Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Vascular > Chapter 27: The Hepatoportal System > Flashcards

Chapter 27: The Hepatoportal System Flashcards

1
Q

an abnormal connection between the hepatic artery and the portal venous system

A

arterioportal fistula

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

an abnormal connection between the hepatic artery and the hepatic vein

A

arteriosystemic fistula

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

an abnormal accumulation of fluid within the peritoneal cavity. It is the most common complication of cirrhosis

A

ascites

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

any nonmalignant venous thrombosis. This term is most often used in the context of malignancy, to differentiate malignant from nonmalignant thrombus

A

bland thrombus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

hepatic venous outflow obstruction at any level from the small hepatic veins to the junction of the IVC and the right atrium, regardless of the cause of obstruction

A

Budd-Chiari syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

A chronic diffuse degenerative disease in which normal liver cells are damaged and replaced by fibrous connective tissue and regenerating nodules

A

cirrhosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

spiraling, swirling, “helix” flow pattern demonstrating hepatopetal, hepatofugal, or simultaneous bidirectional flow; uncommon flow pattern seen in 2% of the population

A

Helical portal vein flow

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Compensatory mechanism to maintain perfusion to the liver by arterial vasodilation when portal vein flow is obstructed in patients with advanced cirrhosis

A

hepatic arterial buffer response

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

a pleural effusion in patients with liver cirrhosis in the absence of cardiopulmonary disease. The pathophysiology involves the passage of ascitic fluid from the peritoneal cavity to the pleural space through diaphragmatic defects

A

hepatic hydrothorax

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Refers to retrograde flow, away from the liver (physiologically abnormal direction of flow within portal-splenic venous system)

A

hepatofugal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Refers to antegrade flow; toward the liver (pathophysiologically normal direction of flow within the portal-splenic venous system)

A

hepatopetal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Elevated pressure gradient between the portal vein and IVC or hepatic veins of 10 to 12 mm Hg or greater

A

portal hypertension

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

formation of abnormal blood vessels that shunt portal blood flow bypassing the liver to the systemic circulation, decompressing increased portal venous pressure

A

portosystemic collaterals

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

formerly known as hepatic veno-occlusive disease; is a syndrome of tender hepatomegaly, RUQ pain, jaundice, and ascites; most often occurring in patients in patients undergoing hematopoeitic cell transplantation, and less commonly following radiation therapy to the liver, liver transplantation, and ingestion of alkaloid toxins

A

sinusoidal obstruction syndrome (SOS)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

a percutaneously created connection within the liver between the hepatic vein and the portal vein that allows blood flow to bypass the liver as a means to reduce portal pressure in patients with complications related to portal hypertension

A

transjugular intrahepatic portosystemic shunt (TIPS)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Indications for hepatoportal duplex ultrasound

A

liver cirrhosis
portal hypertension
thrombus
Budd-Chiari syndrome
Pre/post interventional procedures
abdominal trauma
sudden onset of ascites
patients with a history of abdominal malignancy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

most often joins the portal system at the splenoportal confluence; with portal hypertension, diameter <7mm; can demonstrate hepatofugal flow that often leads to esophageal varices

A

coronary vein (left gastric vein)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

origin, gastroesophageal junction, lower esophagus, and submucosal region of the gastric fundus; dilated vessels posterior to the left lobe of the liver at the GEJ

A

gastroesophageal veins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

fetal remnant arising from LPV, coursing along the anterior edge of the falciform ligament to the abdominal wall; connects to systemic veins around the umbilicus “caput medusa”; located in the fissure for the ligamentum teres; diameter >3mm, hepatofugal flow

A

recanalized paraumbilical vein/abdominal wall

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

large tortuous vessels seen in the hilar region of the spleen and left kidney; shunts blood to the left renal vein, terminating in the IVC, decompressing the portal circulation

A

splenorenal veins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

portosystemic shunt between the cystic vein and the right branch of the portal vein, systemic veins of the anterior abdominal wall, or patent portal vein branches within the liver; dilated pericholecystic vascular channels, 3-8 mm in diameter within or outside the gallbladder wall, demonstrating low-velocity continuous flow

A

gallbladder varices

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

most common imaging technique used to evaluate the liver and its vasculature

A

duplex sonography

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

The hepatic artery supplies approximately ____ of blood to the liver

A

25%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

carries oxygenated blood through branches in portal triad and enters sinusoids to reach central veins within liver

A

hepatic artery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

The portal vein supplies approximately ____ of blood to the liver

A

75%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

carries nutrient rich blood from the gastrointestinal tract to the portal triad and enters sinusoids to reach central veins

A

portal vein

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Dual blood supply liver

A

hepatic artery
portal vein

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

actual beginnings of hepatic venous systems; enter sublobular veins, which unite and converge to form 3 hepatic veins that drain into IVC

A

central veins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

The ______ comprise primary hepatic outflow vessels.

