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Vascular > Quiz 6 > Flashcards

Quiz 6 Flashcards

1
Q

where does the aorta enter the abdominal cavity?

A

hiatus in the diaphragm at the level of T12

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2
Q

where does the aorta run?

A
  • vertically anterior to the spine

- slightly left of midline

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3
Q

what waveform does the aorta exhibit above the renals?

A

monophasic

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4
Q

what waveform does the aorta exhibit below the renals?

A

triphasic

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5
Q

where does the aorta bifurcate?

A

L4 into left and right common illiac arteries

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6
Q

what do the internal illiacs supply?

A

organs in the pelvis

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7
Q

what do the external illiacs supply?

A

blood to lower extremeties

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8
Q

what waveform do the iliac arteries exhibit?

A

high resistant

triphasic waveform

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9
Q

what do the measurements of the aorta do as you go more inferior?

A

decrease in size

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10
Q

what is the first visceral branch of the aorta?

A

celiac axis or trunk

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11
Q

how long is the celiac trunk?

A

2-3 cm long

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12
Q

what does the celiac trunk trifurcate into?

A
  • common hepatic artery
  • left gastric artery
  • splenic artery
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13
Q

what waveform does the celiac trunk exhibit?

A

monophasic

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14
Q

what does the common hepatic artery supply?

A

liver with oxygenated blood

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15
Q

what is a landmark for the anterolateral aspect of pancreas head?

A

Gastroduodenal artery (GDA)

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16
Q

after the GDA, what does it become?

A

proper hepatic artery

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17
Q

where does the common hepatic artery course?

A
  • anterior to portal vein

- medial to CBD

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18
Q

what does the common hepatic artery branch into?

A

right, left, and middle hepatic arteries

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19
Q

what waveform does the common hepatic artery exhibit?

A

monophasic waveform

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20
Q

which vessel is tortous?

A

splenic artery

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21
Q

how many branches does the splenic artery branch into?

A

6 branches

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22
Q

what waveform does the splenic artery exhibit?

A

monophasic waveform

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23
Q

where does the SMA arise?

A

anterior to aorta 1 cm inferior to celiac trunk

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24
Q

where does the SMA run to the pancreas?

A

posterior to body of pancreas

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25
Q

what does the SMA supply?

A

colon

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26
Q

what waveform does the SMA exhibit?

A
  • high resistance when fasting

- low resistant monophasic post prandial

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27
Q

where does the RRA arise from the aorta and where does it run?

A

anteriolateral and more superior than the left and runs posterior to IVC as it courses inferiorly

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28
Q

where does the LRA arise from the aorta and where does it run?

A

left lateral aspect of aorta and follows posterior lateral course

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29
Q

where do the gonadal arteries arise from the aorta?

A

-anterior aspect
-inferior to renal arteries
(not visualized on US)

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30
Q

what does the IMA supply?

A

some of colon and most of small intestine

not usually seen on US

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31
Q

where do the lumbar arteries arise off the aorta?

A

laterally from the right and left side of the aorta and supplies the lumbar region

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32
Q

where is the confluence of the common illiac veins to form the IVC?

A

L4

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33
Q

where does the IVC lie in the body?

A

slightly right

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34
Q

what is the function of the IVC?

A

carries deoxygenated blood into the right atrium of the heart

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35
Q

when does the IVC increase in size?

A

respiration

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36
Q

when does the IVC decrease in size?

A

decease with the valsalva maneuver

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37
Q

what type of waveform is the IVC?

A

phasic waveform

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38
Q

where do the right gonadal veins drain?

A

directly into the IVC below renal veins

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39
Q

where do the left gonadal veins drain?

A

drains into the left renal vein

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40
Q

which renal vein is longer?

A

left renal vein

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41
Q

where is the RRV located in relation to the RRA?

A

RRV is anterior

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42
Q

what is the course of the LRV?

A

follows a course anterior to the aorta and posterior to SMA before entering the IVC

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43
Q

what are the last tributaries prior to entering the Rt atrium?

A

hepatic veins

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44
Q

what is the waveform of the hepatic veins?

A

exhibit a pulsatile, phasic flow pattern that is reflective of the heart motion and respiration

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45
Q

what veins are apart of the portal venous system?

A
  • splenic vein
  • IMV
  • SMV
  • MPV
  • Intrahepatic portal veins
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46
Q

where does the splenic vein run?

A

posterior surface of the body and tail of pancreas

47
Q

what does the IMV drain?

A

small intestine and some colon

48
Q

what does the SMV drain?

A

colon and some small intestine

49
Q

where is the portal confluence formed?

A

posterior to the pancreas neck

50
Q

what waveform does the portal vein exhibit?

A

low resistant monophasic waveform

51
Q

what walls are more echogenic than hepatic veins?

A

intrahepatic portals because of collagen in walls

52
Q

in the resting state what waveform do the peripheral vessels display?

A

high resistant triphasic flow

53
Q

what is the direction of flow in the hepatic artery?

A

hepatopedal

54
Q

what waveforms do hepatic arteries demonstrate?

A

low resistance and high diastolic flow velocities

55
Q

what is normal hepatic arterial PSV is a fasting adult?

A

30-40 cm/s

56
Q

what is the normal hepatic arterial EDV in a fasting adult?

A

10-15 cm/s

57
Q

where may a replaces right hepatic artery arise from?

A

SMA

58
Q

what is resistive index?

A

measure of pulsatile blood flow that reflects resistance to blood flow paused distal to site of meaasurement

59
Q

what is used for hepatic arterial evaluation?

A

RI (PSV-EDV/PSV)

60
Q

what is the usual RI in normal HA and post transplant individuals?

