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Cara and Jason's Flashcards > IR Cara's flashcards > Flashcards

IR Cara's flashcards

1
Q

Average size of aortic root

A

3.6cm

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2
Q

Average size of distal descending aorta

A

2.4cm

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3
Q

Bovine arch

A

common origin of brachiocephalic artery and left CCA (15%)

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4
Q

What is the 3rd most common arch variant?

A

left CCA coming off the brachiocephalic proper (10%)

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5
Q

What is the 4th most common arch variant?

A

4 separate origins (left vert off of arch) (5%)

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6
Q

What side does the Artery of Adamkiewicz arise?

A

Left (70%) between T8-L1 (90%) aka great anterior medullary a.

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7
Q

First branch off the SMA

A

inferior pancreaticoduodenal

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8
Q

What makes the Arc of Riolan?

A

left colic (from IMA) to the middle colic (from SMA)

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9
Q

Branches of the SMA

A

inferior pancreaticoduodenal, middle colic, right colic, ileo-colic (appendicular)

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10
Q

Branches of the IMA

A

left colic, sigmoid branches, superior rectal (marginal artery)

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11
Q

2 most common hepatic artery variants

A

right hepatic replaced off the SMA and left hepatic replaced off the left gastric

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12
Q

Is there normally a vessel in the ligamentum venosum?

A

No, it s an accessory or replaced left hepatic arising from the left gastric

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13
Q

How do you tell if it s a replaced right hepatic?

A

Proper right hepatic is anterior to right portal vein. Replaced right hepatic is posterior to the main PV

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14
Q

Most common hepatic venous variant

A

Accessory right inferior hepatic vein (drains seg 6/7 into IVC)

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15
Q

Branches of internal iliac artery (posterior division)

A

Iliolumbar, Lateral Sacral, Superior Gluteal (I Love Sex) + Inferior gluteal (sometimes)

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16
Q

Branches of internal iliac artery (anterior division)

A

Umbilical, Obturator, Inf. vesicular/uterine, middle rectal, internal pudendal

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17
Q

What is the first branch off the popliteal artery?

A

Anterior tibialis

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18
Q

When does the CFA start?

A

inguinal ligament

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19
Q

When does the SFA start?

A

once the CFA gives off the profunda femoris

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20
Q

When does the popliteal artery start?

A

as the SFA exits the adductor canal

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21
Q

When the popliteal artery end?

A

terminates as the ant tibial and tibioperoneal trunk

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22
Q

When does the axillary artery start?

A

at the first rib

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23
Q

When does the brachial artery start?

A

as it crosses the teres major

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24
Q

When does the brachial artery end?

A

bifurcates tot he ulnar and radial arteries

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25
Q

What hand arch does the ulnar artery supply?

A

superficial arch

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26
Q

What hand arch does the radial artery supply?

A

deep arch

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27
Q

What supplies to the intraosseous branch?

A

ulnar artery (usually)

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28
Q

Arc of Buhler

A

collateral pathway from celiac to SMA (independent of GDA and inf. pancreatic)

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29
Q

Normal collateral pathway from celiac to SMA

A

celiac - GDA - sup pancreatic duodenal - inf pancreatic duodenal - SMA

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30
Q

Marginal artery of Drummond

A

SMA to IMA connection, continuous arterial circle/arcade along the inner border of the colon

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31
Q

IMA to Iliac normal collateral pathway

A

IMA - superior rectal - inferior rectal - internal pudenal - anterior branch of internal iliac

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32
Q

Winslow pathway

A

IMA to iliac collateral pathway seen in aorto-iliac occlusive dz (subclavian - int. thoracic/mammary - sup. epigastric - inf. epigastric - extenal iliac)

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33
Q

what vessels does the corona mortis connect?

A

obturator and ext. iliac

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34
Q

what abnormal vessel courses over the superior pubic rim?

A

corona mortis (injured during surgery or pelvic trauma)

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35
Q

Most gastric varices are formed by which vein?

A

left gastric/coronary

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36
Q

What vein drains the gastric cardia?

A

left gastric/coronary

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37
Q

What vein drains the gastric fundus?

A

posterior and short gastric

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38
Q

enlarged splenorenal shunts are associated with?

A

hepatic encephalopathy

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39
Q

where does a left SVC drain?

A

coronary sinus (92%) or left atrium (8%)

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40
Q

duplicated IVC associations

A

renal stuff - horse shoe and crossed fused ectopic + circumaortic renal collars

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41
Q

which limb is superior in circumaortic venous collar?

A

anterior limb

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42
Q

other name for azygous continuation

A

absence of the hepatic segment of the IVC

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43
Q

where do hepatic veins drain in azygous continuation?

A

directly into right atrium

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44
Q

azygous continuation association

A

polysplenia

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45
Q

persistent sciatic artery

A

continuation of the internal iliac

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46
Q

what abnormal vessel passes posterior to femur in the thigh?

A

persistent sciatic artery

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47
Q

external iliac is acutely occluded, but there s still a strong pulse in the foot

A

persistent sciatic artery

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48
Q

most common cause of aortic dissection + intramural hematoma

A

hypertension (70%)

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49
Q

floating viscera sign

A

IR sign in AA dissection, catheter placed in true lumen with branch vessels arising out of nowhere

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50
Q

most common cause of penetrating ulcer

A

atherosclerosis

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51
Q

IMH progression to dissection?

A

max diam of 5cm is strongest predictor for dissection

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52
Q

true aneursym size

A

1.5 x normal diam

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53
Q

how can histoplasmosis cause SVC syndrome?

A

fibrosing mediastinitis

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54
Q

most common location of traumatic pseudoaneursym?

A

aortic isthmus (90%)

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55
Q

ascending aortic calcification

A

Takayasu and Syphilis

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56
Q

Size cut-offs of aorta

A

> 4cm ascending and transverse, >3.5 cm descending, > 3cm abd

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57
Q

Most common cause of aortic aneursym

A

atherosclerosis

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58
Q

cystic medial necrosis

A

Marfan

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59
Q

size for surgical repair of AAA

A

6cm

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60
Q

who gets sinus of valsalva aneurysm

A

Asian Men, usually right sinus

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61
Q

vascular findings in NF-1

A

aneurysms/stenosis lg vessels, renal artery stenosis/renovascular HTN (5% of NF1 kids)

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62
Q

vascular findings in NF-1

A

annuloaortic ectastia - aortic valve insufficiency, recurrent dissection, PA enlargement

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63
Q

tulip bulb

A

Marfan ascending aneursym

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64
Q

orbital finding in Loeys Dietz

A

hypertelorism (crazy wide eyes)

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65
Q

what procedures should be avoided in Ehlers Danlos

A

angio + percutaneous b/c of arterial dissection risk

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66
Q

vascular findings in Ehlers Danlos are similar to?

A

Marfan

67
Q

“tree bark” intimal calcfications

A

syphilitic, saccular ascending aorta aneursym

68
Q

what part of the bowel is involved in aortic-enteric fistula?

A

3rd and 4th portion of duodenum

69
Q

AAA + increased ESR

A

inflammatory aneurysm

70
Q

who gets inflammatory aneurysm?

A

young men who smoke

71
Q

inflammatory aneursym spares the?

A

posterior wall

72
Q

leriche syndrome

A

complete occlusion of the aorta

73
Q

triad of leriche

A

ass claudication, absent femoral pulses, impotence

74
Q

triad of mid aortic syndrome

A

HTN, claudication, renal failure

75
Q

who gets mid aortic syndrome

A

children, young adults (intrauterine insult with fragmentation of the elastic media)

76
Q

infantile aortic coarctation

A

pre-ductal, blood supply to descending aorta is PDA

77
Q

how does adult aortic coarctation present?

A

(Ductal), differential arm/leg BP

78
Q

association of aortic coarctation

A

Bicuspid aortic valve (80%), Turners (15-20%)

79
Q

pseudocoarctation

A

looks like coarc, but NO pressure gradient, collateral formation, or rib notching

80
Q

order of involvement in thoracic outlet syndrome

A

nerve (95%) - subclavian vein - subclavian artery

81
Q

most common cause of thoracic outlet syndrome

A

compression by anterior scalene muscle

82
Q

paget schroetter

A

thoracic outlet syndrome + subclavian vein thrombosis

83
Q

who gets paget schroetter

A

athletes (pitchers, weightlifters)

84
Q

can you stent the subclavian vein in paget schroetter?

A

no, it gets crushed. you have to do surgery.

85
Q

3 causes of PA aneursyms/psa

A

iatrogenic/swan ganz, Behcets, Chronic PE

86
Q

hughes-stovin

A

recurrent thrombophlebitis + PA aneursym formation/rupture

87
Q

rasmussen aneursym

A

PA pseudoaneursym 2/2 pulmonary TB

88
Q

PA aneursym in a congenital heart kid

A

patch aneursym from RVOT repair in TOF

89
Q

most common location of chronic mesenteric ischemia

A

splenic flexure (watershed of SMA and IMA)

90
Q

arterial vs. venous acute mesenteric ischemia

A

arterial = thin wall, non-dilated, diminished enhancement; venous = thick wall, dilation, fat stranding

91
Q

true splenic artery aneursyms

A

HTN, portal HTN, cirrhosis, liver tx, pregnancy

92
Q

false splenic artery aneuryms

A

pancreatitis

93
Q

mimic of splenic a. aneursym

A

islet cell pencreatic tumor (hypervascular). don t biopsy!

94
Q

median arcuate ligament syndrome

A

compression of celiac a. by median arcuate ligament

95
Q

how to treat median arcuate ligament syndrome?

A

surgical release

96
Q

typical presentation for median arcuate ligament?

A

20-40 years old, worse with expiration

97
Q

Heyde syndrome

A

colonic angiodysplasia + aortic stenosis

98
Q

other name for osler weber rendu

A

hereditary hemorrhagic telangiectasia

99
Q

common imaging for osler weber rendu

A

multipic hepatic and pulmonary AVMs

100
Q

how to osler weber rendu patient die?

A

stroke or brain abscess (pulmonary AVM)

101
Q

most common cause of renal artery stenosis

A

atherosclerosis (75%)

102
Q

2nd most common cause of renal artery stenosis

A

FMD

103
Q

renovascular HTN in young women

A

FMD

104
Q

string of beads

A

FMD

105
Q

treatment for FMD

A

angioplasty WITHOUT stenting

106
Q

nutcracker syndrome

A

smashing left renal vein as it slides under the SMA

107
Q

nutcracker syndrome

A

left flank/abd pain and hematuria

108
Q

what other vein is involved in nutcracker (besides left renal)

A

left gonadal vein (drains into left renal), left testicle pain in men, LLQ pain in women

109
Q

testicular varicocele side

A

LEFT 98% (left vein is longer and drains into renal vein at acute angle)

110
Q

what is the bad buzzword for varicocele?

A

“non-decompressible”, can be related to neoplasm in men >40

111
Q

which side is the bad side of varicocele?

A

RIGHT, raises concern for RCC, retroperitoneal fibrosis, or adhesions if new in adult

112
Q

2 kind of uterine AVMs

A

congenital and acquired

113
Q

how do you treat aquired uterine AVM?

A

embolization

114
Q

May Thurner

A

DVT of L CIV 2/2 compression of the left common iliac vein by the overlying right common iliac artery

115
Q

presentation of May Thurner

A

swollen left leg (L CIV DVT)

116
Q

most common peripheral arterial aneursym

A

popliteal

117
Q

association of popliteal artery aneursym

A

30-50% will have AAA

118
Q

how often is popliteal artery aneursym bilateral?

A

50-70%

119
Q

most dreaded complciation of popliteal artery aneurysm?

A

acute limb from thrombosis and distal embolization

120
Q

what causes popliteal entrapment?

A

compression by medial head of the gastrocnemius (less common the popliteus)

121
Q

presentation of popliteal entrapment

A

normal pulses that decrease with plantar flexion or dorsiflexion of foot

122
Q

3 looks of hypothenar hammer on angio?

