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Cindy Test 3 CH. 9,13,17 > Ch.9 The Vascular System > Flashcards

Ch.9 The Vascular System Flashcards

1
Q

Tiny arteries and veins that supply the walls of the blood vessels

A

Vasa Vasorum

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2
Q

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

A

Tunica media

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3
Q

Outer layer of the vascular system, contains the vasa vasorum

A

Tunica adventitia

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4
Q

Inner layer of the vascular system

A

Tunica intima

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5
Q

Communication between two blood vessels without any intervening capillary network

A

Anastomosis

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6
Q

Minute vessels that connect the arterial and venouis systems

A

Capillaries

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7
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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8
Q

Vascular structures that carry blood away from the heart

A

Arteries

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9
Q

Small branch supplying the caudate and left lobes of the liver

A

Left hepatic artery

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10
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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11
Q

Arises from the posterolateral wall of the aorta, travels posterior to the inferior vena cava to supply the kidney

A

Right renal 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

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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14
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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15
Q

Arises from the celiac axis to supply the stomach and lower third of the esophagus

A

Left gastric artery

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16
Q

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

A

Splenic artery

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17
Q

Arises from the celiac trunk to supply the liver

A

Common hepatic artery

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18
Q

Supplies the gallbladder via the cystic artery

A

Right hepatic artery

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19
Q

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

A

Left renal artery

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20
Q

Supplies the stomach

A

Right gastric artery

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21
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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22
Q

Three lage 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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23
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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24
Q

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

A

Right renal vein

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25
Q

Collapsible vascular structures that carry blood toward the heart

A

Veins

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26
Q

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

A

Inferior mesenteric vein

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27
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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28
Q

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

A

Superior mesenteric vein

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29
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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30
Q

Weakening of the arterial wall

A

Cystic medial necrosis

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31
Q

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

A

Aneurysm

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32
Q

Thrombosis of the hepatic veins

A

Budd- Chiari syndrome

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33
Q

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

A

Arteriosclerosis

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34
Q

Circumferential enlargement of a vessel with tapering at both ends

A

Fusiform aneurysm

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35
Q

Transjugular intrahepatic portosystemic shunt

A

TIPS

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36
Q

Localized dilation of the vessel

A

Saccular aneurysm

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37
Q

Condition in which the aortic wall becomes irregular from plaque formation

A

Atherosclerosis

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38
Q

Periportal collateral channels in patients with chronic portal vein obstruction

A

Cavernous transformation of the portal vein

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39
Q

Tear in the intima or media of the abdominal aorta

A

Dissecting aneurysm

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40
Q

Communication between an artery and a vein

A

Arteriovenous fistula

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41
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

42
Q

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

A

Pseudoaneurysm

43
Q

Heredity disorder of connective tissue, bones, muscles, ligaments, and skeletal structure

A

Marfan syndrome

44
Q

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

A

True aneurysm

45
Q

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

A

Resistive

46
Q

Flow toward the liver

A

Hepatopetal

47
Q

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

A

Nonresistive

48
Q

Peak systole minus peak diastole devided by the peak systole

A

Resistive index

49
Q

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

A

Spectral broadening

50
Q

Flow away from the liver

A

Hepatofugal

51
Q

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

A

Doppler sample volume

52
Q

The root of the aorta arises from the _______ outflow tract of the heart.

A

Left Ventricular

53
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

54
Q

The __________supplies the gallbladder via the cystic artery and the liver.

A

Right hepatic artery

55
Q

The aprta continues to flow in the __________ cavity anterior and slightly _______ of the vertebral column

A

Retroperitoneal, left

56
Q

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

A

Celiac

57
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

58
Q

The diameter of the abdominal aorta measures approximately______cm, tapering to ______ cm after it proceeds inferiorly to the bifurication into the iliac arteries

A

2-3,1.0-1.5

59
Q

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

A

SMA

60
Q

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

A

Smaller

61
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

62
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

63
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, and left subclavian

64
Q

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

A

Portal vein

65
Q

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

A

Splenic

66
Q

The portion of the femoral artery posterior to the knee is the ____________

A

Popliteal artery

67
Q

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

A

Hepatic veins

68
Q

List the five sections into which the aorta is devided

A
  1. Root of the aorta
  2. Ascending aorta and arch
  3. Descending aorta
  4. Abdominal aorta and abdominal branches
  5. Bifurcation of the aorta into iliac arteries
69
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. The elasticity of the larger arteries is important for maintaining a steady blood flow. Veins are hollow collapsible tubes with diminished tunica media that carry blood toward the heart. The veins appear collapsed because they have little elastic tissue or muscle within their walls. Veins have a larger total diameter than the arteries, and they move blood more slowly.

