of the vascular system, contains the vasa vasorum

A

tunica adventitia

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6
Q

Middle layer of the vascular system; veins have thinner tunica media than arteries

A

tunica media

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7
Q

Arises from the posterolateral wall of the aorta, travels posterior to the inferior vena cava to supply the kidney, stomach and lower third of the esophagus

A

left gastric artery

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8
Q

Supplies the gallbladder via the cystic artery

A

right hepatic artery

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9
Q

Vascular structures that carry blood away from the heart

A

arteries

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10
Q

Arises from the celiac trunk to supply the liver

A

common hepatic artery

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11
Q

Supplies the stomach

A

right gastric artery

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12
Q

Branch of the common hepatic artery that supplies the stomach and duodenum

A

gastroduodenal artery

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13
Q

Arises inferior to the celiac axis to supply the proximal half of the colon and the small intestine

A

superior mesenteric artery

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14
Q

The abdominal aorta bifurcates at the level of the umbilicus into these, which supply blood to the lower extremities

A

common iliac arteries

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15
Q

Arises from the anterior aortic wall at the level of the third or fourth lumbar vertebra to supply the left transverse colon, descending colon, sigmoid colon, and rectum

A

inferior mesenteric artery

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16
Q

Arises from the posterolateral wall of the aorta directly into the hilus of the kidney

A

left renal artery

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17
Q

Largest arterial structure in the body; arises from the left ventricle to supply blood to the head, upper and lower extremities, and abdominopelvic cavity

A

aorta

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18
Q

Small branch supplying the caudate and left lobes of the liver

A

left hepatic artery

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19
Q

Arises from the celiac axis to supply the spleen, pancreas, stomach, and greater omentum

A

splenic artery

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20
Q

Drains the spleen; travels horizontally across abdomen (posterior to the pancreas) to join the superior mesenteric vein to form the portal vein

A

splenic vein

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21
Q

Collapsible vascular structures that carry blood back to the heart

A

veins

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22
Q

Formed by the union of the superior mesenteric vein and splenic vein near the porta hepatis of the liver

A

portal vein

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23
Q

Drains the left third of the colon and upper colon and joins the splenic vein

A

inferior mesenteric vein

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24
Q

Drains the proximal half of the colon and small intestine travels vertically (anterior to the inferior vena cava) to join the splenic vein to form the portal veins

A

superior mesenteric vein

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25
Q

Three large veins that drain the liver and empty into the inferior vena cava at the level of the diaphragm

A

hepatic veins

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26
Q

Leaves the renal hilum, travels anterior to the aorta and posterior to the superior mesenteric artery to enter the lateral wall of the inferior vena cava

A

left renal vein

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27
Q

Largest venous abdominal vessel that conveys blood from the body below the diaphragm to the right atrium of the heart

A

inferior vena cava

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28
Q

Leaves the renal hilum to enter the lateral wall of the inferior vena cava

A

right renal vein

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29
Q

Disease of the arterial vessels marked by thickening, hardening, and loss of elasticity in the arterial walls

A

arteriosclerosis

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30
Q

Condition in which the aortic wall becomes irregular from plaque formation

A

atherosclerosis

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31
Q

Tear in the intima or media of the abdominal aorta

A

dissecting aneurysm

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32
Q

Permanent localized dilation of an artery, with an increase of 1.5 times its normal diameter

A

aneurysm

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33
Q

Periportal collateral channels in patients with chronic portal vein obstruction

A

cavernous transformation of the portal vein

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34
Q

Circumferential enlargement of a vessel with tapering of both ends

A

fusiform aneurysm

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35
Q

Weakening of the arterial wall

A

cystic medial necrosis

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36
Q

Pulsatile hematoma that results from leakage of blood into soft tissue abutting the punctured artery with fibrous encapsulation and failure of the vessel wall to heal

A

pseudoaneurysm

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37
Q

Transjugular intrahepatic portosystemic shunt

A

TIPS

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38
Q

Most commonly results from intrinsic liver disease; however, also results from obstruction of the portal vein, hepatic veins, inferior vena cava, or prolonged congestive heart failure; may cause flow reversal to the liver, thrombosis of the portal system, or cavernous transformation of the portal vein

A

portal venous hypertension

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39
Q

Communication between an artery and a vein

A

arteriovenous fistula

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40
Q

Localized dilation of the vessel

A

saccular aneurysm

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41
Q

Thrombosis of the hepatic veins

A

Budd-Chiari syndrome

42
Q

Hereditary disorder of connective tissue, bones, muscles, ligaments, and skeletal structures

A

Marfan syndrome

43
Q

Permanent dilation of the artery that forms when tensile strength of the arterial wall decreases

A

true aneurysm

44
Q

Vessels that have high diastolic component and supply organs that need constant perfusion (i.e., internal carotid artery, hepatic artery, and renal artery)

A

nonresistive

45
Q

Flow toward the liver

A

hepatopetal

46
Q

Peak systole minus peak diastole divided by peak systole

A

resistive index

47
Q

Flow away from the liver

A

hepatofugal

48
Q

Vessels that have little or reversed flow in diastole and supply organs that do not need a constand blood supply (i.e., external carotid artery and brachial arteries)

A

resistive

49
Q

Increased turbulence is seen within the spectral tracing that indicates flow disturbance

A

spectral broadening

50
Q

Sonographer selects the exact site to record Doppler signals and sets the sample volume (gate) at this site

A

Doppler sample volume

51
Q

The root of the aorta arises from the left __________ outflow tract in the heart.

A

left ventricular

52
Q

The __________ passes anterior to the third part of the duodenum and posterior to the neck of the pancreas, where it joins the splenic vein to form the main portal vein.

A

SMV

53
Q

The __________ supplies the gallbladder via the cystic artery and the liver.

A

right hepatic artery

54
Q

The aorta continues to flow in the __________ cavity anterior and slightly __________ of the vertebral column.

A

retroperitoneal, left

55
Q

The __________ trunk is the first anterior branch of the aorta, arising 1 to 2 cm inferior to the diaphragm.

A

celiac

56
Q

The __________ flows from the kidney posterior to the superior mesenteric artery and anterior to the aorta to enter the lateral wall of the inferior vena cava.

A

left renal vein

57
Q

The diameter of the abdominal aorta measures approximately __________ cm, tapering to __________ cm after it proceeds inferiorly to the bifurcation into the iliac arteries.

A

2-3, 1-1.5

58
Q

The __________ is the second anterior branch, arising approximately 2 cm from the celiac trunk.

A

SMA

59
Q

Portal veins become __________ as they progress into the liver from the porta hepatis.

A

smaller

60
Q

The __________ courses from the aorta posterior to the inferior vena cava and anterior to the vertebral column in a posterior and slightly caudal direction to enter the hilum of the kidney.

A

right renal artery

61
Q

The __________ courses along the upper border of the head of the pancreas, behind the posterior layer of the peritoneal bursa, to the upper margin of the superior part of the duodenum, which forms the lower boundary of the epiploic foramen.

A

gastroduodenal artery

62
Q

Three arterial branches arise from the superior border of the aortic arch to supply the head, neck, and upper extremities: the __________, __________, and __________.

A

brachiocephalic, left common carotid, left subclavian arteries

63
Q

The __________ is formed posterior to the pancreas by the union of the superior mesenteric vein and splenic veins at the level of L2.

A

portal vein

64
Q

The __________ artery takes a somewhat tortuous course horizontally to the left as it forms the superior border of the pancreas.

A

splenic

65
Q

The portion of the femoral artery posterior to the knee is the __________.

A

popliteal artery

66
Q

The __________ originate in the liver and drain into the inferior vena cava at the level of the diaphragm.

A

hepatic veins

67
Q

List the five sections into which the aorta is divided.

