Chapter 9 Abdominal Vasculature Flashcards
The outer wall layer of a vessel is the:
Tunica adventitia
Branches of the celiac axis:
- Hepatic artery
- Splenic artery
- Left gastric artery
An aneurysm associated with infection is termed:
Mycotic
The first main visceral branch of the abdominal aorta is the:
Celiac artery
What vessel can be often noted coursing between the SMA and the abdominal aorta in the transverse scan plane?
Left renal vein
The inner wall layer of a vessel, closest to the passing blood, is the:
Tunica intima
A disorder of the connective tissue characterized by tall stature and aortic and mitral valve insufficiency is:
Marfan Syndrome
Enlargement of the IVC, with subsequent enlargement of the hepatic veins, is seen cases of:
Right-sided heart failure
____would have a pulsatile, triphasic blood flow pattern
hepatic veins
The diameter of the IVC should never exceed:
2.5 cm
The left gonadal vein drains directly into the:
Left renal vein
What vessel may attach to the splenic vein before reaching the portal confluence?
Inferior mesenteric vein
What vessel travels directly anterior to the left renal artery?
Left renal vein
What abnormality would the failure of an EVAR to isolate an aneurysm from circulation most likely results in?
Endoleak
The hepatic artery should demonstrate:
Low-resistance flow
Sections of the IVC:
Pancreatic
The veins seen attaching to the IVC just below the diaphragm are the:
Hepatic veins
The aorta originates at the:
Left ventricle
The main portal vein is created by the union of the:
Splenic vein and SMV
Which vascular structure may be confused for the main pancreatic duct?
Splenic artery
The IVC terminates the:
Right atrium
Occlusion of the hepatic veins describes:
Budd-chiari syndrome
The most common shape of an AAA is:
Fusiform
What branch and its tributaries of the abdominal aorta appears as a “seagull” in the transverse plane?
Celiac artery
An AAA is present when the diameter of the abdominal aorta exceeds:
3CM
What flow pattern would the postprandial SMA yield in small bowel ischemia?
High resistance
_____would most likely yield a high-resistance flow pattern?
Fasting SMA
What should the postprandial flow pattern be within the SMA:
Low resistance
The second main branch of the abdominal aorta is the:
SMA
In the sagittal plane, you recognize a circular, anechoic vascular structure posterior to the IVC. The structure is most likely?
Right renal artery
_____shows a different flow pattern after eating?
SMA
Iliac artery aneurysms are most often associated with:
Abdominal aortic aneurysm
The most common splanchnic artery aneurysm are:
- Splenic aneurysm
- Hepatic aneurysm
_____appears as a thin, linear echo flap within the arterial lumen
Aortic dissection
_____typically produces a low-level echo pattern and tends to accumulate along the anterior and lateral walls of the aortic lumen
Thrombus
Lack of normal tapering of the aorta means?
True aneurysm
Focal dilation along the course of the aorta means?
True aneurysm
A true aneurysm is identified sonographically as a ______ greater than 3.0cm near its bifurcation point
Dilation of the aorta
The sonographic findings of the atherosclerosis include:
- Luminal irregularities
- Tortuosity
- Vessel wall calcification
The main portal vein is formed at the junction of the:
Splenic vein and SMV
The three hepatic veins:
- Left
- Right
- Middle
The left renal vein traverses the abdomen, coursing anteriorly to the aorta and posterior the SMA to finally enter the:
Lateral aspect of the IVC
The right renal vein is generally shorter than the left renal vein because of the:
Right kidney’s proximity to the IVC
The veins most consistently seen entering the IVC are the:
- Common iliac veins
- Renal veins
- Hepatic veins
The IVC is the large vessel that returns blood to the _____ from the lower limbs, pelvis, and abdomen
Right atrium
At the umbilicus, the aorta bifurcates into the:
Left and right common iliac arteries
The last major branch to arise from the abdominal aorta is the:
IMA
The left renal artery arises from the:
Left lateral (posterolateral) aspect of the aorta
The right renal artery arises from:
Right lateral aspect of the aorta
The SMA originates from the:
Anterior surface of the aorta
The second major aorta abdominal branch vessel is the:
SMA
The celiac axis (CA) is about 1cm long before it divides into:
*Hepatic artery
*Left gastric artery
*Splenic artery
The ____ is the main artery of the chest and abdomen from which all other branch vessels are derived
Aorta
Blood vessels are composed of three distinct layer:
*Tunica intima
*Tunica media
*Tunica adventitia
The most common findings of IVC thrombosis are:
- IVC enlargement
- Absence of flow
- Material within the IVC lumen
With time, thrombus will become more:
- Echogenic
- May calcify
- Produce acoustic shadowing
The doppler waveform of the IVC is _____ near the heart and _____ near the common iliac veins
*Pulsatile
*More phasic
The right and left common iliac veins combine to form the:
