Brainscape's Knowledge GenomeTM

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


See full index

Vascular > Portal Venous > Flashcards

Portal Venous Flashcards

1
Q

TIPS

A

therapeutic porto-sytemic shunts

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

portal venous system

A

vessels involved in drainage of capillary beds of GI tract and spleen to the liver

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

liver receives blood from

A

PV- deoxygenated

HA - oxygenated

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

pressure of portal blood are

A

lower than in other organs

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

portal HTN most commonly due to

A

liver cirrhosis

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

liver cirrhosis can be due to

A

EtOH or viral

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

morbidity from PHTN

A

bleeding from GE varices

liver failure

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

hepatic blood flow

A

HVs drain into IVC

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

blood from PV branches pass through

A

cavities between hepatocellular sinusoids

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

blood flow from HA

A

mixed in sinusoids to supply hepatocytes with oxygen

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

mixture of blood HA and PV

A

percolates through sinusoids, collects in central vein, drains into HV -> IVC

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

PV supplies _____ blood to liver

A

70-75%

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

HA supplies _____ blood to liver

A

25-30%

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

MPV formed by confluence of

A

SMV, SV

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

MPV terminates at

A

porta hepatis

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

MPV courses

A

SUP, to right, behing 1st portion of duodenum

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

HA flow direction

A

hepatopedal

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

HA flow pattern

A

low resistance

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

HA PSV

A

30-40 cm/s

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

HA EDV

A

10-15 cm/s

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

HA RI

A

0.6 -0.7

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

PV flow

A

low velocity, hepatopedal

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

PV flow velocity

A

10-40 cm/s

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

PV flow profile

A

slightly phasic: increase with inspiration, decrease with expiration

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

measure MPV diameter where

A

crosses IVC

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

HV normal flow

A

pulsatile, phasic: increase with inspiration, decrease with expiration

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

HV normal flow pulsatile due to

A

transmission of RA pulsations

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

HV velocity

A

22-39 cm/s

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

left gastic vein aka

A

coronary vein

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

PV tributaries

A

left gastric vein, IMV

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

collateralization results in

A

normalization of PV flow and calibre

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

PHTN when portosystemic pressure gradient is

A

> 10 mmHg

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

increase in portosystemic pressure gradient due to

A

increase in resistance to flow within liver

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

increase in resistance to flow within liver can be secondary to

A

morphological abn, circulatory vasoconstrictors

35
Q

hyperdynamic circulation

A

increased liver congestion, worsened portosystemic gradient

36
Q

prehepatic causes of PHTN

A

thrombosis of PV or SV
extrinsic compression of PV
congenital atresia of PV

37
Q

intrahepatic causes of PHTN

A

cirrhosis
hepatic fibrosis
lymphoma

38
Q

post hepatic causes of PHTN

A

IVC obstruction

HV obstruction

39
Q

PV changes with PHTN

A

increased MPV diameter
loss of respiratory variation (phasicity) - waveform flattens
decreased velocity - bidirectional, then reverses

40
Q

HA changes with PHTN

A

flow increases as PV flow decreases, HA becomes dilated and tortuous with cork-screw appearance

41
Q

SV and SMV changes with PHTN

A

diameter will not increase with deep inspiration

42
Q

vascular changes with PHTN

A

portosystemic collaterals

43
Q

normal gradient of PV

A

< 7 mmHg

44
Q

mild pHTN

A

7-10 mmHg

45
Q

PHTN resulting in GE varices

A

10-12 mmHg

46
Q

PHTN with increased risk of variceal bleeding

A

> 12-15 mmHg

47
Q

most specific US finding for PHTN

A

portosystemic collaterals (varices)

48
Q

incidence of varices is related to

A

severity of liver disease

49
Q

risk of bleeding in GE varices directly related to

A

portosystemic gradient

50
Q

________ % of varices can be visualized

A

65-95 %

51
Q

cirrhosis volume redistribution

A

right lobe - smaller

increased size of caudate lobe + lateral segment of Left lobe

52
Q

cirrhosis appearance

A

coarse, nodular surface, focal masses, heterogeneous, ascites, splenomegaly, Gamna-Gandy nodules

53
Q

Gamna-Gandy nodules

A

splenic siderotic nodules

54
Q

Gamna-Gandy nodules

A

focal deposits of iron and calcium in spleen, echogenic, less than 1 mm

55
Q

PHTN treatment

A

pharmocological therapy - beta blockers
endoscopic procedures - scherotherapy, variceal ligation
surgical - decompressive shunts, devascularization procedures, liver transplant

56
Q

TIPS

A

transjugular intrahepatic portocaval shunt

57
Q

TIPS - what is it

A

stent inserted between the hepatic inflow (portal system) and hepatic outflow (HV or IVC)

58
Q

TIPS for who

A

pt with persistent uncontrolled bleeding from esophageal varices

59
Q

TIPS contraindications

A 
HCC - esp in right lobe
polycystic liver disease - lack of adequate liver parnchyma to keep stent in stable position
acute infection
biliary obstruction - risk of bile leak
PV thrombosis 
severe hepatic encephalopathy
inadequate liver reserve - fulminant liver failure due to ischemia
severe right heart failure
60
Q

TIPS is effective for

A

reducing ascites, preventing hemorrhage from GE varices, improving quality of life for patients with cirrhosis

61
Q

fulminant

A

severe and sudden onset

62
Q

TIPS causes of acute morbidity

A

hemorrhage, cardiopulmonary failure (due to volume overload), infection, hepatic encephalopathy

63
Q

hepatic encephalopathy

A

toxic metabolites present in blood stream due to improper liver function. (liver not removing toxins, filtering blood properly)

64
Q

velocities with TIPS are

A

higher

65
Q

TIPS flow direction

A

hepatopetal at portal end (into liver)

hepatofugal at hepatic end (towards IVC)

66
Q

LPV and branched of RPV direction

A

hepatofugal - towards TIPS

67
Q

normal flow velocity in TIPS

A

> 90 cm/s up to 200 cm/s, turbulent

68
Q

normal flow velocity in PV with TIPS

A

> 40 cm/s

69
Q

velocities in HV less than ___ suggest impending failure

A

30 cm/s

70
Q

velocities at portal end of shunt less than ___ suggests stenosis of concern within TIPS

A

50 cm/s

71
Q

post TIPS waveform

A

monophasic, slightly pulsatile, moderate turbulence- spectral broadening

72
Q

PSV in shunt should be

A

50-60 cm/s

73
Q

PSV in shunt can be up to

A

90-120 cm/s, can be pulsatile

74
Q

new onset of ascites indicates

A

stenosis in shunt

75
Q

recurrent varices suggests

A

stenosis in shunt

76
Q

hepatopetal flow in LPV despite well-functioning shunt indicates

A

recannalized umbilical vein

77
Q

reversed flow in HVs suggests

A

stenosis (flow directed towards TIPS)

78
Q

most pts with stenoses are

A

asymptomatic

79
Q

stenoses usually occur at ___ end of stent

A

hepatic end

80
Q

TIPS occlusion may be indicated by

A

varices, ascites, pleural effusion

81
Q

late TIPS stenosis or thrombosis

A

pseudointimal hyperplasia, turbulent blood flow

82
Q

velocity at portal end should be ____ to velocity at hepatic end

A

similar

83
Q

PV velocity post TIPS

A

at least 30 cm/s; 37-47 cm/s

Vascular (5 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions