Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Vascular 1 > Liver Vasculature > Flashcards

Liver Vasculature Flashcards

1
Q

what is the primary supplier of oxygen rich blood in the liver

A

Hepatic Artery

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

what percentage of blood does the hepatic artery supply to the liver

A

30%

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

where is the prox portion of the hepatic artery visualized best

A

in tranvesre @ the celiac axis level

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

where is the distal portion of the hepatic artery visualized best

A

intercostally @ the level of the MPV

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

what kind of flow pattern does the HA have

A

low resistance

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

why is there a fill-in of the spectral window on the HA

A

because of the small artery diameter

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

what causes the HA to have variable velocities

A

tortuosity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what is the RI of the HA

A

0.5-0.7

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

when is the intrahepatic artery evaluated

A

in liver duplex exams
pre and post liver transplant studies
to rule out veno-occlusive disease in bone marrow transplant patients

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

normal HA blood flow with a celiac artery occlusion would result in what

A

collateralization occurring through the pancreaticduodenal network of vessles

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

true or false: there are many varients of the HA circulation

A

true

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

IVC is formed by the union of which vessels

A

common iliac veins

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

what is the location of the IVC

A

anterior to the spine

to the right of the aorta

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

where do the HV empty into the IVC

A

just inferior to the diaphragm

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

what kind of window usually the best to visualize the intrahepatic portion of the IVC

A

intercostal

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

what kind of waveform does the IVC have

A

spontaneous

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

what kind of spectral waveform does the prox portion of the IVC have

A

pulsatile

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

what kind of spectral waveform does the distal portion of the IVC have

A

Phasic

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

size of the IVC will vary with what factors

A

size of the patient
respiration
right atrial pressure (CHF)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

typically how many major hepatic veins are there

A

3

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

true or false: accessory HV are common

A

true

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

HV drain into where

A

IVC

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

what happens to HV as they approach the IVC

A

they enlarge

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

how does the RHV run

A

coronally between the anterior and posterior segments of the right lobe

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

how does the MHV lie

A

between the right and left lobes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

how does the LHV run

A

between the medial and lateral segments of the left lobe

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

does the caudate lobe gave its own drainage into the IVC

A

yes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

commonly what happens the left and middle HV before they enter the IVC

A

they join together

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

which HV is usually absent with agensis

A

RHV

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

to visualize all 3 HV what kind of scanning plane needs to be optimized

A

transverse in a subxiphoid scan plane

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

what kind of spectral tracing does the HV have

A

mutli-phasic

pulsatile flow pattern

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

are the walls more or less defined then the PV

A

less, because of no echogenic sheath

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

what are patency and distension a indication of

A

Budd Chiari or CHF

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

PV drain what kind of blood from the bowl and spleen to the liver

A

nutrient rich blood

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

what percentage of blood does the PV bring to the liver

A

70%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

how is the PV formed

A

by the confluence of the splenic vein and SMV

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

what also forms the PV

A

IMV

coronary vein tributaries

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

where does the PV enter the liver

A

@ the porta hepatis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

what are the branches of the PV

A

right

left

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

how is the PV visualized

A

sub or intercostal approach

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

what kind of velocity does the PV have

A

low

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

what is the range of PV velocity

A

15-40 cm/sec

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

what is the mean velocity of the PV

A

15-18 cm/sec

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

what kidn of signal does a PV spectral tracing produce

A

continuous

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

true or false: PV will have subtle phasic variations (slight undulations)

A

true

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

what kind of flow does the PV have

A

hepatopetal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

what have to PV flow post-prandially

A

increases

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

with thrombosis in the PV what will be seen in the porta hepatis

A

numerous collaterals

49
Q

with thrombosis what does the PV get termed

A

cavernous transformation

50
Q

with the presence of thrombosis, sonographically what is the appearance of the PV

A

multiple small tortuous vessels in the porta hepatis with the MPV not visualized

51
Q

what does a liver duplex exam determine

A

flow direction

normal waveform

52
Q

a liver duplex exam includes the interrogation of which veins

A

hepatic veins
portal veins
splenic vein

53
Q

what do you look for when looking for the cause of portal hypertension

A

collateral routes and indications

54
Q

doppler assessment is assed during what kind of respiration

A

quiet

55
Q

what are you looking for in the waveform prior to the alteration of flow direction

A

subtle changes

56
Q

what position should the patient be in for a liver duplex exam

A

supine

57
Q

the anterior subxiphoid window assesses what

A

LPV
LHV
SV
MPV

58
Q

coronal (intercostal) assesses what

A 
RHV 
MHV
RPV
MPV
HA
59
Q

colour and spectral doppler assesses what

A

flow direction

quality of flow

60
Q

the hepatic veins should have what kind of flow and waveform

A

hepatofugal flow

multiphasic waveform

61
Q

the portal veins should have what kind of flow and waveform

A

hepatopetal

subtle phasicity

62
Q

when meausring the MPV where is the measurment taken

A

ap diameter

63
Q

the MPV is located what to the IVC

A

anterior

64
Q

how do you elongate the MPV

A

rotating the transducer counter clockwise

> towards the patients right shoulder

65
Q

MPV 2D picture is taken in what window

A

anterior subcostal

66
Q

the patient should have what kind of respiration when assessing the MPV

A

quiet

67
Q

the normal measurement of the MPV is

A

less than 13mm

68
Q

the colour and spectral tracing of the MPV should be taken in what window

A

coronal intercostal

69
Q

the MPV should be sampled where

A

outside the liver

70
Q

the coronal intercostal approch for assessing the MPV gives what kind of angle

A

zero angle

71
Q

the anterior subcostal approach for assessing the MPV gives what kind of angle

A

60 degree angle

72
Q

how is the peak velocity of the MPV assessed

A

with a generic caliper

73
Q

what is the normal velocity range of the MPV

A

15-40 cm/sec

74
Q

the splenic vein protocol consits of what

A

colour and spectral

long axis assessment

75
Q

the LHV protocol consits of what

A

colour and spectral

long axis assessment

76
Q

what window is the SV and the LHV assessed in

A

anterior subcostal

77
Q

LPV protocol consists of what

A

colour and sepectral
long axis assessment
taken in the subxiphoid window

78
Q

RHV protocol consists of what

A

colour and spectral
long axis assesment
taken from a right intercostal window

79
Q

MHV protocol consists of what

A

colour and spectral
long axis assessment
taken from either a midline subxiphoid or intercostal at the anterior axillary line

