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

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
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

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
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

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

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

A

false

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
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

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Which vessels join to form the common iliac veins?

A

external and internal iliac veins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

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

A

medial

posterior

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
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

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is rouleaux flow?

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

A

aggregate of RBC’s

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

The 4 sections of the IVC are

A

hepatic
pre-renal
renal
post-renal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

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

IVC
Aorta
Gonadal Veins
SMA

A

IVC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Where do the hepatic veins originate?

A

Liver

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

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

A

hepatic veins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

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

A

caudate lobe

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

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

A

False

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

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

A

hepatofugal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is the opposite of hepatofugal flow?

A

hepatopedal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

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

A

left suprarenal vein

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What does the right gonadal vein drain into?

IVC
Aorta
left gonadal vein
hepatic veins

A

IVC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
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
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

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

A

MPV

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

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

A

True

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

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

A

True

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

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

A

True

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
The name of the maneuver that produces a variable response in the venous system, allowing dilation and distention with breathing in and out is
Valsalva Maneuver
26
The IVC normally courses through the ____, and lies to the ____ of the AO and is ____ to the vertebral processes.
retroperitoneum right anterolateral
27
The IVC lies ____ to the right kidney and ____ to the liver.
medial | posterior
28
The IVC moves ____ as it courses towards the heart. laterally superiorly anteriorly posteriorly
anteriorly
29
The IVC is normally anechoic, but internal echoes sometimes appear in the IVC and are referred to as ____ AKA _____.
red cell aggregation | Rouleaux Formation
30
T or F? Slow flow is thought to enhance rouleaux formation?
True
31
The hepatic section of the IVC is where
the hepatic veins (HVs) empty into the IVC
32
The pre-renal section of the IVC is located
inferior to the hepatic veins (HVs), but superior to the renal veins
33
The renal section of the IVC is where
the renal veins (RVs) and the multiple tributaries are located
34
The post-renal section of the IVC extends just ____ to the renal veins (RVs) until the bifurcation
inferior
35
A tumor invasion most commonly occurs in the ____ and extends to into the ____.
``` renal veins (RVs) IVC ```
36
The most common tumor involving the IVC is
Renal Cell Carcinoma
37
The hepatic veins (HVs) originate in the ____ and empty into the ____, superior to the locations of the ____.
liver IVC renal veins (RVs)
38
The right and left hepatic veins (RHVs and LHVs) empty the ____ ____ of the ____, and the middle hepatic vein (MHV) drains the ____.
right and left lobes of the liver, respectively | caudate lobe
39
T or F? The hepatic veins (HVs) exhibit pulsatility. Why?
True | it is a reflection of cardiac and respiratory activity
40
Flow going away from the liver is called
hepatofugal
41
Caudate lobe veins drain directly into the ____ and are occasionally seen on US.
IVC
42
T or F? Suprarenal veins (SRVs)/Adrenal veins (AVs) are normally seen with US.
False
43
The renal veins (RVs) return blood from the ____ and empty into the _____, immediately _____ to the level of the renal arteries (RAs).
kidneys IVC superior
44
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.
Nutcracker Syndrome It is the engorgement of the LRV due to its compression by the SMA and AO
45
Why is the RRV well demonstrated with US?
Because of the overlying hepatic tissue forms an acoustic window
46
The Right Gonadal Vein comes off the ____, while the Left Gonadal Vein comes off the _____.
IVC | left renal vein (LRV)
47
The RRV *MAY* receive the _____ vein.
right suprarenal
48
Are the gonadal veins usually seen with US?
No
49
The left gonadal vein (LGV) opens into the ____ and the right gonadal vein (RGV) drains directly into the ____, just ____ to the RRV.
left renal vein (LRV) IVC inferior RRV
50
The veins that provide an alternate pathway for venous return in the case of IVC obstruction are called
azygos and hemi-azygos veins
51
The azygos vein is located on the ____ side.
RIGHT
52
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.
RRA | RRV
53
RVs are generally ____ to RAs, but crossing over can occur. How can you check this?
anterior | using pulsed wave or color doppler is helpful
54
T or F? The IVC is easily displaced.
True
55
Tumors in the RVs will most likely invade the ____.
IVC
56
The HVs originate in the liver and end at the ____.
IVC
57
What 2 veins enter the LRV besides the IVC?
LGV (left gonadal vein) | LSV (left suprarenal vein)
58
Where does the RGV (right gonadal vein) drain into?
the IVC
59
Does the portal venous system enter the IVC?
No
60
The portal venous system is made of (4)
Portosplenic Confluence MPV RPV (and branches) LPV (and branches)
61
T or F? The SV is less tortuous than the SA.
True
62
The SV begins at the
hilum of the spleen
63
What does the splenic vein drain (3)?
spleen part of the pancreas stomach
64
The SV passes _____ to the _____, across the posterior abdominal wall, _____ to the SA and _____ to the body and tail of the pancreas.
transversely right inferior posterior
65
What 2 vessels are used as landmarks to locate the pancreas? Which one is the main one?
SA | SV - main one
66
In general, the SV is located _____ to the pancreatic body and tail.
posterior
67
The SA is tortuous but usually follows the _____ border of the pancreatic body and tail.
anterior
68
What is the name of the ligament that crosses over the CA?
median arcuate ligament
69
What 3 veins make up the portosplenic confluence?
SV SMV IMV
70
What vessel supplies the liver with 80% of its blood supply and originates behind the pancreatic neck?
MPV
71
What makes up the Mickey Mouse image?
the porta hepatis in oblique view | MPV, CHD, PHA
72
What is the porta hepatis?
an area of the liver hilum, made up of 3 vessels
73
What are the 3 vessels that make up the porta hepatis? And what is the silly phrase to remember this?
MPV PHA CHD mashed, potatoes, and corn
74
What is the "Steerhead Sign"?
the medial and lateral branches of the LPV
75
What does the PHA divide into?
RHA and LHA
76
The CHA changes into the ____ after it divides into the GDA.
PHA
77
What vessel does the RHA give rise to?
cystic artery
78
From where does the cystic vein originate, giving a branch to the ____ lobe before entering the ____ lobe of the liver.
RPV Caudate lobe Right
79
The IMV joins the _____ and drains into the ____ part of the large intestines, as well as the area along the _____, _____ area, and the _____ colon.
``` SV inferior rectum sigmoid descending ```
80
The SMV originates at the _____, where the ileum and small intestine join the _____ of the large intestine.
ileocecal valve | cecum
81
The SMV courses _____ towards the midline.
superiorly
82
The SMV joins the _____ and _____, and these two vessels become the _____.
SV IMV portal-splenic confluence
83
The portal-splenic confluence continues to course _____ and become know as the _____.
laterally | MPV
84
The MPV is made up of the (3)
SMV IMV SV
85
The MPV ascends _____ to the _____, passing behind the _____ portion of the duodenum, CBD, PHA, and GDA, as well as _____ to the IVC.
obliquely right superior anterior
86
The branches of the _____ supply 20% of the liver's blood.
HAs
87
The MPV begins _____ the neck of the pancreas.
behind
88
The origin of the _____ is used as a landmark for the pancreatic neck.
MPV
89
The MPV courses ______ and ______ for about 5-6cm before it enters the liver through the _____, and then divides into the ______ and ______.
superiorly laterally porta hepatis RPVs and LPVs
90
The Mickey Mouse Sign of the Porta Hepatis is seen in an ______ scanning plane.
oblique
91
The LPV is _____ (shorter/longer) than the RPV and has a _____ (bigger/smaller) diameter than the RPV.
longer | smaller
92
The LPV gives branches to the _____ before entering the _____ lobe of the liver.
caudate lobe | left
93
The origin of the LPV is the _____ and courses _____.
MPV | medially
94
The _____ vein originates from the RPV and gives a branch to the ______ lobe before entering the ______ lobe of the liver.
cystic caudate right
95
The RPV courses laterally to the ______ and then divides into branches called the ______ and ______ segments.
right anterior posterior
96
The PVs can be distinguished from other structures because ______, and this is because of
their walls are highly echogenic | the high collagen content in the walls
97
The CHA arises from the CA and bifurcates into the ______ and ______.
GDA | PHA
98
Just prior to the bifurcation of the CHA, it passes ______ to the MPV.
anterior
99
The ______ begins at the bifurcation and ascends to the porta hepatis of the liver within the folds of the ______ ligament.
PHA | hepatoduodenal
100
The PHA divides within the porta hepatis into the ______ and ______.
RHAs and LHAs
101
The RHA gives rise to the ______.
cystic artery
102
The cystic artery supplies the (3)
GB hepatic ducts part of the CBD
103
T or F? Both the MPV and PHA should be the same color doppler because the blood flow is going in the same direction.
True
104
When can the IMV be seen with ultrasound?
When it dilates from portal HTN