Vascular Flashcards
Where does the abdominal aorta begin?
The diaphragm
What are the vessel layers?
Tunica Intima, tunica media, tunica adventitia
What are the branches of the Celiac axis?
Which is not seen in ultrasound?
Hepatic artery, left gastric artery, splenic artery.
Left gastric is not seen on ultrasound.
Banana peel sign refers to…
Renal arteries.
What are the branches of the abdominal aorta?
Celiac axis, SMA, rt & lt renal arteries, IMA, bifurcation rt & lt common iliac arteries.
Right renal artery courses
Posterior to IVC
What is atherosclerosis?
What are risk factors?
What could it cause?
How does it appear on ultrasound?
Alteration of vessel wall due to lipid deposits.
Smoking, HTN, diabetes, hyperlipidemia
May cause aneurysm
Vessel looks tortuous and may have Ca+
What is ectasia?
Vessel dilation (aorta >3cm)
What is an aneurysm?
What are clinical findings of an aneurysm?
What are the types of aneurysms?
Which type is the most common?
What is the most common location?
What is the most common cause of aneurysm?
What are the risk factors?
When are elective repairs performed?
Focal vessel enlargement,
pulsatile abdominal mass, may have bruit
Dumbell, bulbous, saccular, fusiform
Fusiform (has uniform dilation)
Inferior to the renal arteries
Atherosclerosis
Tobacco use, HTN, vasc disease, COPD, male, > 60 yrs, family hx
Aneurysms > 5.5cm
A true aneurysm involves all 3 layers of aorta.
A false aneurysm is a pseudoaneurysm, mc in groin from catheters inserted through common femoral artery during arteriographic procedures.
What are AAA rupture symptoms/findings?
What is the mortality rate with surgery on a ruptured aneurysm?
What happens if the AAA is 6-7cm?
US findings
Back pain, hypotension, falling hematocrit.
50%.
Rupture rate dramatically increases.
Aneurysm w. free fluid
What is dissection?
Tear in the intimal lining of the arterial wall.
What is the Standard and DeBakey classifications of dissection?
In what part of the aorta increases mortality rate with dissection?
Causes
Symptoms
US findings
Standard:
A-ascending aorta
B-not asc aorta
DeBakey:
I-entire aorta
II-asc aorta
III-desc aorta
Asc aorta inc mortality rate
Male, 40-60 yrs, HTN, pregnancy, aortic valve disease, CHD, Cushing’s syndrome, trauma, Marfan syndrome
Pain, n/v, paralysis, blind, coma, confusion, absent extremity pulse
Linear flap with motion. Acute or chronic (has clot in false lumen)
What is an aortic graft?
Used to repair an aneurysm. A guided wire inserted through femoral artery up to aorta.
IVC
Expands with inspiration. < 2 cm, terminates at rt atrium
Left renal vein courses
Anterior to aorta and posterior to SMA
Portal splenic confluence contains
Splenic vein, SMV, main portal vein
Mickey Mouse sign / Portal Triad
CBD (rt ear), MPV (face), HA (lt ear)
What is Budd Chiari syndrome?
Thrombosis of hepatic veins or IVC
What is portal vein HTN?
What are causes?
Signs/symptoms
US findings
Increase in portal venous pressure
Cirrhosis, hepatitis, ETOH abuse, PV thrombus, Budd Chiari, schistosomiasis
Ascites, gi bleed, dec renal function, dec coagulation
Portal vein diam >13mm, hepatofugal flow, patent umbilical vein, collaterals, ascites, splenomegaly, sm nodular liver
Portal vein thrombosis
Clot in PV, dec blood flow, low level echoes in PV
Echogenic material within lumen, inc PV diam, portosystemic collateral circulation, cavernous transformation
Filter placed in IVC to catch thrombosis before reaching the heart
Hepatic veins
Right, middle, left
Pulsatile
Arteries vs Veins
Arteries carry blood away from the heart. Arteries are pulsatile.
Veins carry blood to the heart. Veins expand with inspiration. Veins have a larger diameter. Veins have valves.
What is vasa vasorum
Tiny arteries & veins that supply vessel wall
Sections of Aorta
Root (3 cusp prevents back flow to heart), asc aorta, aortic arch (brachiocephalic, lt common carotid, lt subclavian), desc aorta, abdominal aorta (celiac trunk, SMA, renals, IMA)