A

hepatic veins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

The portal triad consists of:

A

branch of hepatic artery
branch of portal vein
bile duct

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

begins at junction of splenic vein and superior mesenteric vein

A

main portal vein

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

runs along lesser curvature of stomach; drains into portal system near portal splenic confluence

A

main portal vein

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

The main portal vein lies ____ to the IVC>

A

anterior

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

transverse fissure on visceral surface of liver between caudate and quadrate lobes

A

porta hepatis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

At the porta hepatis, the _____ and _____ enter the liver and the _____ leaves the liver.

A

portal vein
hepatic artery
hepatic duct

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

The main portal vein divides into a smaller, more anterior and cranial _____ portal vein and a larger, more posterior and caudal ____ portal vein.

A

left
right

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

The portal veins branch into ____ and ____ divisions on the left.

A

medial
lateral

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

The portal veins branch into ____ and _____ divisions on the right.

A

anterior
posterior

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

The _____ have no valves.

A

portal veins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

composed mostly of loosely arrayed, non parallel connective tissue fibers and minor amount of collagen

A

main portal vein

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

composed mostly of tightly packed collagen fibers

A

hepatic veins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

The hepatic veins are ______.

A

intersegmental

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

Patient preparation

A

fast overnight

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

The _____ branches off the celiac trunk to the right.

A

hepatic artery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

excellent visualization of porta hepatis

A

right coronal oblique

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

provides optimal visualization of splenic vein and splenic artery

A

left coronal oblique

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

The liver is evaluated for ____, ___, and ____.

A

size
texture
surface contour

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

The normal portal vein diameter during quiet respiration is ___ mm or less.

A

13

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

The portal vein may increase up to __ mm with deep inspiration

A

16

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

Normal portal venous outfloq

A

hepatopetal; laminar, low-velocity flow with mild respiratory and moderate pulsatile variations

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

abnormalities associated with helical flow

A

portosystemic collaterals

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

Portal vein velocity ____ during inspiration and _____ during expiration

A

decreases
increases

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

Postprandially, portal vein flow velocity increases __-___%

A

50-100

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

Resting PSV in portal vein

A

16 cm/s

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

mean flow velocity portal vein

A

19.6 + 2.6 cm/s

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

Diameter of the splenic vein measures up to __ mm.

A

10

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

Normal splenic vein flow and direction

A

antegrade

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

Splenic vein velocity _____ during inspiration and _____ during expiration

A

decreases
increases

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

Normal PSV of splenic vein

A

9-30 cm/s

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

Normal mean velocity of splenic vein

A

5 to 12 cm/s

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

Normal spectral Doppler waveform of splenic vein

A

respirophasic with slight pulsatility

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
62
Q

drains into portal system near portal splenic confluence

A

left gastric or coronary vein

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
63
Q

The left gastric vein measures up to __ mm in diameter

A

6

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
64
Q

The superior mesenteric vein can measure up to __ mm at the trunk.

A

10

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
65
Q

Normal flow of SMV

A

antegrade

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
66
Q

Normal PSV of SMV

A

8 and 40 cm/s

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
67
Q

Normal mean velocity of SMV

A

9 to 18 cm/s

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
68
Q

Normal spectral Doppler waveform of SMV

A

respirophasic with slight pulsatility

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
69
Q

SMV velocity ____ during inspiration and ____ during expiration

A

decreases
increases

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
70
Q

Postprandial velocity SMV increases __ - ___ %

A

50-100

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
71
Q

Normal diameter of right hepatic vein

A

less than 6 mm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
72
Q

The hepatic veins normally exhibit pulsatile waveforms with two ____ waves and two ____ waves.

A

antegrade
retrograde

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
73
Q

Ventricular systole demonstrates the __-wave

A

S

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
74
Q

Ventricular diastole demonstrates the __-wave

A

D

75
Q

reflects overfilling of right atrium at end of ventricular systole, resulting in retrograde wave

A

V-wave

76
Q

Atrial contraction demonstrates the __-wave

A

A

77
Q

The PSV of the hepatic veins ranges between __ and __ cm/s

A

22
39

78
Q

The hepatic artery demonstrates ____ flow.

A

hepatopetal; monophasic, low-resistance waveform with continuous antegrade flow throughout cardiac cycle

79
Q

When portal venous perfusion decreases, hepatic arterial flow _____

A

increases

80
Q

With food ingestion the portal vein velocity _____

A

increases

81
Q

The normal PSV of hepatic artery

A

70-120 cm/s

82
Q

The mean velocities of the hepatic artery

A

20-40 cm/s

83
Q

The normal resistance index of the hepatic artery

A

0.55 and 0.7

84
Q

The IVC demonstrates normal ____ flow

A

antegrade

85
Q

proximal Doppler IVC

A

pulsatile due to effects of right atrial pressure

86
Q

distal Doppler IVC

A

respirophasic

87
Q

Normal PSV IVC

A

44-118 cm/s

88
Q

IVC size ranges from __ - ____ mm in diameter

A

1.5-2.5

89
Q

The IVC is normally dilated ____ level of obstruction

A

below

90
Q

hepatopetal flow rerouted away from the liver through collateral channels to low-pressure systemic vessels

A

portal hypertension

91
Q

Normal pressure of IVC and hepatic veins

A

5 and 10 mm Hg

92
Q

Portal hypertension should be suspected if the pressure gradient exceeds:

A

10-12 mm Hg

93
Q

Most common etiology of portal hypertension

A

sinusoidal obstruction due to cirrhosis

94
Q

Most common cause of cirrhosis is

A

hepatitis C

95
Q

2nd most common cause of cirrhosis is

A

alcohol abuse

96
Q

Primary complication of portal hypertension

A

gastrointestinal bleeding from ruptured esophageal and gastric varices

97
Q

3 levels of portal hypertension

A

prehepatic
intrahepatic
posthepatic

98
Q

An enlarged MPV diameter is an indicator of _____

A

increased portal venous pressure

99
Q

Most specific finding of portal hypertension

A

portosystemic collateral

100
Q

_____ varices are found in 14-60% of patients

A

splenorenal

101
Q

_____ and _____ varices are found in 30-35% of patients.

A

paraumbilical
abdominal wall

102
Q

_____ varices are found in 50% of patients.

A

gastroesophageal

103
Q

Most prevalent collateral pathway found in 80-90% of patient.

A

coronary vein or left gastric vein

104
Q

hepatic arterial flow increases as a homeostatic mechanism to maintain hepatic perfusion

A

arterialization (increased hepatic artery flow)

105
Q

hepatic artery enlargement, increased flow, tortuous “corkscrew” appearance, high-velocity flow

A

arterialization

106
Q

abnormal communications between the artery and the vein in which blood flows directly from an artery into a vein bypassing some capillaries

A

arteriovenous fistulae

107
Q

Three types of intrahepatic fistulas

A

portosystemic venous
arterioportal
arteriosystemic

108
Q

Portosystemic venous fistula

A

portal vein to hepatic vein or IVC

109
Q

arterioportal fistula

A

hepatic artery to portal vein

110
Q

arteriosystemic fistula

A

hepatic artery to hepatic vein

111
Q

nonsurgical procedure performed to decompress portal venous system for management of uncontrollable variceal bleedingand refractory ascites

A

TIPS

112
Q

curvilinear echogenic structure with corrugated borders that course through hepatic parenchyma and extends squarely into both in flowing portal vein and outflowing right hepatic vein

A

TIPS stent

113
Q

Normal velocities in TIPS stent

A

90 - 190 cm/s

114
Q

Velocites tend to ____ from portal end to hepatic end of stent

A

incrase

115
Q

Mean velocity is ___ cm/s at portal venous end of TIPS stent

A

95

116
Q

Mean velocity is ___ cm/s at midportion of TIPS stent

A

120

117
Q

Normal spectral waveform in TIPS stent

A

high velocity turbulent flow and pulsatility; respirophasic

118
Q

The portal vein velocity may increase ___ to ___ cm/s greater than pre-TIPS velocities

A

37-47

119
Q

The hepatic artery may exceed ___ cm/s post TIPS

A

130

120
Q

results from flow stasis secondary to cirrhosis and portal hypertension

A

portal venous thrombosis

121
Q

sudden onset of ascites, acute abdominal pain, elevated D-dimer

A

portal venous thrombosis

122
Q

PVT persists of to 12 months; multiple serpignous vessels can appear within 6 to 20 days after acute occlusion to reestablish portal flow

A

cavernous transformation

123
Q

spectrum of hepatic disorders that occur in setting of right-sided heart failure

A

congestive hepatopathy

124
Q

increased right atrial pressure creating both antegrade and retrograde componenets

