Chapter 9: Abdominal Vasculature Flashcards

1
Q

What is abdominal aortic aneurysm?

A

enlargement of the diameter of the abdominal aorta to greater than 3 cm

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2
Q

What is atherosclerosis?

A

a disease characterized by the accumulation of plaque within the walls of the arteries

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3
Q

What is an embolism?

A

a blockage caused by an abnormal mas within the blood stream that hinders circulation downstream, leading to tissue damage

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4
Q

What is a false aneurysm?

A

a contained rupture of a blood vessel that is most likely secondary to the disruption of one or more layers of that vessel’s wall

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5
Q

What is false lumen?

A

the residual channel of a vessel created by the accumulation of a clot within the vessel

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6
Q

What is fusiform?

A

shaped like a spindle; wider in the middle and tapering towards the ends

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7
Q

What is high-resistance flow?

A

the flow pattern that results from small arteries or arterioles that are contracted, which produces an increase in the resistance to blood flow to the structure that is being supplied

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8
Q

What is an intimal flap?

A

observation of the intimal layer of a vessel as a result of a dissection

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9
Q

What is low-resistance flow?

A

the flow pattern characterized by persistent forward flow throughout the cardiac cycle

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10
Q

What is Marfan syndrome?

A

a disorder of the CT characterized by tall stature and aortic and mitral valve insuffiency

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11
Q

What are mycotic aneurysms?

A

aneurysms caused by infection

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12
Q

What does postprandial mean?

A

after a meal

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13
Q

Psuedoaneurysm AKA

A

false aneurysm

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14
Q

What is a saccular aneurysm?

A

a saclike dilation of a blood vessel

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15
Q

What is small bowel ischemia?

A

a condition resulting in interruption or reduction of the blood supply to the small intestines

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16
Q

What is a thrombus?

A

a blood clot

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17
Q

What is TCC?

A

a malignant tumor of the urinary tract that is often found within the urinary bladder or within the renal pelvis

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18
Q

What is a true aneurysm?

A

the enlargement of a vessel that involves all three layers of the lumen

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19
Q

What is true lumen?

A

the true channel within the vessel

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20
Q

What is tunica adventitia?

A

the outer wall layer of a vessel

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21
Q

What is tunica intima?

A

the inner wall layer of the vessel

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22
Q

What is tunica media?

A

the middle, muscular layer of the vessel

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23
Q

What is Wilms tumor?

A

the most common solid malignant pediatric abdominal mass; or renal mass AKA nephroblastoma

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24
Q

The aorta originates where?

A

the left ventricle

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25
Q

Most abdominal arteries are considered to have _____ -________ flow

A

low resistance flow

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26
Q

Where on the abdominal aorta does the celiac trunk arise from?

A

anterior aspect, between the crura of the diaphragm

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27
Q

What are the three branches of the celiac trunk?

A
  • splenic art
  • left gastric art
  • common hepatic art
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28
Q

Describe the flow pattern of the suprarenal aorta

A

low-resistance flow

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29
Q

Describe the flow pattern of the infrarenal aorta

A

high-resistance flow

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30
Q

Does the celiac artery have low or high resistance flow?

A

low-resistance

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31
Q

Does the common hepatic artery have low or high resistance flow?

A

low-resistance

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32
Q

Does the common iliac artery have low or high resistance flow?

A

high-resistance flow

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33
Q

Does the splenic art have low or high resistance flow?

A

low-resistance

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34
Q

The SMA of a fasting patient has what kind of flow?

A

high-resistance

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35
Q

The SMA of a postprandial patient has what kind of flow?

A

low-resistance

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36
Q

Renal arteries have what kind of flow?

A

low-resistance

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37
Q

Is the splenic artery tortuous or straight?

A

tortuous

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38
Q

The common hepatic artery branches into the ______ at the level of the pancreatic head

A

gastroduodenal artery

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39
Q

When does the common hepatic art become the proper hepatic art?

A

after the pancreatic head

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40
Q

Where does the proper hepatic artery enter the liver?

A

porta hepatis

41
Q

The cystic artery comes off what branch of the hepatic arteries?

A

right hepatic artery, and supplies the GB

42
Q

The SMA supplies blood to what?

A
  • small intestines
  • some of colon
  • pancreas
43
Q

The SMA can be ID’d sonographically by what?

A

the echogenic fat layer surrounding it

44
Q

If wave forms look backwards in the SMA, what is suspected?

A

small bowel ischemia

45
Q

The third main visceral branches of the aorta are what?

A

paired renal arteries

46
Q

Describe location of right renal artery?

A

originates from the right anterolateral aspect of the aorta and travels posterior to the IVC on its way to the right renal hilum

47
Q

Describe the location of the left renal artery ?

A

originates from the left anterolateral aspect of the aorta and travels posterior to the left renal vein as it progresses to the left renal hilum

48
Q

Which renal artery is longer?

A

right

49
Q

T/F: duplication of the renal arteries is common?

A

true

50
Q

What are the fourth branches of the abd. aorta?

A

gonadal arteries..either testicular or ovarian

51
Q

The IMA arises from where?

A

the anterior surface of the abd aorta

52
Q

The IMA supplies what?

A
  • transverse colon
  • descending colon
  • rectum
53
Q

The aorta will gradually become more _____ as it travels away from the diaphragm

A

anterior

54
Q

The upper normal limit of the abdominal aorta just below the diaphragm is ___ cm

A

2.5 cm

55
Q

The aorta in the mid abd. should measure ____cm or less

A

2cm

56
Q

The distal aorta diameter should measure ____cm

A

1.8 cm or less

57
Q

The common iliac arteries are considered enlarged if their diameter exceeds ___ cm

A

2 cm

58
Q

Describe the normal flow pattern for the infrarenal aorta

A

triphasic, high resistance flow pattern with reversal of flow during early diastole

59
Q

An aneurysm results from

A

weakening of the vessel wall

60
Q

Most AAA’s are what?

A

true aneurysms

61
Q

The most common shape of an AAA is

A

fusiform

62
Q

Saccular can be described as

A

sudden dilation of artery, often spherical and can be fairly large

63
Q

The most common location of an AAA

A

infrarenal

64
Q

What is the most common cause of aneurysms in the US?

A

atherosclerosis

65
Q

Aneurysms of the AA have been associated with

A
  • atherosclerosis
  • Marfan syndrome
  • syphilis
  • familial inheritance
  • infection
66
Q

Aneurysms caused by infection are called

A

mycotic aneurysms

67
Q

Complications of AAA include

A
  • distal embolism
  • infection
  • dissection
  • rupture
68
Q

Clinical findings of AAA

A
  • pulsatile abd. mass
  • bruit
  • back pain
  • abd. pain
  • lower extremity pain
69
Q

Son findings of AAA

A
  • diameter of AA measures greater than 3 cm
  • thrombus within the lumen of aorta
  • calcifications, along with thrombus, may produce acoustic shadowing
70
Q

List the clinical findings of aortic dissection:

A
  • intense chest pain
  • htn
  • abdominal pain
  • lower back pain
  • neurologic symptoms
71
Q

What size AAA is more prone to rupture?

A

7cm or greater

72
Q

Clinical findings of AAA rupture:

A
  • decreased hematocrit
  • hypotension
  • pulsatile abd. mass
  • abdominal bruit
  • back pain
  • abdominal pain
  • lower extremity pain
73
Q

Psuedo/false aneurysms may be associated with what?

A
  • interventional procedures
  • surgery
  • trauma
  • infection
74
Q

Where is a common site for pseudoaneurysm development after a heart cathaterization?

A

the groin at the level of the femoral art

75
Q

The IVC is created by the union of what?

A

common iliac veins

76
Q

Where does the IVC terminate?

A

right atrium

77
Q

What are the four sections of the IVC from superior to inferior?

A
  • hepatic
  • prerenal
  • renal
  • postrenal
78
Q

The most superior portion of the IVC courses

A

posterior to the caudate lobe of the liver and through the bare area

79
Q

Variants of the hepatic veins include

A
  • duplication

- branching anomalies

80
Q

Describe waveform of hepatic veins

A

pulsatile, triphasic blood flow pattern

81
Q

Which renal vein is longer?

A

left

82
Q

Renal veins have what kind of flow?

A

low velocity, continuous

83
Q

The right gonadal vein drains into what?

A

IVC

84
Q

The left gonadal vein drains into what?

A

left renal vein (much longer than right gonadal vein)

85
Q

The diameter of the IVC should never exceed

A

2.5cm

86
Q

The main portal vein is created by the union of what vessels?

A

SMV and splenic vein..creating the portal splenic confluence

87
Q

The portal splenic confluence collects blood from where?

A

intestines and spleen

88
Q

Where does the main portal vein enter the liver?

A

porta hepatis

89
Q

Should flow in the portal veins be mono or biphasic?

A

monophasic

90
Q

Typically the diameter of the portal vein is less than

A

13 mm

91
Q

Flow in the splenic vein should be toward:

A

midline

92
Q

Do tumors more often affect the right or left renal veins?

A

right

93
Q

What is the most common cause of IVC obstruction that leads to enlargement?

A

right sided heart failure

94
Q

The abnormal connection between arteries and veins is

A

arteriovenous fistulas

95
Q

Arteriovenous malformations may be caused by

A
  • congenital
  • surgery
  • malignancy
  • biopsy
  • trauma
96
Q

What may be seen in cases of AVM’s?

A

turbulent flow and focal accumulation of vascular structures

97
Q

In small bowel ischemia, the postprandial SMA will yield what flow pattern?

A

high resistance

98
Q

Which vascular structure may be confused for the main pancreatic duct?

A

splenic artery

99
Q
Which of the following is the shortest in length?
A. right renal vein
B. right renal artery
C. left renal vein
D. left renal artery
A

A. right renal vein