IVC near the umbilicus, typically just right of the midline
The right gonadal vein connects to the:
Anterior aspect of the IVC
The _____are derived from the termination of the smaller venous branches within the kidney and travel to the lateral aspect of the IVC
Renal veins
_____is described as the occlusion of the hepatic veins with possible coexisting occlusion of the IVC
Budd-chiari syndrome
The primary function of the IVC is to bring:
Deoxygenated blood from the lower extremities, pelvis, and abdominal organs back the heart
The IVC can be separated into four sections from superior to inferior:
*Hepatic
*Prerenal
*Renal
*Postrenal
The IVC travels through the vena caval foramen of the diaphragm and ultimately terminates in the:
Right atrium of the heart
The IVC is located:
Anterior to the spine and right lateral to the abdominal aorta
The _____is the largest vein in the body
IVC
A false aneurysm may also be called a:
Pseudoaneurysm
Clinical findings of a pseudoaneurysm
- Recent catheterization
- Surgical procedure
- Trauma
- Pulsatile hematoma
Aneurysms that measure greater than _____in diameter are more prone to rupture
7cm
Sonographic findings of an aortic rupture
- Abdominal aneurysm with an adjacent hematoma
Clinical findings of an aortic rupture
- Decreased hematocrit
- Hypotension
- Pulsatile abdominal mass
- Abdominal bruit
- Back pain
- Abdominal pain
- Lower extremity pain
_____occurs when there is a separation of the layers of the arterial wall, predominantly disturbing the intima
Aortic dissection
Sonographic findings of an aortic dissection:
- Possible AAA
- Intimal flap may be noted within the aortic lumen
Clinical findings of an aortic dissection
- Intense chest pain
- Hypertension
- Abdominal pain
- Lower back pain
- Neurologic symptoms
- Marfan syndrome
_____results from the failure of the graft to isolate the aneurysm from circulation resulting in flow disturbances and a propensity for aortic rupture
Endoleak
The EVAR is delivered to the aorta by means of accessing the:
Common femoral artery under angiographic guidance
Treatment for an AAA includes:
*Open surgery
*Endovascular aortic stent graft repair (EVAR)
Sonographic findings of AAA:
- Diameter greater than 3cm
- Thrombus
- Calcifications
Complications of an AAA include:
- Distal embolism
- Infection
- Dissection
- Rupture
Sonographic findings of a pseudoaneurysm
- Perivascular hematoma containing swirling blood and has a neck connecting it to the vessel
- Color doppler demonstration of turbulent flow within the mass
Clinical findings of AAA
- Pulsatile abdominal mass
- Abdominal bruit
- Back pain
- Abdominal pain
- Lower extremity pain
The most common location of an AAA is:
Infrarenal
A _____aneurysm is one that has a gradual enlargement
Fusiform
The most common shape of an AAA is:
Fusiform
An AAA is present when the diameter of the abdominal aorta exceeds;
3cm
An aneurysm results from:
The weakening of the vessel wall
The upper normal limit of the abdominal aorta just below the:
Diaphragm is 2.5cm in diameter
The aorta bifurcates at or near the level of the:
Umbilicus
The IMA supplies blood to the:
*Transverse colon
*Descending colon
*Rectum
The inferior mesenteric artery arises from the:
Anterior surface of the abdominal aorta
The gonadal arteries arise from:
Anterior surface of the abdominal aorta, just below the renal artery level
Normal renal arteries typically demonstrate ______ flow
Low-resistance
The left renal artery 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
The right renal artery originates from the right anterolateral aspect of the aorta and travels:
Posterior to the IVC on its way to the right renal hilum
The third main visceral branches of the abdominal aorta are the:
Paired renal arteries
The SMA supplies blood to:
Parts of the small intestines, some of the colon and the pancreas
The SMA will exhibit _____ flow in the fasting patient
High-resistance
The _____is located posterior to the splenic vein and pancreas and left lateral to the SMV
SMA
The second main branch of the abdominal aorta is the:
SMA
The hepatic artery should yield _______flow
Low-resistance and hepatopetal
The proper hepatic artery enters the liver at the:
Porta hepatis and branches further into the right and left hepatic arteries
_____flow should be noted within the normal splenic artery
Low-resistance
_____is the first main visceral branch of the abdominal aorta and its branches supply blood to several vital abdominal organs
Celiac trunk
The aorta originates at the:
Left ventricle of the heart
The abnormal connection between arteries and veins is referred to as:
Arteriovenous fistulas
The ____lies within the midabdomen and collects blood from the intestines and spleen
Portal splenic confluence
Portal splenic confluence is located?
Posterior to the pancreatic neck
The main portal vein is created by the union of the:
SMV and Splenic vein
_____is used to trap emboli that could be traveling that could be traveling upstream, potentially preventing a pulmonary embolus
Greenfield IVC filter