70
Q

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

A

The celiac trunk, superior and inferior mesenteric arteries, and the renal arteries

71
Q

The function of the circulatory system is

A

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

72
Q

The characteristics of veins are

A

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

73
Q

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

A

Blood is carried away from the heart by the arteries and is returned from the tissues to the heart by the veins. Arteries divide into progressively smaller branches, the smallest of which are the arterioles. These lead into the capillaries, which are minute vessels that branch and form a network where the exchange of materials between blood and tissue fluid take place. After the blood passes through the capillaries, it is collected in the small veins, or venules. These small vessels unite to form larger vessels that eventually return the blood to the heart for recirculation.

74
Q

Describe a capillaries and their function

A

Capillaries are minute, hair-sized vessels connecting the arterial and venous systems. Their walls have only one layer. The cells and tissues of the body receive their nutrients from fluids passing through the capillary walls: at the same time, waste products from the cells pass into the capillaries. Arteries do not always end in capillary beds; some end in anastomoses, which are end-to-end grafts between different vessels that equalize pressure over vessel length and also provide alternative flow channels.

75
Q

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

A

Doppler ultrasound frequently is used to differentiate vessels from nonvascular structures. For example, to distinguish the common bile duct from the hepatic artery, look for direction of flow: to differentiate aneurysm from pancreatic psuedocyst, look for slow flow in the aneurysm; to differentiate dilated intrahepatic bile ducts and prominent hepatic artery, again look for absence of flow in the bile duct

76
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

77
Q

The technique that should be used to image the inferior vena cava

A

The patient should be instructed to hold his or her breath; this causes the patient to perform a slight Valsalva maneuver toward the end of inspiration which dilates the inferior vena cava. The inferior vena cava may expand to 3-4 cm in diameter with this maneuver.

78
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

79
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

80
Q

Differentiate the inferior vena cava from the aorta

A

The pulsatile aorta is easily differentiated from the inferior vena cava because the IVC travels is a horizontal course with its proximal portion curving slightly anterior as it pierces the diaphragm to empty into the right atrial cavity. The aorta, on the other hand, follows the curvature of the spine, with its distal portion lying more posterior, before bifurcating into the iliac vessels

81
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

82
Q

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

A

Parallel

83
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

84
Q

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

A

Low

85
Q

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

A

Increases

86
Q

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

A

Continous

87
Q

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

A

Periportal

88
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 reserved

A

Umbilical

89
Q

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

A

Sagittal scans should be made beginning in the midline with slight angulation of the transducer to the left, from the xiphoid to well below the level of bifurcation of the aorta gradually tapers as it proceeds distally in to abdomen. a low to medium gain should be used to demonstrate the walls of the aorta without “noisy” artifactual internal 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. Try to use different techniques of breath holding to eliminate these artifactual echoes. Sometimes increased gentle pressure may help displace the bowel gas or may compress the fatty tissue, so the transducer will be closer to the abdominal aorta. If the abdomen is very concave, the patient may be instructed to “extend his abdomen” (“push the abdomen muscle out”), so as to provide a better scanning plane

90
Q

The most common causes of aneurysms are _________ and ________________

A

Arteriosclerosis and atherosclerosis

91
Q

The large aneurysm may rupture into the peritoneal cavity or retroperitoneum, causing ___________ and a drop in _______

A

Intense back pain, hematocrit

92
Q

The normal measurement for an adult aorta is less than 3 cm, measuring from ______ to _______ walls

A

Outer to outer

93
Q

Thrombus usually occurs along the _______ or ___________ wall

A

Anterior or anteriolateral

94
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

95
Q

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

A

The typical patient is 40 to 60 years old and hypertensive; male are predominant over females. The patient usually is known to have and aneurysm, and sudden excruciating chest pain radiating to the back may develop because of a dissection. Patients may go into shock very quickly, and CT is generally ordered to obtain the most information in the shortest amount of time. However, patients who present with some symptoms and are stable may have a slow leak aneurysm, and these patients are appropriately imaged with sonography. The sonographer should look for a dissection “flap” or a recent channel with or without frank aneurysmal dilatation. Dissection of blood is noted along the laminar planes of the aortic media with formation of a blood-filled channel within the aortic wall.

96
Q

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

A

Type 1- Dissection begins at the root of the aorta and may extend the entire length of the arch, descending to the aorta and into the abdominal aorta. This is the most dangerous, especially if the dissection spirals around the aorta, cutting off the blood supply to the coronary, carotid, brachiocephalic,and subclavian vessels.
Type 2- occurs secondary to cystic medial necrosis (weakening of the arterial wall), to the inherited disease Marfan’s syndrome or to hypertension. Color Doppler may be used to detect flow into the false channel.
Type 3- Begins at the lower end of the aorta. This may be critical if the dissection spirals around to impede the flow of blood into the renal vessels

97
Q

Pseudopulsatile abdominal masses may stimulate an aortic aneurysm by

A

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

98
Q

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

A

Expirations

99
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

100
Q

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

A

Lower

Cindy Test 3 CH. 9,13,17 (3 decks)

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