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*Ultrasound* > IVC > Flashcards

IVC Flashcards

1
Q

What is the purpose of the IVC?

A

To transport deoxygenated blood back to the heart and lungs to oxygenate it again

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2
Q

What does the venous system contain within the lumen of the vessel that helps the blood move forward?

blood clots
stems
valves
gates

A

valves

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3
Q

If the valves in the venous system are leaking or damaged, what do we call the flow of blood in those vessels when it goes in reverse or backwards?

antegrade
retrograde
rouleaux flow
reverse flow

A

retrograde

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4
Q

T or F? The venous system usually demonstrates pulsatile flow.

A

false

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5
Q

What happens to the venous system if the valsalva maneuver is utilized?

distends and dilates
collapses
becomes pulsatile
forms blood clots

A

distends and dilates

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6
Q

Which vessels join to form the common iliac veins?

A

external and internal iliac veins

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7
Q

The IVC lies ____ to the right kidney and ____ to the liver.

A

medial

posterior

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8
Q

What would be a reason(s) to ultrasound the IVC?

look for thrombus
look for tumor invasion
both a and b
none of the above

A

both a and b

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9
Q

What is rouleaux flow?

fast flow
reversed flow
aggregate of RBC’s
no flow at all

A

aggregate of RBC’s

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10
Q

The 4 sections of the IVC are

A

hepatic
pre-renal
renal
post-renal

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11
Q

If a tumor is seen in the renal veins, what other vessel would you interrogate?

IVC
Aorta
Gonadal Veins
SMA

A

IVC

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12
Q

Where do the hepatic veins originate?

A

Liver

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13
Q

What vessel(s) drain all of the blood out of the liver?

A

hepatic veins

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14
Q

The RHV empties the RLL, and the LHV empties the LLL. What does the MHV empty?

A

caudate lobe

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15
Q

T or F? The hepatic veins decrease in diameter as they approach the IVC.

A

False

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16
Q

What is the name of the blood flow if it is flowing AWAY from the liver?

A

hepatofugal

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17
Q

What is the opposite of hepatofugal flow?

A

hepatopedal

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18
Q

What other vein enters the LRV instead of the IVC and the left gonadal vein?

A

left suprarenal vein

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19
Q

What does the right gonadal vein drain into?

IVC
Aorta
left gonadal vein
hepatic veins

A

IVC

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20
Q

The major abdominal venous system consists of

A 
IVC (from the common iliac veins to the diaphragm)
Splenic Vein
IMV
SMV
Hepatic Veins
Renal Veins
Portal Veins
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21
Q

The PHA shares a partnership with the venous circulatory supply of the liver, which is the

A

MPV

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22
Q

T or F? Venous vessels will demonstrate tube-like structures with well-defined, echogenic walls and an echofree lumen.

A

True

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23
Q

T or F? The walls of ARTERIES and PV STRUCTURES will be more echogenic than the thinner walled VEINS.

A

True

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24
Q

T or F? A vein lumen open and close with respiration.

A

True

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25
Q

The name of the maneuver that produces a variable response in the venous system, allowing dilation and distention with breathing in and out is

A

Valsalva Maneuver

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26
Q

The IVC normally courses through the ____, and lies to the ____ of the AO and is ____ to the vertebral processes.

A

retroperitoneum
right
anterolateral

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27
Q

The IVC lies ____ to the right kidney and ____ to the liver.

A

medial

posterior

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28
Q

The IVC moves ____ as it courses towards the heart.

laterally
superiorly
anteriorly
posteriorly

A

anteriorly

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29
Q

The IVC is normally anechoic, but internal echoes sometimes appear in the IVC and are referred to as ____ AKA _____.

A

red cell aggregation

Rouleaux Formation

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30
Q

T or F? Slow flow is thought to enhance rouleaux formation?

A

True

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31
Q

The hepatic section of the IVC is where

A

the hepatic veins (HVs) empty into the IVC

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32
Q

The pre-renal section of the IVC is located

A

inferior to the hepatic veins (HVs), but superior to the renal veins

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33
Q

The renal section of the IVC is where

A

the renal veins (RVs) and the multiple tributaries are located

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34
Q

The post-renal section of the IVC extends just ____ to the renal veins (RVs) until the bifurcation

A

inferior

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35
Q

A tumor invasion most commonly occurs in the ____ and extends to into the ____.

A 
renal veins (RVs)
IVC
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36
Q

The most common tumor involving the IVC is

A

Renal Cell Carcinoma

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37
Q

The hepatic veins (HVs) originate in the ____ and empty into the ____, superior to the locations of the ____.

A

liver
IVC
renal veins (RVs)

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38
Q

The right and left hepatic veins (RHVs and LHVs) empty the ____ ____ of the ____, and the middle hepatic vein (MHV) drains the ____.

A

right and left lobes of the liver, respectively

caudate lobe

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39
Q

T or F? The hepatic veins (HVs) exhibit pulsatility. Why?

A

True

it is a reflection of cardiac and respiratory activity

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40
Q

Flow going away from the liver is called

A

hepatofugal

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41
Q

Caudate lobe veins drain directly into the ____ and are occasionally seen on US.

A

IVC

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42
Q

T or F? Suprarenal veins (SRVs)/Adrenal veins (AVs) are normally seen with US.

A

False

43
Q

The renal veins (RVs) return blood from the ____ and empty into the _____, immediately _____ to the level of the renal arteries (RAs).

A

kidneys
IVC
superior

44
Q

The LRV courses anterior to the AO, and lies between the aortic wall and the SMA - this is called ____, often causing the LRV to appear dilated prior to this point. Explain what this is.

A

Nutcracker Syndrome

It is the engorgement of the LRV due to its compression by the SMA and AO

45
Q

Why is the RRV well demonstrated with US?

A

Because of the overlying hepatic tissue forms an acoustic window

46
Q

The Right Gonadal Vein comes off the ____, while the Left Gonadal Vein comes off the _____.

A

IVC

left renal vein (LRV)

47
Q

The RRV MAY receive the _____ vein.

A

right suprarenal

48
Q

Are the gonadal veins usually seen with US?

A

No

49
Q

The left gonadal vein (LGV) opens into the ____ and the right gonadal vein (RGV) drains directly into the ____, just ____ to the RRV.

A

left renal vein (LRV)
IVC
inferior
RRV

50
Q

The veins that provide an alternate pathway for venous return in the case of IVC obstruction are called

A

azygos and hemi-azygos veins

51
Q

The azygos vein is located on the ____ side.

A

RIGHT

52
Q

The right crus can be mistaken for either the ____ or ____ if care is not taken to follow vessels to see if they arise from the AO or empty into the IVC.

A

RRA

RRV

53
Q

RVs are generally ____ to RAs, but crossing over can occur. How can you check this?

A

anterior

using pulsed wave or color doppler is helpful

54
Q

T or F? The IVC is easily displaced.

A

True

55
Q

Tumors in the RVs will most likely invade the ____.

A

IVC

56
Q

The HVs originate in the liver and end at the ____.

A

IVC

57
Q

What 2 veins enter the LRV besides the IVC?

A

LGV (left gonadal vein)

LSV (left suprarenal vein)

58
Q

Where does the RGV (right gonadal vein) drain into?

A

the IVC

59
Q

Does the portal venous system enter the IVC?

A

No

60
Q

The portal venous system is made of (4)

A

Portosplenic Confluence
MPV
RPV (and branches)
LPV (and branches)

61
Q

T or F? The SV is less tortuous than the SA.

A

True

62
Q

The SV begins at the

A

hilum of the spleen

63
Q

What does the splenic vein drain (3)?

A

spleen
part of the pancreas
stomach

64
Q

The SV passes _____ to the _____, across the posterior abdominal wall, _____ to the SA and _____ to the body and tail of the pancreas.

A

transversely
right
inferior
posterior

65
Q

What 2 vessels are used as landmarks to locate the pancreas? Which one is the main one?

A

SA

SV - main one

66
Q

In general, the SV is located _____ to the pancreatic body and tail.

A

posterior

67
Q

The SA is tortuous but usually follows the _____ border of the pancreatic body and tail.

A

anterior

68
Q

What is the name of the ligament that crosses over the CA?

A

median arcuate ligament

69
Q

What 3 veins make up the portosplenic confluence?