80
Q

RPV protocol consists of what

A

colour and spectral
taken from a coronal intercostal
> same window and area as MPV

81
Q

HA protocol consists of what

A

colour and spectral
taken from a coronal intercostal window
> same window and as MPV colour and spectral image

82
Q

can the patient hold there breath for the assessment of the HA

A

yes

83
Q

why does the scale have to be adjusted accordingly when assessing portal venous flow whem compared to the hepatic vein flow

A

because it is slower

84
Q

sweep speed should be should be adjusted to what

A

medium

85
Q

for portal veins what should be done to the baseline

A

moved down slightly

86
Q

for hepatic veins what should be done to the baseline

A

moved up slightly

87
Q

all the images have quiet respiration except which one

A

HA

88
Q

for intercostal scanning what should be done to the probe

A

rotate the transducer to go between the ribs

point transducer indicator towards patients right scapula

89
Q

what is portal hypertension

A

elevated pressure in the portal venous system which impedes blood flow through the liver

90
Q

what does PHT cause

A

volume overload

increased resistance to flow

91
Q

what are the three classifications

A

pre-hepatic
intrahepatic
post-hepatic

92
Q

what is the most common clssification of PHT

A

intrahepatic

93
Q

which classifcations are extrahepatic PHT

A

pre-hepatic

post-hepatic

94
Q

what are causes Pre-hepatic PHT

A 
portal thrombosis 
splenic thrombosis
portal vein invasion
splenic vein invasion
inflammation of the pancreas (pancreatitis)
extrinsic compression by a tumor
95
Q

what is pre-hepatic PHT

A

pathology that occurs to blood flow before it enters the liver

96
Q

what is intraheptic PHT caused from

A

damage to the liver
sinusoids
hepatocytes

97
Q

what is intrahepatic PHT

A

hepatocellular disease

98
Q

what are the four main causes of intrahepatic PHT

A

cirrhosis
hepatitis
fatty infiltration
tumor invasion

99
Q

can hepatitis, fatty infiltration anf tumor invasion lead to cirrohis

A

yes

100
Q

what are the 3 steps of cirrhosis

A
  1. normal liver tissue becomes inflammed
  2. regeneration and scarring of liver tissue (fibrosis)
  3. increased risistance to blood flow at the sinusoid level
101
Q

what are the cause of post-hepatic PHT

A

thrombosis of the hepatic veins
thrombosis of the IVC
CHF
right sided heart disease

102
Q

what is post-hepatic PHT effect

A

drainage of blood from the liver (outflow)

103
Q

what is Budd Chiari

A

thrombosis of the hepatic veins

104
Q

can tumor invade into the portal vein

A

yes

105
Q

what are the risk factors of chronic liver disease that proceeds fibrosis or cirrhosis

A

viral hepatitis: chronic hep B or C
alcoholic liver disease
autoimmune disorders: primary biliary cirrhoosis, primary sclerosing cholangitis
metabolic & geetic disorders: hemochromatosis, Wilson’s disease
schistosomiasis
non-alcoholic steatohepatitis (NASH)
sarcoidosis

106
Q

what are the risk factors of heart diease that results in increased right sided heart pressure

A

tricuspid regurgitation
CHF
constrictive pericarditis

107
Q

if these people have these risk factor are they at a higher risk to have PHT

A

yes, but it does not mean that they will get PHT

108
Q

what are the clinical signs that are related to PHT

A 
ascites: abdominal distension
splenomagaly
GI bleed
jaundice
abnormal LFT
109
Q

what is jaundice common sign of

A

cirrhosis

110
Q

can patients be asymptomatic if they have vascular liver disease

A

yes

111
Q

manifestations of signs and symptoms associated with underlying disease is most common with which 2 diseases

A

pancreatitis

liver disease

112
Q

what is hematemesis

A

blood in the vomit

113
Q

what is melena

A

blood in the stool

114
Q

what are other patient symtoms for PHT/vascular liver disease

A

variceal hemorrhage

bacterial peritonitis

115
Q

what are the fidings of a physical examination when assessing for PHT

A

jaudice (if liver is sufficiently impaired)
splenomegaly (could lead to low platlet count)
dialted abdominal wall veins
hepatic encephalopathy (confusion due to poor liver function)

116
Q

2-D sonographic evaluation includes documentation of what structures

A

portal vein diameter greater than 13mm
cavernous transformation (intra-abdominal collaterals)
portocaval anastomoses
dilation/recanalization of the umbilical vein
splenomegaly greater than 13cm

117
Q

duplex evaluation of the patency of vessels including collaterals inculdes what kind of documentation

A

colour doppler assessinf for flow or the lack of flow

power doppler looking tortuous vessels and collaterals

118
Q

duplex evaluation of the direction of flow inculdes what kind of documentation

A

colour and spectral
there is a possility of reverse flow in portal/splenic veins
assessing hepatofugal and hepatopedal flow

119
Q

duplex evaluation of the loss of phasic variations inculdes what kind of documentation

A

spectral tracing

Vascular 1 (3 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions