ABD Workbook 1 - Vascular Structures

Iliac artery aneurysms are most often a continuation of an ____ ____ aneurysm and tend to be ____.

- Abdominal aortic - Bilateral

The CA, SMA, and IMA originate from the ____ aspect of the aorta. The right and left renal arteries arise from the ____ aspect of the aorta.

- Anterior - Lateral

Renal artery stenosis is most often a result of _____ and occurs at the ____ of the renal artery.

- Atherosclerosis - Origin

The normal IVC _____ with inspiration and ____ with expiration. During the valsalva maneuver, the IVC lumen _____.

- Collapses - Expands - Collapses

The IVC is formed by the junction of the right and left ____ ____ ____. They course through the abdominal cavity, enter the thoracic cavity, and empty into the ____ atrium of the heart.

- Common iliac veins - Right

An incomplete seal between the endograft and wall of the aorta may result in an ____. This may result in ____ or ____ of the aortic aneurysm.

- Endoleak - Expansion - Rupture

Portal hypertension can result in many sonographically visible changes including, ____ varices, an enlarged ____ vein, and a patent ____ vein seen within the ____ ligament.

- Esophageal - Coronary - Umbilical - Falciform

Blood flow toward the liver is ____ Blood flow away from the liver is ____

- Hepatopedal - Hepatofugal

Which of the following vessels must be evaluated to rule out "Budd-Chiari" disease?

- IVC - Hepatic veins

Patients with acute portal vein thrombosis may ____ the diameter of the portal vein. Patients with chronic portal vein thrombosis may ____ the diameter of the portal vein.

- Increase - Decrease

The aorta originates off the ____ ventricle. Once it penetrates the diaphragm it's called the ____ aorta. Finally it bifurcates into the right and left ____ ____ arteries.

- Left - Abdominal - Common iliac

An increase in portal venous pressure is called ____ ____. Common signs and symptoms include ____ and ____.

- Portal hypertension - Ascites - GI bleeding

TIPS is used to decompress portal vein pressure by connecting the ____ ____ with one of the ____ ____ bypassing flow through the liver.

- Portal veins - Hepatic veins

When an abdominal aortic aneurysm is diagnosed, the ____ arteries and ____ arteries should also be examined to evaluate for extension of the aneurysm.

- Renal - Iliac

Malignant invasion of the IVC most commonly occurs from ____ ____ ____. Respiratory changes are typically ____ or ____ below the level of obstruction.

- Renal cell carcinoma - Decreased - Absent

A ____ aneurysm is a protrusion toward one side or the other. A ____ aneurysm is more uniform.

- Saccular - Fusiform

Mesenteric insufficiency results from a hemodynamically significant stenosis or occlusion of two out of three of the vessels that supply the intestinal tract. Which vessels are they?

- Superior mesenteric artery - Celiac axis - Inferior mesenteric artery

What is the typical sonographic appearance of an aortic dissection?

- Thin linear flap - Pulsating within aortic lumen - Blood flow visible on both sides of flap

Name the three layers of vessel walls

- Tunica adventitia - Tunica media - Tunica intima

In the primary form of Budd-Chiari syndrome, the vessels are occluded by a congenital ____. In the secondary form of Budd-Chiari syndrome, the vessels are occluded by ____ or ____.

- Web - Thrombus - Tumor

What are the three branches of the celiac axis?

1. Hepatic artery 2. Splenic artery 3. Left gastric artery

The portal vein is formed by the junction of the: 1. 2. 3.

1. Splenic vein 2. Inferior mesenteric vein 3. Portal confluence

The normal portal vein measures less than ____ in diameter.

13 mm

How large must the aortic diameter be to diagnose an aortic aneurysm?

3cm

At what size does the risk of rupture greatly increase in an abdominal aortic aneurysm?

5cm

Connection between two vessels

Anastomosis

Focal dilation of an artery caused by a structural weakness in the wall

Aneurysm

Connection allowing communication between an artery and a vein

Arteriovenous fistula

_____ is a form of arteriosclerosis that is characterized by an accumulation of lipids, blood products, and sometimes calcium deposits along the intimal lining of the arteries.

Atherosclerosis

What is the most likely cause of portal hypertension?

Cirrhosis of the liver

The portal vein carries blood to the liver from the _____.

Intestines

Which vessel courses posterior to the SMA and anterior to the aorta?

L. Renal Vein

____ ____ results from a lack of adequate blood supply to the intestinal tract. This may cause weight loss, postprandial pain, and change of bowel habits.

Mesenteric insufficiency

The compression of the left renal vein between the aorta and the SMA is referred to as the:

Nutcracker phenomenon

Which of the following veins does NOT drain into the IVC? A. Celiac axis B. Portal vein C. IVC D. Main hepatic vein

Portal Vein

What does the superior mesenteric vein and splenic vein join together to form?

Portal vein

An artificial substitute for a body part

Prosthesis

Caused by a hematoma that forms as a result of a leaking hole in an artery

Pseudoaneurysm

What is a pulsatile anechoic mass at the anastomosis of an endograft that demonstrates a swirling blood flow pattern with color Doppler?

Pseudoaneurysm

Which type of aneurysm typically has a neck and demonstrates a swirling pattern on color Doppler?

Pseudoaneurysm

Which vessel lies posterior to the IVC?

Right renal artery

What is the most common cause of IVC obstruction?

Right-sided heart failure

What does TIPS stand for?

TIPS: Transjugular intrahepatic portosystemic shunt

The formation of a clot in a blood vessel

Thrombosis

True or False: Arteries have a thicker muscle layer and therefore maintain a constant shape.

True

True or False: Because the walls of veins contain less muscle, they are more easily compressed.

True

______ is a syndrome in which the IVC and/or one or more of the hepatic veins are occluded.

Budd-chairi syndrome

True or False: Portal hypertension can also be caused by Budd-Chiari syndrome.

True

True or False: Portal hypertension can result in collateral formation involving the coronary vein, gastroesophageal veins, and splenorenal veins.

True

True or False: Portal hypertension is typically caused by increased hepatic vascular resistance.

True

True or False: The walls of arteries and veins contain the same three layers.

True

While performing a liver exam, there is difficulty identifying the main portal vein, but you see tortuous vessels in the porta hepatic. This collateralization is called ____ ____ of the portal vein.

Cavernous tranformation

The celiac axis is _____ to the origin of the superior mesenteric artery.

Cephalad

Which of the following is NOT characteristic of a vascular stenosis?

Decreased Doppler velocities at the level of the stenosis

Which of the following is NOT a complication of aortic endografts? A. Endoleaks B. Abscess C. Dissecting aneurysm D. Pseudoaneurysm

Dissecting aneurysm

Aortic ____ is a separation of the layers of the aortic wall that typically presents with extreme chest of abdominal pain.

Dissection

What does EVAR stand for?

EVAR: endovascular repair of abdominal aortic aneurysm

Dilation, expansion, or distention

Ectasia

A metallic stent covered with fabric and placed inside an aneurysm to prevent rupture

Endograft

True or False: The diameter of the portal vein is almost always decreased in cases of portal hypertension.

False

True or False: Both arteries and veins contain valves to keep blood moving.

False Arteries do not contain valves

What is an aneurysm that is uniform in nature called?

Fusiform

Any tissue or organ for implantation or transplantation

Graft

Which vessel lies posterior to the bile duct and anterior to the portal vein?

Hepatic Artery

What is the most common clinical symptom of renal artery stenosis?

Hypertension

What happens when blood flow in the IVC is obstructed?

IVC will dilate proximal to the level of obstruction