A

0.55-0.8

61
Q

when is arterial RI most often assessed?

A

during evaluation of a liver transplant

62
Q

when does the RI increase?

A

diastolic flow decreases and absent or reversed diastolic flow (RI of 1)

63
Q

when are hepatic arterial complications significant?

A

post liver transplant patients

64
Q

where does the biliary tree derive its blood supply from after transplantation?

A

hepatic arteries

65
Q

what can hepatic arterial complications lead to after transplantation?

A
  • biliary ischemia
  • biliary strictures
  • necrosis
  • abscesses
  • allographt failure
66
Q

where does RLHA arise from?

A

left gastric artery

67
Q

where does the RRHA arise from?

A

SMA

68
Q

which hepatic artery is more common?

A

replaced right hepatic artery

69
Q

where does the RRHA travel?

A

posterior to the PV

70
Q

what does the celiac axis supply?

A

liver
spleen
stomach

71
Q

what is the only major artery that nourishes the abdominal digestive organs that does not have a similarly named vein?

A

celiac axis

72
Q

what is the normal velocity peak systolic waveform in celiac axis?

A

118-200 cm/s

73
Q

what is the normal end diastolic waveform in the celiac axis?

A

3-75 cm/s

74
Q

what is the celiac artery flow pattern?

A

sharp upstroke

monophasic waveform

75
Q

left gastric artery branches

A
  • esophageal branch

- stomach branch

76
Q

common hepatic artery branches

A
  • proper hepatic artery
  • right gastric artery
  • GDA
77
Q

splenic artery branches

A
  • dorsal pancreatic artery
  • short gastric arteries
  • left gastro-omental artery
  • greater pancreatic artery
78
Q

what is the waveform of the vena cava?

A

varies according to the specific segment sampled

79
Q

what is the flow in the proximal inferior vena cava influenced by?

A

influenced by the activity of the right atrium and shows back-pressure changes identical to those seen in hepatic venous flow

80
Q

what is the flow in the distal inferior vena cava influenced by?

A

cardiac activity has a lesser effect on flow velocities and variations in thoracic or abdominal pressure cause greater variability in forward flow

81
Q

what should the diameter of the vena cava not exceed?

A

2.5 cm

82
Q

where is the body do the hepatic veins converge into the IVC?

A

just below the diaphragm

83
Q

what do the hepatic veins drain?

A

all the liver except the caudate lobe

84
Q

pulsations of the right atrium are transmitted directly where?

A

into the inferior vena cava and hepatic veins

85
Q

do the IVC and hepatic veins contain valves?

A

no

86
Q

what is the normal hepatic vein waveform?

A

its undulating and mirrors motion of the right heart

87
Q

when may the hepatic veins dialate?

A

in the even of right heart failure cause congestion within the liver

88
Q

what does the waveform of hepatic veins look like?

A

a “W”

89
Q

what is the larger first pulse below the baseline in a hepatic vein?

A

ventricular systole

90
Q

what is the smaller second pulse below the baseline in a hepatic vein?

A

ventricular diastole

91
Q

what is the short pulse above the baseline in a hepatic vein?

A

atrial contraction

92
Q

how much does the PV supply the incoming blood to the liver?

A

70%

93
Q

what is the normal blood flow velocity in the PV?

A

13-23 cm/s (average 18cm/s)

94
Q

flow velocity in PV is somewhat _______

A

phasic because of rocking motion of the liver caused by motion of heart moves the PV under doppler SV or because of respiration

95
Q

if there is reversal of flow (hepatifugal) flow of the portal vein, what could this mean?

A

portal hypertension

96
Q

what is the normal measurement of the PV?

A

under 13mm in diameter

otherwise it suggests portal hypertension

97
Q

where is slight respiration variation common?

A

splenic vein

98
Q

what is a normal diameter of the splenic vein?

A

under 10 mm

otherwise it suggests porta hypertension

99
Q

what does reversal of blood flow suggest with the splenic vein?

A

advanced portal hypertension

100
Q

sinistral

A

splenic vein thrombosis -indicating it is left sided

101
Q

what is cavernous transformation?

A

acute or chronic hepatocellular disease can block the flow of blood throughout the liver causing it to back up into the hepatic portal circulation

102
Q

what occurs because of cavernous transformation?

A
  • blood pressure in the hepatic circulation to increase (portal hypertension)
  • thrombus forms in the portal vein due to stasis
103
Q

what relives pressure for cavernous transformation?

A

collateral veins are formed that connect to the systemic veins, bypassing the thrombus (known as varicose veins)

104
Q

where is varicose veins common?

A
  • esophagus
  • stomach
  • rectum
105
Q

what could happen if a varicose vein ruptures?

A

cause massive bleeding that may result in dealth

106
Q

how much blood is filtered through the kidneys?

A

up to a third of total cardiac output

107
Q

where is the renal artery located in relation to the renal vein?

A

renal artery above the renal vein

108
Q

what are the most common renovascular anomaly

A

supernumerary renal arteries (two or more arteries to a single kidney)

109
Q

what is the normal renal artery waveform?

A

rapid upstroke in systole with continuous forward flow in diastole

  • low resistant
  • monophasic
110
Q

what is the normal PSV is renal arteries?

A

under 150-180 cm/s

111
Q

what is the RI of renal arteries?

A

under 0.7

112
Q

talking about renal arteries and inside the kidneys, what happens to EDV and PSV?

A

PSV and EDV is lower within the kidney

113
Q

what is the RI with interlobar and arcuate arteries?

A

0.4-0.7 RI

Vascular (10 decks)

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