Chapter 9: Abdominal Vasculature Flashcards
enlargement of the diameter of the abdominal aorta to greater than 3 cm
abdominal aortic aneurysm
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
false aneurysm (pseudoaneurysm)
the residual channel of a vessel created by the accumulation of a clot within that vessel
false lumen
shaped like a spindle; wider in the middle and tapering toward the ends
fusiform
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
high-resistance flow
observation of the intimal layer of a vessel as a result of a dissection
intimal flap
the flow pattern characterized by persistent forward flow throughout the cardiac cycle
low-resistance flow
a disorder of the connective tissue characterized by tall stature and aortic and mitral valve insufficiency
Marfan syndrome
aneurysms caused by infection
mycotic aneurysms
a saclike dilation of a blood vessel
saccular aneurysm
a condition resulting in interruption or reduction of the blood supply to the small intestines
small bowel ischemia
the enlargement of a vessel that involves all three layers of the wall
true aneurysm
the true channel within a vessel
true lumen
the outer wall layer of a vessel
tunica adventitia
the inner wall layer of a vessel
tunica intima
the middle, muscular layer of a vessel
tunica media
where does the aorta originate?
the left ventricle of the heart
3 layers of the aorta and IVC
tunica intima
tunica media
tunica adventitia
3 branches of the celiac artery
splenic artery
common hepatic artery
left gastric artery
3 vessels in the “seagull sign”
celiac artery
common hepatic artery
splenic artery
what kind of flow does the normal splenic artery have?
low-resistance flow
what does the common hepatic artery branch into at the level of the pancreatic head?
gastroduodenal artery
what kind of flow does the normal hepatic artery have?
low-resistance flow
the first main branch of the abdominal aorta
celiac artery
the second main branch of the abdominal aorta
superior mesenteric artery (SMA)
what 3 things does the SMA supply with blood?
small intestines
some colon
pancreas
what kind of flow does the SMA have? (fasting and post-prandial)
fasting - high-resistance
30-90 minutes postprandial - low-resistance
the third main branches of the abdominal aorta
renal arteries
the right renal artery travels _________ to the IVC
posterior
which renal artery is longer?
right
which renal vein is longer?
left
what kind of flow do the normal renal arteries have?
low-resistance flow
the fourth branches of the abdominal aorta
gonadal arteries (testicular or ovarian arteries, not usually seen with sonography)
upper normal measurement for the abdominal aorta just below the diaphragm
2.5 cm in diameter
upper normal measurement for the abdominal aorta in the mid-abdomen
2 cm or less
upper normal measurement for the abdominal aorta in the lower abdomen
1.8 cm or less
the common iliac arteries are considered enlarged if their diameter exceeds ____
2 cm
what causes an aneurysm?
weakening of the vessel wall
the most common shape of an AAA
fusiform (has gradual enlargement)
the most common location of an AAA
infrarenal
most common cause of aneurysms in the United States
atherosclerosis
Clinical findings: pulsatile abdominal mass abdominal bruit back pain abdominal pain lower extremity pain
abdominal aortic aneurysm
Sonographic findings:
diameter of the abdominal aorta measures greater than 3 cm
thrombus within the lumen of the aorta
calcifications, along with the thrombus, may produce acoustic shadowing
abdominal aortic aneurysm
Clinical findings: intense chest pain hypertension abdominal pain lower back pain neurologic symptoms
aortic dissection
Sonographic findings:
possible abdominal aortic aneurysm
intimal flap may be noted within the aortic lumen
aortic dissection
aneurysms that measure more than ___ are more prone to rupture
7 cm
Clinical findings: decreased hematocrit hypotension pulsatile abdominal mass abdominal bruit back pain abdominal pain lower extremity pain
aortic rupture
Sonographic findings:
abdominal aneurysm with an adjacent hematoma
aortic rupture
common site for pseudoaneurysm development
within the groin at the level of the femoral artery following a heart catheterization
Clinical findings:
recent catheterization, surgical procedure, or trauma
pulsatile mass in the area of the puncture location
pseudoaneurysm
Sonographic findings:
perivascular hematoma containing swirling blood and has a neck connecting it to the vessel
color Doppler demonstration of turbulent flow within the mass
pseudoaneurysm
where does the IVC terminate?
right atrium of the heart
4 sections of the IVC
hepatic
prerenal
renal
postrenal
what kind of blood flow pattern do the hepatic veins have?
pulsatile and triphasic, secondary to their association with the right atrium
first connections to the IVC
hepatic veins
second connections to the IVC
renal veins
which renal vein is longer?
left
what kind of blood flow do the renal veins have?
low-velocity, continuous flow
third connections to the IVC
gonadal veins (testicular or ovarian)
the left gonadal vein drains into the _____________
left renal vein
which gonadal vein is the longest?
left, since it drains into the left renal vein
the diameter of the IVC should never exceed ____
2.5 cm
what two veins join to form the portal vein?
superior mesenteric vein
splenic vein
(portal splenic confluence)
the diameter of the portal vein is typically less than ____
13 mm
which side do most tumors invade the IVC from?
right, secondary to the shorter length of the right renal vein
most common cause of IVC obstruction that leads to enlargement
right-sided heart failure
the abnormal connection between arteries and veins that results from trauma or biopsy
ateriovenous fistula
direct communication between arteries and veins that may be congenital or caused by surgery, malignancy, trauma, or biopsy
arteriovenous malformations (AVM)
All of the following are branches of the celiac axis except: A. right gastric artery B. hepatic artery C. splenic artery D. left gastric artery
right gastric artery
What should the postprandial flow pattern be within the superior mesenteric artery?
A. high resistance
B. low resistance
low resistance
In small bowel ischemia, the postprandial superior mesenteric artery will yield what flow pattern?
A. high resistance
B. low resistance
high resistance
The main portal vein is created by the union of the:
A. splenic vein and superior mesenteric vein
B. superior mesenteric vein and inferior mesenteric vein
C. splenic vein and inferior mesenteric vein
D. splenic vein and gastroduodenal vein
splenic vein and superior mesenteric vein
The veins seen attaching to the IVC just below the diaphragm are the: A. renal veins B. superior mesenteric vein C. hepatic veins D. celiac axis
hepatic veins
The hepatic artery should demonstrate:
A. high-resistance flow
B. low-resistance flow
low-resistance flow
What vessel travels posterior to the superior mesenteric artery and anterior to the abdominal aorta? A. left renal vein B. left renal artery C. right renal vein D. splenic vein
left renal vein
Which of the following would most likely have a high-resistance flow pattern? A. celiac artery B. common iliac artery C. splenic artery D. right renal artery
common iliac artery
What vessel travels anterior to the left renal artery? A. left renal vein B. hepatic artery C. right renal vein D. superior mesenteric vein
left renal vein
From the list below, which vessel would be the shortest in length? A. right renal vein B. right renal artery C. left renal vein D. left renal artery
right renal vein