A

SV
SMV
IMV

70
Q

What vessel supplies the liver with 80% of its blood supply and originates behind the pancreatic neck?

A

MPV

71
Q

What makes up the Mickey Mouse image?

A

the porta hepatis in oblique view

MPV, CHD, PHA

72
Q

What is the porta hepatis?

A

an area of the liver hilum, made up of 3 vessels

73
Q

What are the 3 vessels that make up the porta hepatis? And what is the silly phrase to remember this?

A

MPV
PHA
CHD

mashed, potatoes, and corn

74
Q

What is the “Steerhead Sign”?

A

the medial and lateral branches of the LPV

75
Q

What does the PHA divide into?

A

RHA and LHA

76
Q

The CHA changes into the ____ after it divides into the GDA.

A

PHA

77
Q

What vessel does the RHA give rise to?

A

cystic artery

78
Q

From where does the cystic vein originate, giving a branch to the ____ lobe before entering the ____ lobe of the liver.

A

RPV
Caudate lobe
Right

79
Q

The IMV joins the _____ and drains into the ____ part of the large intestines, as well as the area along the _____, _____ area, and the _____ colon.

A 
SV
inferior
rectum
sigmoid 
descending
80
Q

The SMV originates at the _____, where the ileum and small intestine join the _____ of the large intestine.

A

ileocecal valve

cecum

81
Q

The SMV courses _____ towards the midline.

A

superiorly

82
Q

The SMV joins the _____ and _____, and these two vessels become the _____.

A

SV
IMV
portal-splenic confluence

83
Q

The portal-splenic confluence continues to course _____ and become know as the _____.

A

laterally

MPV

84
Q

The MPV is made up of the (3)

A

SMV
IMV
SV

85
Q

The MPV ascends _____ to the _____, passing behind the _____ portion of the duodenum, CBD, PHA, and GDA, as well as _____ to the IVC.

A

obliquely
right
superior
anterior

86
Q

The branches of the _____ supply 20% of the liver’s blood.

A

HAs

87
Q

The MPV begins _____ the neck of the pancreas.

A

behind

88
Q

The origin of the _____ is used as a landmark for the pancreatic neck.

A

MPV

89
Q

The MPV courses ______ and ______ for about 5-6cm before it enters the liver through the _____, and then divides into the ______ and ______.

A

superiorly
laterally
porta hepatis
RPVs and LPVs

90
Q

The Mickey Mouse Sign of the Porta Hepatis is seen in an ______ scanning plane.

A

oblique

91
Q

The LPV is _____ (shorter/longer) than the RPV and has a _____ (bigger/smaller) diameter than the RPV.

A

longer

smaller

92
Q

The LPV gives branches to the _____ before entering the _____ lobe of the liver.

A

caudate lobe

left

93
Q

The origin of the LPV is the _____ and courses _____.

A

MPV

medially

94
Q

The _____ vein originates from the RPV and gives a branch to the ______ lobe before entering the ______ lobe of the liver.

A

cystic
caudate
right

95
Q

The RPV courses laterally to the ______ and then divides into branches called the ______ and ______ segments.

A

right
anterior
posterior

96
Q

The PVs can be distinguished from other structures because ______, and this is because of

A

their walls are highly echogenic

the high collagen content in the walls

97
Q

The CHA arises from the CA and bifurcates into the ______ and ______.

A

GDA

PHA

98
Q

Just prior to the bifurcation of the CHA, it passes ______ to the MPV.

A

anterior

99
Q

The ______ begins at the bifurcation and ascends to the porta hepatis of the liver within the folds of the ______ ligament.

A

PHA

hepatoduodenal

100
Q

The PHA divides within the porta hepatis into the ______ and ______.

A

RHAs and LHAs

101
Q

The RHA gives rise to the ______.

A

cystic artery

102
Q

The cystic artery supplies the (3)

A

GB
hepatic ducts
part of the CBD

103
Q

T or F? Both the MPV and PHA should be the same color doppler because the blood flow is going in the same direction.

A

True

104
Q

When can the IMV be seen with ultrasound?

A

When it dilates from portal HTN

*Ultrasound* (14 decks)

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