Vascular System Flashcards
Arteries carry blood _____ from the heart.
away
Veins carry blood from the tissues ___ the heart.
to
The smallest branches of arteries are _________.
arterioles
Arterioles lead into _______.
capillaries
Capillaries form a network between ______ and _______ systems.
arterial and venous
After blood passes through capillaries, it is collected in ______.
venules
A vessel is made of three layers:
Intima, media, adventitia
The intima is made up of three layers:
endothelial cells, connective tissue, and elastic layer
The tunica media is made up of _____ muscle fibers with _____ and _________ tissue.
smooth muscle fibers with elastic and collagenous tissue
The tunica adventitia is made up of _______ connective tissue with bundles of _______ muscle fibers and _____ tissue.
loose connective tissue with bundles of smooth muscle fibers and elastic tissue
The ____ ________ makes up tiny arteries and veins that supply the walls of blood vessels.
vasa vasorum
The _________ of the larger arteries is important for maintaining steady blood flow.
elasticity
The abdominal aorta is _________ and will not change in diameter with changes in respiration.
pulsatile
Veins are collapsible due to the diminished _____ _______ with less ______ tissue or ______ within their walls.
diminished tunica media with less elastic tissue or muscle
Veins have a _____ total diameter than arteries.
larger
Veins contain valves to prevent _________ and permit blood in one direction against gravity.
backflow
The IVC should dilate slightly with suspended _________.
respiration
The aorta is divided into ____ sections.
5
The five sections of the aorta are the:
root, ascending aorta, descending aorta, abdominal aorta, and bifurcation
The aorta arises from the _____ ________ of the heart.
left ventricle
The abdominal aorta should be less than ____ in diameter.
3 cm
The three major anterior branches of the aorta:
celiac trunk, superior mesenteric artery, inferior mesenteric artery
The celiac trunk has three branches:
common hepatic artery, splenic artery, and left gastric artery
The common hepatic artery divides into two branches:
gastroduodenal artery and proper hepatic artery
The proper hepatic artery divides into three branches:
right and left hepatic arteries, right gastric artery
Three lateral branches of the abdominal aorta:
phrenic arteries, renal arteries, gonadal arteries
The first anterior branch of the AA:
celiac trunk
The celiac trunk arises ___ inferior to the diaphragm.
2 cm
The ______ _______ ligament surrounds the aorta at the level of the celiac trunk and has been known to compress the celiac trunk, known as ____ ______ syndrome.
median arcuate ligament, known as celiac band syndrome
The ______ and ________ arteries create the seagull or dove sign.
Splenic and hepatic
The splenic artery forms the ______ border of the pancreas.
superior
The right gastric and gastroduodenal arteries supply the _________ and parts of the __________.
duodenum and parts of the stomach
The SMA arises ______ (distance) from the celiac trunk.
1 cm
The SMA runs ________ to the neck of the pancreas and _________ to the uncinate process.
posterior to the neck, anterior to the uncinate process
The SMA branches into the _______ and _______.
mesnentery and colon
The renal arteries arise just inferior to the _______ at the level of the ______ lumbar vertebra.
SMA, first lumbar vertebra
The right renal artery courses from aorta _______ to the IVC.
posterior
The right renal artery is longer than the left renal artery because the aorta lies more towards the ______ of the abdomen.
left
The ____ renal artery courses from the aorta directly into the kidney hilum.
left
The gonadal arteries are ______ to the renal arteries.
inferior
The gonadal arteries course along the _____ muscles.
psoas
The IMA supplies blood to the (three parts of a colon) and the _______.
left transverse colon, descending colon, sigmoid colon, and rectum
Three branches of the IMA:
left colic artery, sigmoid artery, and superior rectal artery
The common iliac arteries divide into the:
internal and external iliac arteries
Clinical reasons for an aortic ultrasound: _______ abdominal mass, abdominal pain radiating to the _______, abdominal ______ (abnormal sound), hemodynamic compromise in ________ legs
pulsatile abdominal mass, ab pain radiating to the back, abdominal bruit, hemodynamic compromise in lower legs
Arterial system may be affected by ________ (arteriosclerosis), ________ (ballooning), _______ tissue disorder, ________ (burst), ________ (blood clot), or __________ (caused by germs).
