Veins And Beyond Flashcards
IVC is the main ______ ______.
Trunk vein
What are the major veins?
IVC
Hepatic veins
Renal veins
Common iliac veins
IVC empties into where?
The right atrium
IVC courses to where?
The right of the aorta
The IVC is posterior to what organs?
Duodenum and pancreas
What does the IVC do?
Returns all of the blood from the legs and some of the abdominal organs back to the heart
What kind of vein is the IVC?
A large collapsible vein
Is the IVC pressure higher or lower than the aorta?
Lower pressure
The IVC has what kind of look to it when scanning longitudinally?
It hammocks
What are the 6 retroperitoneum tributaries of the IVC?
Common iliac veins Lumbar veins
Gonadal veins Renal veins
Suprarenal veins Hepatic veins
The IVC longitudinally appears as a…
Tubular structure to the right of the aorta
The IVC transversely appears like a…
Oval structure
How do the IVC walls differ from the aorta?
IVC walls are thinner
What varies the diameter of the IVC?
Breathing
Inspiration does what to the IVC?
Increase the diameter
Expiration does what to the IVC?
Decreases the diameter
What is valsalva?
When a patient bears down, as if having a bowl movement, to cause dilation
What is the diameter of a normal IVC?
Less than 2.0 cm
What symptoms would occur that would indicate to scan the IVC?
Abdominal pain
Palpable mass
F/U filter placement - history of DVT
History of renal tumor
The IVC is affected by what side of the heart?
The right side
IVC dilation could mean what 5 things?
Right ventricular heart failure Congestive heart failure Constrictive pericarditis Tricuspid disease Right heart obstructive tumor
IVC obstructed with a tumor could mean what 3 things?
Distended vessel
Renal cell carcinoma
Wilm’s tumor (in children)
Complete thrombosis of the IVC could be what 2 things?
Pulmonary emboli
Venous thrombosis
Life threatening
What is surgically placed in the IVC if there is thrombosis?
A filter
The IVC is affected by what other organs?
The liver and heart
IVC dilated in the liver could mean what?
Heptomegaly
Increased pressure
Cirrhosis
What would cause the IVC to be compressed?
Later stage of pregnancy - edema in legs/ankles
Malignant retroperitoneal tumors
Hepatic or pancreatic masses
What symptom will pressure on the IVC cause?
Dizziness
Hat are some congenital IVC abnormalities?
Double IVC
Interruption of the IVC
Aorta verse IVC…
Aorta - not affected by valsalva, does not touch the liver, thicker more echogenic walls, cardiac plasticity, multiple anterior branches, no vessels posterior, high flow velocity, not compressable
IVC - diameter affected by valsalva, touches liver, thin walls, respiratory phasicity, hepatica only anterior branch, RRA posterior to IVC, low flow velocity, compressable
Renal veins drain what?
Kidneys, ureters, adrenals
Right renal vein courses how?
Anterior to the IVC
Left renal vein courses how?
Between the aorta and SMA
What creates the “nutcracker” sign?
Left renal vein is anterior to the aorta and posterior to SMA
How can the right renal vein best be seen?
Transverse anterior to renal artery
How can the left renal vein best be seen?
Transverse anterior to the aorta and posterior to the SMA
What pathology can occur in the renal veins?
Obstruction or thrombosis
Hepatic veins are the ________ tributaries.
Largest
What does the right hepatic vein drain and how does it divide the liver?
Drains the right lobe
Divides right lobe of liver into anterior and posterior
What does the left hepatic vein drain and how does it divide the liver?
Drains the left lobe
Divides left lobe of liver into medial and lateral
What does the middle hepatic vein drain and how does it divide the liver?
Drains the caudate lobe
Divides liver into right and left lobes
What does respiration a do to the hepatic veins?
Varies flow and diameters
What happens to the hepatic veins as they get closer to the IVC?
Increase in size
What sign can you see when finding the hepatic veins?
The “bunny” or “reindeer” sign
What are the main veins of the hepatic-portal system?
SMV, IMV, splenic veins, portal veins
What does the hepatic portal system drain?
The GI tract, spleen, pancreas, and gallbladder
What does the hepatic portal system deliver blood to?
The liver
Portal veins is formed where?
Posterior to the pancreas
Portal vein is the union of what 2 veins?
Superior mesenteric vein and splenic vein
The portal vein branches into what 2 veins?
The right and left portal veins
The portal venous blood traverses what organ?
The liver
The portal venous blood drains into where?
The IVC via the hepatic veins
The main portal vein is ______ to the IVC.
Anterior
The main portal vein enters where and splits into what?
Enters the liver at the porta hepatis and splits into the right and left branches
The main portal vein drains what and send blood where?
Drains GI tract and sends blood to the liver for filtration
Why is the portal vein special?
It delivers oxygen to the hepatocytes
How is the main portal vein best seen when scanning?
Transversely as a tubular structure from pancreas head to liver
What changes the main portal veins diameter?
Valsalva and respirstions
What is the normal diameter of the main portal vein?
Less than 13 mm
What makes up the portal triad?
Common bile duct, hepatic artery, portal vein
“Mickey Mouse” sign
What is the portal confluence?
Where the portal vein, splenic vein, and superior mesenteric vein come together
Hepatic veins verse portal veins…
HV - thin walls, increases diameter closer to IVC, flow away from liver, drains cephalad towards diaphragm, triphasic flow
PV - thick reflective walls, constant diameter, flow towards liver
Problems with hepatic veins could mean what?
Chronic heart failure (right heart)
Liver disease
Problems with the portal veins could mean what?
Liver disease
Portal hypertension
Splenic veins originate from where?
At the splenic hilum
Splenic veins course how?
Posterior to the pancreas
The splenic vein joins what to form what?
Joins the superior mesenteric vein to for the main portal vein
Splenic vein drains what?
The stomach, spleen, pancreas
How can the splenic vein best be seen while scanning?
Transversely as a tubular structure posterior to the body and tail of pancreas
How can the superior mesenteric vein best be seen while scanning?
Longitudinally as a tubular structure to the right of the superior mesenteric artery
Transversely seen as a tubular structure
Superior mesenteric vein originates from where?
The mesentery
The superior mesenteric vein joins what?
The splenic vein posterior to the neck of the pancreas to form the main portal vein
The superior mesenteric vein drains what?
The small intestine and proximal colon
List 4 things about the gonadal veins…
Testicular and ovarian
Left - empties into the left renal vein
Right - empties into the IVC
Not usually seen
The inferior mesenteric vein arises from where?
The colon
The inferior mesenteric vein ascends to where?
The left of the inferior mesenteric artery
The inferior mesenteric vein joins what?
The splenic vein posterior to the body of the pancreas
The inferior mesenteric vein drains what?
The distal colon
Can you see the inferior mesenteric vein?
Not usually
Explain arteries and veins above the umbilicus…
Arteries are posterior to veins
Explain arteries and veins below the umbilicus…
The arteries are anterior to the veins