A 
root of the aorta
ascending aorta
descending aorta
abdominal aorta
bifurcation of the aorta into iliac arteries
68
Q

Describe the specific differences between arteries and veins.

A

Arteries are hollow elastic tubes that carry blood away from the heart. They are enclosed within a sheath that includes a vein and a nerve. The smaller arteries contain less elastic tissue and more smooth muscle than the larger arteries. Veins are hollow, collapsible tubes with a diminished tunica media that carry the blood toward the heart. Veins have a larger total diameter than the arteries, and they move blood more slowly.

69
Q

List the four branches of the aorta that supply other visceral organs and the mesentery.

A

celiac trunk
superior mesenteric artery
inferior mesenteric artery
renal arteries

70
Q

Describe the function of the circulatory system.

A

transport gases, nutrient materials, and other important substances to the tissues and subsequently transport waste products from the cells to appropriate sites for excretion

71
Q

List the characteristics of a vein.

A

The veins contain special valves that prevent backflow and permit blood to only flow in one direction–toward the heart. Numerous valves are found within the extremities, especially lower, because flow must work against gravity. Venous return is also aided by muscle contraction, overflow from capillary beds, gravity, and suction from negative thoracic pressure.

72
Q

Describe how blood is transported from the artery and returned by the veins.

A

Blood is transported away from the heart by arteries and back to the heart by veins. Arteries divide into progressively smaller branches (smallest = arterioles). These lead to capillaries, where exchange of materials where blood and tissue fluids take place. It is then collected in small veins or venules. These unite to form larger vessels that return the blood to the heart for recirculation.

73
Q

Define capillaries and describe their function.

A

They are minute, hair-sized vessels connecting the arterial and venous system. Their walls have only 1 layer. Cells and tissues of the body receive their nutrients from fluids passing through capillary walls. Waste products from cells pass into capillaries. Arteries do not always end in capillary beds; some end in anastomoses.

74
Q

Describe how Doppler is used to distinguish the presence or absence of flow in a vessel form nonvascular structures.

A

Bile duct vs. hepatic artery: look for absence of flow in duct
hepatic vs. splenic artery: direction of flow
aneurysm vs. pancreatic pseudocyst: slow flow in aneurysm
Dilated intrahepatic bile ducts vs. prominent hepatic artery: absence of flow in bile duct

75
Q

A flow disturbance (increased velocity or obstruction of flow) may result from the formation of an atheroma, AV fistula, __________, or aneurysmal dilation.

A

pseudoaneurysm

76
Q

Describe the technique that should be used to image the inferior vena cava.

A

The patient should be instructed to hold his/her breath, causing a slight Valsalva maneuver toward the end of inspiration, dilaating the IVC. The diameter of the IVC may expand 3-4 cm with this maneuver.

77
Q

Nonresistive vessels have a high __________ component and supply organs that need constant perfusion, such as the internal carotid artery, the hepatic artery, and the renal artery.

A

diastolic

78
Q

Resistive vessels have very little or even reversed flow in diastole and supply organs that do not need a constant blood supply, such as the __________ carotid and the iliac and brachial arteries.

A

external

79
Q

Explain how to differentiate the inferior vena cava from the aorta.

A

The pulsatile aorta is easily differentiated from the IVC because the IVC travels in a horizontal course with its proximal portion curving slightly anterior as it pierces the diaphragm to empty into the right arterial cavity. The aorta follows the curvature of the spine, with its distal portion lying more posterior, before bifurcating into the iliac veins.

80
Q

__________ is a pattern of blood flow, typically seen in large arteries, in which most cells are moving at the same velocity across the entire diameter of the vessel. In other vessels the different velocities are the result of friction between the cells and arterial walls.

A

plug flow

81
Q

Doppler only records accurate velocity patterns when the beam is __________ to the flow.

A

parallel

82
Q

The flow pattern of the proximal abdominal aorta above the renal arteries shows a high __________ peak and a relatively low __________ component.

A

systolic, diastolic

83
Q

The main renal artery has a(n) __________ impedance (nonresistive) pattern with significant diastolic flow–usually 30% to 50% of peak systole.

A

low

84
Q

During rejection, the vascular impedance __________, resulting in a decrease or even reversal of the diastolic flow.

A

increases

85
Q

The portal vein shows a relatively __________ flow at low velocities, which may vary slightly with respirations.

A

continuous

86
Q

Cavernous transformation of the portal vein demonstrates __________ collateral channels in patients with chronic portal vein obstruction.

A

periportal

87
Q

With a recanalized __________ vein, the main portal vein and the left portal vein show normal flow, but the flow in the right portal vein is reversed.

A

umbilical

88
Q

Describe the effect of gain settings when performing an abdominal aortic ultrasound.

A

A low-medium gain should be used to demonstrate the walls of the aorta without “noisy” artifactual echoes. These weak echoes may result from increased gain reverberation from the anterior abdominal wall fat or musculature or poor lateral resolution. These factors result in echoes being recorded at the same level as those from soft tissues that surround the vessel lumen, particularly if the vessels are smaller in diameter than the transducer.

89
Q

The most common causes of aneurysms are __________ and __________.

A

arteriosclerosis, artherosclerosis

90
Q

The large aneurysm may rupture into the pritoneal cavity or retroperitoneum, causing __________ and a drop in __________.

A

intense back pain, hematocrit

91
Q

The normal measurement for an adult abdominal aorta is less than 3cm, measuring from __________ to __________ walls.

A

outer, outer

92
Q

Thrombus usually occurs along the __________ or __________ wall.

A

anterior, anterolateral

93
Q

A(n) __________ is a pulsatile hematoma that results from the leakage of blood into the soft tissue abutting the punctured artery, with subsequent fibrous encapsulation and failure of the vessel wall defect to heal.

A

pseudoaneurysm

94
Q

What are the clinical findings in a patient with a dissecting aneurysm.

A

Typical: 40-60 hypertensive males; aneurysm and sudden excruciating chest pain radiating to the back; shock; slow-leak = same symptoms but stable

95
Q

Describe the three locations where a dissection of the aorta may occur.

A

Type I: root of aorta and may extend the entire length of the arch, descending to the aorta and into the abdominal aorta
Type II: stretching in all arterial walls, especially in the aorta, resulting in dilation and weakened walls
Type III: lower end of descending aorta and extends into abdominal aorta

96
Q

Describe other pseudopulsatile abdominal masses that may simulate an aortic aneurysm.

A

Other Masses: retroperitoneal tumors, fibroid uterus, and para-aortic nodes.
Because the mass is adjacent to the aorta, pulsations are transmitted from aorta to the mass. After an abdominal aneurysm, the most common cause for pulsatile abdominal mass is enlarged retroperitoneal lymph nodes.

97
Q

In patients with right ventricular failure, the inferior vena cava does not collapse with __________.

A

expiration

98
Q

Describe the complications of inferior vena caval thrombosis.

A

Complete thrombosis of the IVC is life threatening. Patients present with leg edema, low back pain, pelvic pain, gastrointestinal complaints, and renal and liver abnormalities.

99
Q

The most common origin of pulmonary emboli is venous thrombosis from the __________ extremities.

A

lower

100
Q

An elderly male presents with a pulsatile abdominal mass. What does this longitudinal image of the abdomen demonstrate?

A

large abdominal aortic aneurysm with thrombus along the anterior and posterior borders; lumen of vessel is anechoic

101
Q

How can the sonographer determine that the inferior vena cava is dilated?

A

If the IVC measures greater than 2cm and does not show collapse with expiration, it is enlarged.

102
Q

What abnormality is demonstrated in this image?

A

thrombus in the IVC

Ch. 9 Vascular System (1 decks)

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