A

corkscrew configuration or superficial palmar arch, occlusion of ulnar artery, or pseuodaneursym off the ulnar artery

123
Q

klippel-trenaunay triad

A

port wine nevi, bony or soft tissue hypertrophy (local gigantism), and a venous malformation

124
Q

what abnormal vessel is pathognomic of klippel-trenaunay

A

marginal vein of Servelle (superficial vein in the lateral calf and thigh)

125
Q

Kasabach Merritt

A

infant with a rapidly growing vascular tumor is responsible for thrombocytopenia, microangiopathic hemolytic anemia and consumptive coagulopathy.

126
Q

How is Parkes-Weber different from Klippel-Trenaunay?

A

In contrast to children who have Klippel-Trenaunay syndrome, kids with PWS have arteriovenous malformationsthat can cause heart failure.

127
Q

Normal ABI + abnormal values

A

1 = normal, 0.5-0.3 = claudication, <0.3 = rest pain

128
Q

re-stenosis of stent 3-12 months after angioplasty

A

probably from intimal hyperplasia (the bane of endovascular intervention)

129
Q

who gets Takayasu

A

young Asian girls (15-30)

130
Q

vasculitis involving the aorta

A

Takayasu

131
Q

what happens to the aortic wall in Takayasu

A

wall thickening + wall enhancement (acute phase)

132
Q

what vasculitis love old men?

A

Giant Cell

133
Q

vessels involved in giant cell?

A

temporal artery and arm pit vessels

134
Q

cogan syndrome

A

kid with eye and ear sx +/- aortitis

135
Q

is polyarteritis nodosa more common in men or women?

A

PAN is more common in a MAN

136
Q

most common vessels involved in PAN

A

renal (90%), cardiac (70%), GI (50-70%)

137
Q

most common imaging of PAN

A

kidneys with microaneurysms or kidney with areas of infarct

138
Q

kidney abnormality in meth users?

A

“speed kidney”, renal microaneursyms similar to PAN

139
Q

Kawasaki

A

calcified coronary artery aneursym (shown on CXR)

140
Q

most common vascultitis in children

A

Kawasaki (HSP also common)

141
Q

3 ANCA + vasculitides

A

Wegeners, Churg Strauss, Microscopic polyangiitis

142
Q

4 ANCA - vasculitides

A

HSP, Behcets, Buergers

143
Q

Wegeners

A

nasal septum erosions, cavitary lung lesions

144
Q

Churg Strauss

A

transient peripheral lung consolidations

145
Q

microscopic polyangiitis

A

diffuse pulmonary hemorrhage

146
Q

HSP

A

kids, intussusception, massive scrotal edema, MF bowel wall thickening

147
Q

Behcets

A

PA aneursyms (Turkish, mouth and genital ulcers)

148
Q

Buergers

A

male smoker. hand angio showing finger occlusions.

149
Q

buzzword for buergers

A

“auto-amputation”

150
Q

Segmental arterial mediolysis

A

multiple abdominal splanchnic artery saccular aneurysms

151
Q

cystic adventital disease

A

multiple mucoid filled cysts develop in the outer media and adventitia in the pop artery of young men

152
Q

normal ICA/CCA ratio

A

2

153
Q

normal ICA end diastolic velocity

A

<40

154
Q

normal carotid artery velocity

A

125 cm/s

155
Q

PSV + EDV in 50-69% ICA stenosis

A

PSV = 125-230 cm/s, EDV = 40-100, ICA/CCA PSV ratio = 2-4

156
Q

PSV + EDV in >70% ICA stenosis

A

PSV = > 230 cm/s, EDV = > 100, ICA/CCA PSV ratio = >4

157
Q

unilateral tardus parvus carotid artery

A

innominate artery stenosis

158
Q

bilateral tardus parvus cardotid artery

A

aortic stenosis

159
Q

loss of diastolic flow in the CCA

A

ICA occlusion, high resistance waveform like ECA

160
Q

bilateral CCA reversal of diastolic flow

A

aortic regurgitation

161
Q

pulsus bisferiens

A

double systolic peak in the CCA seen in aortic regurgitation

162
Q

classic doppler finding in aortic stenosis

A

bilateral tardus parvus waveform in the CCAs

163
Q

temporal tap

A

method for sonographers to tell the external from internal carotid artery

Cara and Jason's Flashcards (8 decks)

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