Ch.8 Vascular Flashcards
Tiny vessels that connect most arteries and veins
capillaries
What carries blood away from the heart
arteries
What carries blood toward the heart
veins
smallest arterial branches
arterioles
smallest venous branches
venuoles
layers of vessel wall
tunica intima
tunica media
tunica adventitia
What layer is the tunica intima and what tissues is it made of
first layer
endothelial cells
connective tissue
elastic fibers
What layer is the tunica media and what tissue is it made of
second layer
smooth muscle fibers
elastic tissue
collagenous tissue
What layer is the tunica adventitia and what tissue is it made of
third layer
loose connective tissue
bundles of smooth muscle
elastic tissue
Artery of Vein: Thicker Tunica Media
Artery
Artery of Vein: Larger diameter
vein
Artery of Vein: More Pulsatile
artery
Artery of Vein: Collapsible tubes
vein
Artery of Vein: Valves prevent backflow of blood
vein
Artery of Vein: Faster blood flow
artery
Artery of Vein: Thinner Tunica Media
vein
Artery of Vein: Aided by skeletal muscle contractions
vein
The 3 branches that arise from the aortic aarch are
innominate (right brachiocephalic)
left common carotid artery
left subclavian artery
List the 4 major branches of the abdominal aorta
celiac axis
superior mesenteric artery
renal arteries
inferior mesenteric artery
Anteriorly or Laterally: celiac axis
anterior
Anteriorly or Laterally: superior mesenteric artery
anterior
Anteriorly or Laterally: renal arteries
lateral
Anteriorly or Laterally: inferior mesenteric artery
anterior
The aorta bifurcates into the
right/left common illiac arterieds
The common illiac arteries divide into
internal and external iliac arteries
List the 5 sections of the aorta
Aortic root Ascending Aorta Descending Aorta Abdominal Aorta Bifurcation
Ultrasound of the aorta is usually used to assess
aortic diameter aortic aneurysm possible thrombus calcification of aortic wall dissection
What pathology is most commonly assessed with ultrasound
aortic aneurysm
Define aortic ectasia
absence of the normal tapering of the aorta distally
How does the aorta run un relation to the Inferior Vena Cava
left
Where does the vena cava cross? What part of the heart does it enter
diaphragm
right atrium
The IVC should be evaluated for what abnormality
thrombus
How does having the patient hold their breath change the size of the IVC?
causes it to dilate
Dilation of the IVC may be an indication of what disease processes
heart problems of the right side
In transverse plane, the celiac axis forms what sign
seagull
The second anterior abdominal aortic branch is the
superior mesenteric artery
If the angle of the SMA as it arises from the aorta is greater than 15 degrees, it could indicate
lymphadenopathy or adenopathy
How does the longitudinal SMA run in comparison to the aorta
parallel/anterior
How does the right renal artery run in comparison to the IVC most of the time
posterior
The abdominal aorta bifurcates into the
right and left common iliac arteries
Where does the abdominal aorta bufurcate
aorta
How do the renal arteries branch off the aorta
lateral
What level do the renal arteries branch off
1st lumbar vertebra
What type of organ does a low resistance vessel supply
one that needs constant perfusion
what do the signs resemble in the transverse image of the hepatic veins draining into the IVC
playboy
reindeer
The portal Vein is formed by the confluence of the
mesenteric vein
splenic vein
What artery arises from the celiac trunk, passes anterior to the portal vein to enter the liver at the porta hepatis
common hepatic artery
Define hepatofugal
away from the liver
define hepatopetal
toward the liver
What is the normal direction of flow in the portal vein
hepatopetal
In case of severe portal hypertension, the blood flow in the portal vein will be
hepatofugal
The IMA distributes blood to the
left transverse colon
descending colon
sigmoid colon
rectum
The SMA supplies blood to
proximal half of the colon
small intestine
Doppler is used to detect what characteristics of blood flow
presence and absence of flow
direction of flow
flow disturbance pattern
tissue characterization
In the sagittal plane, what artery passes posterior to the neck of the pancreas and anterior to the uncinate process of the pancreas
SMA
What vessel is seen coursing between the aorta and the SMA in the transverse plane
left renal vein
What factors make a person at high risk for developing an aortic aneurysm
over age 60
have hypertension
smokers
have vascular disease
What are the 3 predisposing factors for developing an aortic aneurysm
arteriosclerosis
syphilis
trauma
What predisposing factor for developing an aortic aneurysm is most common
arteriosclerosis
Define aneurysm
permanent localized dilation of an artery with diameter over 1.5 times normal size
List the 2 different descriptions used from aneurysms
fusiform
saccular
What is the accuracy rate for ultrasound in detecting aortic aneurysms if it is done properly
98.8%
What is the modality of choice for detecting aortic aneurysm
ultrasound
List the possible locations of an aortic aneurysm
infrarenal
perirenal
suprarenal
Which is the most common location of an aortic aneurysm
infrarenal
What is the most common site of rupture of an aortic aneurysm
the lateral wall below the renal vessels
What is the normal aortic diameter
less than 3cm
Define aortic dissection
separation of the layers of the aortic wall with blood coursing through the “false lumen”
What makes a patient more likely to develop an aortic dissection
aneurysm
sudden onset chest pain radiating to back
40-60 years of age
more common in males
Describe first type of aortic dissection
most dangerous
starts at root and can extend length of arch, can cut off arch vessels blood supply
Describe second type of aortic dissection
Starts at or below the left subclavian and extends down the descending aorta
Describe third type of aortic dissection
Begins at the lower end of descending aorta, extends into abdominal aorta
danger of spiraling and cutting off blood supply to renal arteries
What is arteriovenous fistula
an abnormal connection between an artery and vein
When the IVC is obstructed, what system takes over and “acts” as the IVC
the azygos and/or the hemiazygos system
What condition may cause flow in the portal vein to be reversed
portal hypertension
What is the most common predisposing factor for portal hypertension
intrinsic liver disease
What are the characteristics of “plug flow”
A clear window in spectral wave form, mot of the blood cells are traveling about same velocity across the vessel
What constitutes a normal resistive index (good perfusion)
0.7
What is Budd-Chiari Syndrome
thrombosis of the hepatic veins
List the clinical signs of Renal vein obstruction
flank pain hematuria flank mass proteinuria maternal diabetes transient hypertension
What are the sites of spontaneous shunting that naturally decompress portal hypertension
gastroesophageal paraumbilical vein
hemorrhoidal anastomosis
retroperitoneal anastomosis
The hepatic veins originate in the
liver
the hepatic veins drain into the
IVC