atheroma, anuerysm, connective tissue disorder, rupture, thrombosis, or infection
Arteriosclerosis occurs when the arterial vascular system becomes ______ and ______.
thick and stiff
Atherosclerosis is a form of _________. Occurs when aortic wall becomes irregular from _______ build-up.
arteriosclerosis, plaque build-up
An aortic aneurysm is a localized dilation with an increase in diameter greater than _____ times its normal diameter or more than __% increase when compared to adjacent ________ segment.
1.5 times, 50%, proximal segment
Surgery is considered when an aneurysm is greater than ______.
5 cm
Aneurysms are classified ____ or ______ aneurysms.
True or false
Risk factors for AAA: _____ (snuff), _____ (HBP), ______ disease, chronic obstructive _________ disorder, family history for ________.
tobacco, hypertension, vascular disease, COPD, family history of AAA
The most common cause of AAA:
atherosclerosis
Other causes of a AAA: _____ (injury), ______ defects, _____ (STD), _____ (fungal dissection), cystic medial _______, inflammation of the _____ and ________, increased _______, abnormal _____ load.
trauma, congenital defects, syphilis, mycosis, cystic medial necrosis, inflammation of the media and adventitia, increased pressure, abnormal volume load
True anuerysms involve all ______.
three layers of artery
True aneurysms is most commonly caused by __________ but also occur secondary to _________ diseases.
atherosclerosis, congenital diseases
AAA’s most commonly develop ________ (location) ____ %
infrarenally, 95%
Two forms of true anuerysms:
fusiform and saccular
A fusiform anuerysm extends over the ____ of the aorta to resemble a ‘_____‘-like shape
length, football
A saccular anuerysm is connected to a vascular lumen by the _______ that varies in size but may be as ______ as the aneurysm itself.
mouth, large
A false anuerysm is also known as a ____________
psuedoanuerysm
In a false anuerysm, blood escapes through a hole in the _________ but is contained by the ___________ layers of the aorta or by adjacent tissue.
intima, deeper
False aneurysms can occur after trauma or injury to the vessel as a result of _______, ________, or ______________.
accident, surgery, cauterization
In a dissecting anuerysm blood escapes through the lumen through a _____ or ____ in the _______ wall.
dissect or tear, in the intimal wall
The type of dissecting aneurysm that involves the ascending aorta and aorta arch.
Type 1 and 2
The type of dissecting aneurysm that has a high mortality rate.
Type 1 and 2
The type of dissecting aneurysm that involves the descending aorta.
Type 3
The mortality rate of an AAA rupture:
50%
Most common site for an AAA rupture:
infrarenal
Aneurysms greater than 5cm have a ____ cumulative incidence of rupture over 8 years.
25%
Symptoms of an AAA rupture are excruciating ______ pain, _____ (trauma), expanding abdominal ____.
abdominal pain, shock, expanding abdominal mass
Aortic grafts repairs anuerysms with a _______ graft material attached to the end of the remaining intact _____.
flexible, intact aorta
Aortic grafts are placed within: (3 sites)
aorta, iliac, or femoral arteries
Aortic grafts produce ____ echo reflections
bright
Complications of aortic grafts include forming another _______, ________ (blood pooling), _______ (germs), degeneration of _______ material.
aneurysm, hematoma, infection, degeneration of graft material
Aortic ectasia implies the ______ distortion of a vessel.
diffuse
An aneurysm is a region of _____ enlargement.
focal
The IVC is a large, collapsible vein that returns blood into the right ____ of the heart.
atrium
The IVC is formed by the union of the _______.
common iliac veins
The IVC ascends vertically through the __________ space on the _____ side of the aorta.
retroperitoneal, right
Intrahepatic portion of the IVC is seen by using the ____ as an acoustic window.
liver
Complete IVC is imaged on _____ plane.
Sagittal
The hepatic veins return _____ blood from the _____.
unoxygenated, liver
There are three hepatic veins:
right hepatic, middle hepatic, left hepatic
All 3 hepatic veins drain into the _____ on its ________ aspect at the level of the diaphragm.
IVC, anterior
The right suprarenal vein is a _____ tributary.
lateral
The left suprarenal vein drains into the _______.
Left renal vein
Renal veins are ______ tributaries.
lateral
The left renal vein courses between the ____ and ______.
SMA, aorta
The right renal vein is ____ than the left because of the position of the _____.
shorter, IVC
The left gonadal vein drains into the _____ or _____.
left renal vein or left adrenal vein
The right gonadal vein enters into the ____ on the ________ border above the lumbar veins.
IVC, anterolateral border
There are _____ lateral abdominal wall vein tributaries:
five; inferior phrenic and four lumbar veins
The three veins of origin are the:
two common iliac veins and median sacral vein
Acquired abnormalities of the IVC are ______ (enlargement), _______ (mass), ________(clot).
dilation, tumor, and thrombosis
The most common tumor is a _________ usually arising from the _________.
renal cell carcinoma, right kidney
______’s tumor can be seen extending into the IVC and _____ atrium.
Wilm’s, right
Patients with IVC thrombosis present with leg ____, low _____ pain, ______ (area of body) pain, GI ________, and ____/_____ (two organs) abnormalities.
edema, low back pain, pelvic pain, GI complaints, and renal/liver abnormalities
An IVC filter is a wire mesh implanted to trap small _____ that may cause problems in the ____ or the _______.
emboli, heart or the lungs
The most common origin of pulmonary emboli is venous thrombosis from the ___________.
lower extremities
IVC filters are used to prevent recurrent embolization in patients who can’t tolerate __________.
anticoagulants
The preferred placement of IVC filters are at:
iliac bifurcation below renal veins
The portal vein supplies the _____ with incompletely ______ venous blood from the ________ and _______.
liver, oxygenated, spleen and intestines
The portal vein supplies ___% incompletely oxygenated blood
80%
The portal vein forms the ______ border of the pancreas.
posterior
The portal system carries blood from the _________ to the liver by ___ main branches.
intestines, two
The two main branches of the portal system are:
right and left portal veins
The right portal vein bifurcates into:
anterior and posterior branches
The left portal vein bifurcates into:
medial and lateral branches
The portal venous system drains blood from the __________ tract, lower end of the _____ to the upper end of the _____ canal; and from the: (3 organs) ______, ______, _____ ducts, and ________.
gastrointestinal tract, lower end of the esophagus to the upper end of the anal canal and from the gallbladder, CBD, pancreas, and spleen
Portal venous hypertension is caused by the ______ of the portal vein, ____ vein, IVC, or prolonged _________.
obstruction, hepatic, prolonged congestive heart failure
Portal flow towards transducer:
hepatopetal
Portal flow away from transducer:
hepatofugal
Portal venous hypertension is treated with ______.
TIPS
TIPS stands for:
Transjugular intrahepatic portosystemic shunt
In portal venous hypertension, blood is diverted in a ________ direction via various ______ pathways.
hepatofugal, collateral
The sonographic findings of portal venous hypertension include: dilated (veins) ____, _____, _____.
portal, splenic, SMV
The sonographic findings of portal venous hypertension include: patent _________ vein
paraumbilical
The sonographic findings of portal venous hypertension include: _____ (swollen veins), ______ (enlarged spleen), diminished response to _______ in portal system.
varices, splenomegaly, respiration
The sonographic findings of portal venous hypertension include: dilated ______ and ______ arteries
hepatic and splenic arteries
The sonographic findings of portal venous hypertension include: _____ (fluid in abdomen) and _____ liver with ______ surface or _____ liver with ______ texture.
ascites, small liver with irregular surface or large liver with abnormal texture
The portal triad consists of:
portal vein, hepatic artery, and bile duct
The portal vein has an ______ wall
echogenic
The portal triad forms the ________ sign.
Mickey Mouse
The splenic vein begins at the _____ of the _____.
hilum of the spleen
The splenic vein is joined by the _____ and ______ veins.
gastric and left gastroepiploic veins
The splenic vein runs along the _______ border of the pancreas.
posteriomedial
The splenic vein crosses ________ to the aorta and IVC and also along the _____ and _____ borders of the pancreatic body and tail.
anterior, medial and posterior borders
The SMV joins the _____ to form the main portal vein.
splenic vein
The SMV passes ______ to the third part of the duodenum and _______ to the neck of pancreas.
anterior, posterior
The SMV lies _____ to the SMA and ______ to the IVC.
adjacent, anterior
The SMV lies ____ to the uncinate process of the pancreas and _____ to the pancreatic body.
anterior, posterior
The inferior mesenteric vein drains the left third of the ______ and upper _____ and ascends retroperitoneally along the left ______ muscle.
colon, colon, left psoas muscle
The IMV runs ________ in the posterior abdominal wall on the left side of the IMA to join the _______ vein posterior to the pancreas.
superiorly, splenic vein
Abdominal Doppler techniques can show the presence or _______ of flow, _______ of flow, _________ of flow, ______ characterization.
absence, direction, disturbance, tissue characterization
Doppler waveform can be non-________ or _______.
non-resistive or resistive
Nonresistive vessels are also known as ______ resistance.
low
Nonresistive vessels have a _____ diastolic component.
high
Nonresistive vessels supply organs that need ______ perfusion.
constant
Examples of nonresitive vessels include the internal _______ (brain), _________ (liver) artery, and _______ (kidney) artery.
ICA, hepatic artery, and renal artery
Resistive vessels are known as _____ resistance.
high
Resistive vessels have very ______ or even ______ flow in diastole.
little or even reversed flow
Resistive vessels supply organs that do not need a constant ______ supply.
blood
Examples of resistive vessels are the ________ artery, _______ artery (legs) and _______ arteries (arms).
ECA, iliac artery and brachial arteries
The spectral display has three axes:
x = time
y = Doppler shift frequency (velocity)
z = gray scale
What does the Doppler shift frequency indicate in positive and negative shifts?
positive = flow toward transducer above the baseline
negative = flow away from transducer below the baseline
More red blood cells produce a ________ gray scale.
brighter
The proximal aorta has a ____ systolic and _____ diastolic flow.
High systolic and low diastolic
Distal aorta demonstrates _______ flow.
triphasic
The celiac axis is ________ after meals.
unchanged
The splenic artery is prone to ________.
aneurysm
The SMA is ______ resistive in fasting patients.
highly
The SMA is ______ resistive in nonfasting patients.
Nonresistive
The hepatic artery is crucial in ______ transplants.
heart
The renal artery has a ________ flow.
nonresistive
The renal vein has ______ flow like the IVC.
variable
The _____ vein is evaluated with transplants.
renal
The IVC and hepatic veins vary with ________.
respiration
The IVC and hepatic veins flow _____ and ____ the baseline. This is due to reflux from the _________.
above and below, right atrium
Budd-Chiari syndrome is the thrombosis of the ____________.
hepatic veins
Hepatic veins are small with ________ material in Budd-Chiari.
echogenic
The presence of ______ flow in the hepatic veins excludes Budd-Chiari syndrome.
normal
The portal vein has ________ flow.
hepatopetal
The portal vein has a _______ flow pattern that varies slightly with __________.
continuous flow, respiration
The portal vein can have a ___________ transformation.
cavernous
Cavernous transformation of the portal vein is seen in patients with _______ portal vein obstruction or _______.
chronic, thrombosis
In canvernous transformation of the portal vein, the _________ portal vein is not visualized.
extrahepatic
In canvernous transformation of the portal vein, an echogenic area is present in the _________.
porta hepatis
In canvernous transformation of the portal vein, _________collaterals are present.
periportal
