Chapter 4 - Abdominal Vascular

Question 1

Which of the following is the main source of oxygenated blood for the liver?

The hepatic artery
The SMA
The aorta
The portal vein

Answer 1

The hepatic artery is the livers major source of oxygenated blood, allowing it to carry out many of its functions.

Question 2

In terms of volume, most of the blood travels to the liver by way of _____?

Answer 2

Portal vein

Portal vein delivers blood to the liver to be filtered & processed

Question 3

Of the following, which is not part of the system that makes up the portal vein?

Splenic vein
Hepatic vein
SMV
IMV

Answer 3

Hepatic vein

Question 4

Vessels that form the portal vein include ___ ____ ____?

Answer 4

SMV , IMV , & splenic vein

The portal system is separate from the IVC

Question 5

Which of the following is true for most aortic aneurysms?

They are dissecting in nature
They are proximal in location
They are distal in location
They involve the renals

Answer 5

They are distal in location

Below the level of the renal arteries, and just above the level of the common iliac bifurcation

Question 6

What is the most common cause of aortic aneurysm?

Answer 6

Atherosclerosis

Which is the build up of plaque in the arteries

Question 7

Which of the following Words describes an aorta that is diffusely dilated?

Ecstatic
Saccular
Fusiform
Dissecting

Answer 7

An ectatic aorta is diffusely dilated throughout the entire length - 3.5 cm

Question 8

A fusiform aneurysm includes

Answer 8

Both walls of the vessel

Typically spindle shaped

Question 9

What is the most common aneurysm?

Answer 9

Fusiform

Accounts for 90% of all aneurysms

Question 10

Saccular aneurysms involve

Answer 10

Only the anterior wall

Question 11

What type of aneurysm occurs when a lining is torn and blood rushes into the the space between the layers of the wall

Answer 11

Dissecting aneurysm

Usually occurs in the tunica intima or tunica media

Question 12

The Mickey Mouse sign refers to which of the following structures?

The portal triad
The celiac axis
The biliary tree
The hepatic veins

Answer 12

The portal triad

Made up of the branch of the portal vein, hepatic artery & hepatic duct.

Question 13

The left renal vein runs in which direction?

Posterior to the aorta
Between the SMA & aorta
Posterior to the IVC
Parallel to the portal vein

Answer 13

Passes between the aorta & SMA on its way to the IVC

Question 14

What can cause anterior displacement of the IVC

Answer 14

Lymphadenopathy. As the lymph nodes enlarge they can displace the IVC anteriorly
Also, an adrenal tumor on the right side can do the same thing

Question 15

Which of the following is the largest arterial branch of the celiac axis?

Hepatic artery
Splenic artery
Left gastric artery
GDA - gastroduodenal artery

Answer 15

The splenic artery

Question 16

Which of the following is the major visceral branch of the IVC?

Portal vein
Hepatic vein
IMV
SMV

Answer 16

The hepatic veins are the major visceral branches of the IVC

The other veins listed are part of the portal system
Which are separate of the IVC

Question 17

Of the following which is not a layer of a vessel wall?

Tunica intima
Tunica media
Tunica Adventitia
Tunica vascularis

Answer 17

The tunica vascularis.

The intima is the inner lining
The media is the middle lining
& the Adventitia is the outer lining

Question 18

Hepatic veins drain into what structure?

The portal vein
The SMV
THE IVC

Answer 18

IVC

The three major trunks of the hepatic veins drain toward the diaphragm and directly into the IVC. They drain the liver of deoxygenated blood.

Question 19

Which of the following Is the most common tumor of the IVC?

Hematoma
Hypernephroma
Pheochromocytoma
Leiomysosarcoma

Answer 19

Hypernephroma

These the way they most metastasize is by growing into the renal vein and then on the IVC. Liver tumors can invade the hepatic veins & grow into the IVC as well, but renal tumors are more frequent.

Leiomysosarcoma are rare.

Question 20

Abdominal pain that worsens with an erect or upright position?

Dissection
Portal hypertension
Ruptured aneurysm
Retroperitoneal fibrosis

Answer 20

Ruptured aneurysm

Dissections produce excruciating anterior chest pain that radiates to the back and down the spine.

Portal hypertension and Retroperitoneal fibrosis have less obvious symptoms.

Question 21

The GDA courses _____ to the head of the pancreas.

Medial and superior
Medial and inferior
Lateral and posterior
Lateral and anterior

Answer 21

It runs lateral and anterior

It also runs parallel to the CBD

Question 22

The left gastric artery is seen:

Best longitudinally
Branching from the GDA
Inferior to the pancreatic head
Joining the splenic artery to form the portal artery

Answer 22

Best seen longitudinally

It is not routinely observed

Question 23

The SMA is best recognized transversely by which quality?

Pulsation
Position
Fatty collar
Thin walls

Answer 23

The thick fatty, echogenic ring around the SMA is seen transversely

Question 24

Which of the hollowing is true of hepatic veins?

They have thick, echogenic walls
They are used by sonographers to divide the liver into segments
They compress with valsalva maneuver
They help make up the portal system

Answer 24

The three major branches of the hepatic veins are used to divide the liver into four segments

Question 25

The abdomen has three separate vascular systems called:

Answer 25

The arterial, venous & portal system

Question 26

As a rule, arteries lie _______ to the veins until the aorta bifurcates

Answer 26

They lie posterior to the vein