A

regurgitant portal vein flow

125
Q

highly pulsatile inverted “W” type pattern; prominent V-wave; diminished S-wave

A

hepatic vein waveform congestive hepatopathy

126
Q

results from chronically increased pressure and sinusoidal stasis; causes an accumulation of deoxygenated blood, parenchymal atrophy, necrosis, collagen deposition, fibrosis

A

congestive hepatopathy

127
Q

Budd-Chiari syndrome is classified according to:

A

etiology
site of obstruction

128
Q

results from endoluminal thrombus or webs

A

primary hepatic vein obstruction

129
Q

occurs outside of venous system, maliginant tumor infiltration, parasitic mass, extrinsic compression by neighboring mass

A

secondary hepatic venous flow obstruction

130
Q

Collaterals that are most frequently seen that drain into unobstructed hepatic veins

A

accessory hepatic veins
caudate lobe veins
subcapsular veins
portal veins

131
Q

condition resulting from toxic injury to hepatic sinusoidal endothelial cells, which then undergo necrosis and sloughing, occluding hepatic sinusoids, and terminal hepatic venules

A

sinusoidal obstruction syndrome

132
Q

_______ most commonly occurs after hematopoeitic stem cell transplantation

A

sinusoidal obstruction syndrome

133
Q

What percentage of blood is supplied to the liver through the portal vein?

A

75%

134
Q

What is the transverse fissure on the visceral surface of the liver between the caudate and quadrate lobes?

A

porta hepatitis

135
Q

Which of the following describes the portal veins within the liver?
a. thin, invisible walls; course between the liver segments
b. thin, invisible walls; course within the liver segments
c. thick, bright walls; course between the liver segments
d. thick, bright walls; course within the liver segments

A

d

136
Q

Which landmark identifies the start of the proper hepatic artery from the common hepatic artery?

A

gastroduodenal artery

137
Q

What is the relationship between the main portal vein and the inferior vena cava?

A

MPV is anterior to the IVC

138
Q

Which of the following patient positions offers excellent visualization of the porta hepatis?
a. transverse epigastric
b. transverse right costal
c. right coronal oblique
d. left coronal oblique

A

c

139
Q

At which location should the portal vein diameter be measured?

A

where it crosses the inferior vena cava

140
Q

Which transducer can be useful for assessing the liver surface for nodularity?

A

7 to 9 MHz linear

141
Q

What is normal portal vein diameter with quiet respiration?

A

13 mm or less

142
Q

Severe liver disease, presence of portosystemic collaterals, and size mismatch between a donor portal vein and native portal vein can all cause what type of flow in the portal vein?

A

helical

143
Q

What does an increase in caliber of less than 20% in the splenic vein during deep inspiration indicate?

A

portal hypertension

144
Q

Which of the following increases blood flow within the portal, splenic, and superior mesenteric veins?
a. inspiration and ingestion of food
b. inspiration and exercise
c. expiration and exercise
d. expiration and ingestion of food

A

d

145
Q

When assessing hepatic vein flow, the S and D waves should show blood flow toward which organ?

A

heart

146
Q

What is a normal resistive index in the hepatic artery?

A

0.5 to 0.7

147
Q

What is the most common etiology for portal hypertension in North America?

A

cirrhosis

148
Q

What is the primary complication of portal hypertension?

A

gastrointestinal bleeding

149
Q

Which of the following is NOT a duplex sonographic finding associated with portal hypertension?
a. increased portal vein diameter
b. decreased or absent respiratory variation in the portal and splenic veins
c. hepatopetal flow in the portal and splenic veins
d. portosystemic collaterals (varices)

A

c

150
Q

What is the most common portosystemic collateral shunt in the presence of portal hypertension?

A

splenorenal varices

151
Q

What type of flow may be seen in the portal vein when an arterioportal fistula is present?

A

pulsatile hepatofugal flow

152
Q

Which of the following is a treatment of portal hypertension that involves jugular vein cannulation with stent placement in the liver?
a. mesocaval shunt
b. splenorenal shunt
c. TIPS
d. PVTS

A

c

153
Q

Which of the following is NOT a normal finding in a transjugular portosystemic shunt?
a. hepatofugal flow in the main portal vein
b. velocities within the stent in the range of 90 to 190 cm/s
c. hepatofugal flow in intrahepatic portal veins beyond the site of stent connection
d. increased flow velocities in the splenic vein

A

a

154
Q

Upon duplex evaluation of the portal system, the vascular technologist visualizes increased portal vein caliber with no detectable flow by color, power, and spectral Doppler. Increased hepatic arterial flow is also documented. What do these findings suggest?

A

portal vein thrombosis

155
Q

Besides IVC dilatation, what distinct finding helps differentiate between congestive heart failure and portal hypertension?

A

increased pulsatility in the hepatic veins only

156
Q

Which of the following is NOT a sonographic finding in Budd-Chiari syndrome?
a. dilatation of the IVC with intraluminal echoes
b. pulsatile, phasic flow in nonoccluded portions of the hepatic veins
c. enlarged caudate lobe
d. ascites and hepatomegaly

A

b

157
Q

Clinical features of sinusoidal obstruction syndrome include all of the following EXCEPT:
a. sudden onset of hepatomegaly
b. abdominal pain
c. weight loss
d. fluid retention and ascites

A

c

158
Q

The junction of the splenic and superior mesenteric veins forms the _____

A

main portal vein

159
Q

The ____ portal vein branches into anterior and posterior segments, and the _____ portal vein branches into medial and lateral segments.

A

right
left

160
Q

Hepatic veins _____ in size as the approach the diaphragm.

A

increase

161
Q

The patient and transducer position that provides optimal visualization of the splenic vein and artery is the ______/

A

left coronal oblique

162
Q

Using a lower frequency transducer with a smaller footprint is more effective in obtaining acoustic windows using the ____ approach.

A

intercostal

163
Q

In patients with portal hypertension, congestive heart failure, constrictive pericarditis, and portal vein thrombosis, portal vein diameters can be expected to ______

A

increase

164
Q

Portal vein flow is normally _____ in direction with constant antegrade flow throughout the cardiac cycle.

A

hepatopetal

165
Q

Patients with tricuspid regurgitation, right-sided congestive heart failure, or arteriovenous fistulas may present with ____ flow in the portal vein.

A

helical

166
Q

Both the ____ and _____ veins demonstrate monophasic flow with slight pulsatility that is directed toward the liver.

A

splenic
superior mesenteric

167
Q

Hepatic veins exhibit ____ waveforms that correspond to cyclic pressure changes within the heart.

A

pulsatile

168
Q

With ingestion of food, portal vein flow velocities _____, whereas hepatic artery velocities _____.

A

increase
diminish

169
Q

Patient size, right atrial pressure, and fluid overload or heart failure affect IVC _____.

A

diameter

170
Q

Portal hypertension becomes significant when the pressure gradient between the portal vein and IVC exceeds _____

A

10-12 mm Hg

171
Q

Until recently, the most common cause of cirrhosis was alcohol abuse, however, _____ infection now accounts for a larger percentage of cases.

A

hepatitis c

172
Q

Cirrhosis would be considered a(n) ____ cause of portal hypertension.

A

common

173
Q

Sonographic findings of portal hypertension can include portal vein diameter greater than __ mm and ______ flow in the portal vein.

A

16
hepatofugal

174
Q

The most specific finding of portal hypertension is the detection of ______

A

portosystemic collateral veins

175
Q

Color duplex imaging findings of an enlarged hepatic artery with high-velocity, turbulent flow, and a tortuous “corkscrew” appearance is referred to as ______

A

arterialization

176
Q

Penetrating trauma, iatrogenic trauma due to liver biopsy, transhepatic cholangiography, and transhepatic catheterization of the bile ducts or portal veins may create a(n) _______ which may cause life-threatening portal hypertension

A

arterioportal fistulaAn

177
Q

An abnormal connections between the portal vein and the hepatic vein is termed as _______, which can lead to an increased pulsatility in the portal vein waveform

A

portosystemic venous fistula

178
Q

A TIPS is typically placed to the management of uncontrollable _____ and refractory ascites.

A

variceal

179
Q

If portal vein thrombosis persists without lysis, development of periportal collateral veins increases and is known as ______

A

cavernous transformation

180
Q

A spectrum of hepatic disorders that occurs in the setting of right-sided heart failure and causes an accumulation of deoxygenated blood, parenchymal atrophy, necrosis, collagen deposition, and ultimately fibrosis is termed ______

A

congestive hepatopathy

181
Q

Malignant tumor infiltration, parasitic mass, or extrinsic compression from a neighboring mass can result in _____ hepatic venous outflow obstruction./

A

secondary

182
Q

A patient with fatigue, abdominal swelling, and signs and symptoms of portal hypertension but with patency of the large hepatic and portal veins would likely be diagnosed with ______

A

sinusoidal obstruction syndrome

183
Q
A

Vascular (33 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions