Abdominal Vasculature Sonography Review
What is the upper normal limit of the distal aorta?
1.8 cm
The diameter of the portal vein can vary although it's typically less then?
13 mm
Common iliac arteries are considered aneurysmal if their diameter exceeds?
2 cm
What is the upper normal limit of the mid abdominal aorta?
2 cm
The diameter of the IVC should never exceed: a. 1.5 cm b. 2.5 cm c. 3.5 cm d. 8 mm
2.5 cm
The upper normal limit of the aorta just below the diaphragm is?
2.5 cm in diameter
And abdominal aortic aneurism is present when the diameter of the aorta exceeds?
3 cm
Aneurisms that measure greater than blank in diameter are more prone to rupture
7 cm
The common iliac arteries typically measure between?
8 to 10 mm
What is a pseudoaneurysm?
A contained rupture of a blood vessel that is most likely secondary to the disruption of one or more layers of the vessel walls
What are the sonographic findings of aortic rupture?
Abdominal aneurism with adjacent haematoma
A true aneurism involves what?
All three layers of a vessel wall
The coeliac trunk is the first main visceral branch of the abdominal aorta and arises from the blank aspect of the aorta?
Anterior
The fourth branch of the abdominal aorta is the gonadal arteries which arise from the blank surface?
Anterior
The inferior mesenteric artery arises from the blank surface of the abdominal aorta
Anterior
The left renal vein travels from the left renal highland, blank to the left renal artery and abdominal aorta, and blank to the SMA
Anterior, posterior
An outpatient with a history of back pain and hypertension presents to the ultrasound department for an abdominal aorta sonogram. Sonographically you visualize at 6 cm infra renal aneurism with an echogenic linear structure noted gently swaying in the aortic leaving. What is the most likely diagnosis?
Aortic dissection
Where is a common site for a pseudoaneurysm?
At the level of the femoral artery following a heart catheterization
What is the most common cause of aneurisms in the United States?
Atherosclerosis
Occlusion of the hepatic veins describes what syndrome?
Budd-Chiari syndrome
What branch and it's tributaries of the aorta appears as a seagull in transverse plane
Coeliac artery
Describe arteriovenous malformation's
Congenital or caused by surgery, malignancy, biopsy, or trauma. Turbulent flow and focal accumulation of vascular structures will be noted in the area
What are the clinical findings of aortic rupture?
Decreased hematocrit, hypotension, Pulsatile abdominal mass, abdominal bruit, back pain, abdominal pain, lower extremity pain
What are the sonographic findings of an abdominal aortic aneurysm?
Diameter of the aorta greater than 3 cm, thrombus within the lumen of the aorta, calcifications that may produce acoustic shadowing
The most common shape of an AAA is?
Fusiform
A fusiform aneurism is one that has a blank enlargement?
Gradual
what is the normal flow pattern within the portal vein?
Hepatopedal and monophasic
What is the normal flow pattern of the common iliac artery in the fasting superior mesenteric artery?
Hi resistant
Where can the splenic artery often be noted?
How long does superior margin of the pancreas
What vessel may attach to the splenic vein before reaching the portal conference?
Inferior mesenteric vein
The most common location of an AAA is?
Infrarenal
What are the findings of aortic dissection?
Intense chest pain, hypertension, abdominal pain, lower back pain, neurologic symptoms, Marfan syndrome
The renal vein's travel to the blank aspect of the IVC
Lateral
The left renal artery originates from the blank aspect of the aorta and travels blank to the left renal vein
Left anterior lateral aspect, posterior
The SMA is located blank to the superior mesenteric vein
Left lateral
The right gonadal vein connects to the anterior aspect of the IVC while the left gonadal vein drains into the what?
Left renal vein
What vessel can be often noted coursing between the SMA and the aorta in the transverse scanning plane?
Left renal vein
What is the normal flow pattern of the coeliac artery, common hepatic artery, splenic artery, renal arteries, and post prandial superior mesenteric artery?
Low resistance
What is the normal flow pattern of the abdominal aorta?
Low resistance suprarenal, high resistance infrarenal
Renal veins have what flow pattern?
Low velocity continuous flow
A disorder of the connective tissue characterized by small stature and aortic and mitral valve insufficiency is?
Marfan syndrome
Aneurisms of the abdominal aorta are associated with?
Marfan syndrome, syphilis, family inheritance, and infection
An aneurism associated with infection is termed?
Mycotic
Aneurisms caused by infections are referred to as?
Mycotic aneurism
What are the treatments for AAA?
Open surgery and endovascular aortic stent graft repair
What are the sonographic findings of an aortic dissection?
Possible AAA, intimal flap may be noted within the aortic lumen
The SMA is located blank to the splenic vein and pancreas?
Posterior
The splenic vein is located blank to the pancreatic body and tail
Posterior
once the right renal artery branches from the aorta it, travels blank to the IVC on the way to the right renal hilum
Posterior
Where is the portal splenic confluence located?
Posterior to the pancreatic neck
The left renal vein should be noted blank to the SMA and blank to the abdominal aorta
Posterior, anterior
Once the common hepatic artery branches into the gastroduodenal artery becomes the what?
Proper hepatic artery
What are clinical findings of AAA?
Pulsatile abdominal mass, abdominal bruit, back pain, abdominal pain, lower extremity pain
The hepatic veins will have what kind of blood flow pattern?
Pulsatile triphasic
What are the clinical findings of a pseudo aneurysm?
Recent catheterization, surgical procedure, or trauma. A pulsatile mass in the area of the puncture location
Tumour invasion of the IVC is often associated with?
Renal cell carcinoma, Wilms tumor, renal transitional cell carcinoma
When the left renal vein sometimes travel supposed terrier to the aorta it is termed what?
Retro aortic left renal vein
Is the IVC intraperitoneal or retroperitoneal?
Retroperitoneal
The right renal artery originates from the blank aspect of the aorta
Right anterior lateral
In the sagittal plane you recognize a circular and a cooling vascular structure posterior to the IVC which of the following would this structure be most likely? Abdominal aorta, left renal vein, right renal artery, SMA
Right renal artery
Which vessel would be the shortest in length? Right renal vein, right renal artery, left renal vein, left renal artery?
Right renal vein
Enlargement of the hepatic veins in IVC is often seen with?
Right sided heart failure
A patient presents with unexplained abdominal pain for a vascular assessment of the SMA. Sonographically you note that the patient's SMA yields a persistent high resistance flow pattern. This is indicative of?
Small bowel ischemia
An IVC filter is also referred to as?
The Greenfield inferior vena cava filter
Once the aorta passes through the aortic hiatus of the diaphragm it is referred to as what?
The abdominal aorta
What are arteriovenous fistulas?
The abnormal connection between arteries and veins
The SMA arises from what aspect of the abdominal aorta?
The anterior aspect, distal to the coeliac trunk
After the proper hepatic artery enters the liver branches into left and right segments. What is the significant branch of the right hepatic artery?
The cystic artery that supplies blood to the gallbladder
The common hepatic artery travels towards the liver and branches into blank at the level of the pancreatic head?
The gastroduodenal artery
Besides the superior mesenteric vein in splenic vein, what other vessels contribute to the portal venous system?
The inferior mesenteric vein in the coronary vein
What vessel travels directly anterior to the left renal artery?
The left renal vein
The third main visceral branch of the abdominal aorta is what?
The renal arteries
The SMA supplies blood to all parts of the body?
The small intestine, some of the colon, and the pancreas
The coeliac trunk branches into which arteries?
The splenic artery, common hepatic artery, and left gastric artery
A saccular aneurism is described as?
The sudden dilation of a vessel often spherical and fairly large
What is the second main branch from the abdominal aorta?
The superior mesenteric artery
The main portal vein is created by the union of?
The superior mesenteric vein in the splenic vein
Dissection of the abdominal area occurs when?
There is a separation of the layers in the arterial wall
The IMA supplies blood to the blank
Transverse colon, descending colon, rectum
Arteriovenous fistula's can result from?
Trauma or biopsy
Normal spectral Doppler characteristics with in endovascular aortic stent graft repairs are considered?
Triphasic
The inner wall layer of a vessel closest to the passing blood is the
Tunica intima
What are the three layers of the IVC?
Tunica intima, to the comedian, and to look at adventitia
The aorta bifurcates at or near the level of the blank?
Umbilicus
What are the most common findings of IVC thrombosis?
Vessel enlargement, absence of Flo, and material noted within the lumen
An aneurism results from what?
Weakening of the vessel wall
The IVC can be separated into four sections from superior to inferior:
hepatic, prerenal, renal, postrebal
False aneurisms are associated with what?
interventional procedures, surgery, trauma, or infection
The aorta can be found on what side of the spine?
left
The aorta originates at the
left ventricle
What are the sonographic findings of a pseudo aneurism
perivascular haematoma containing swirling blood and has a neck connecting to the vessel. Colour Doppler demonstration of turbulent flow within the mass
Is the aorta retroperitoneal or intraperitoneal?
retroperitoneal
The IVC is to what side of the spine?
right
The IVC terminates at the:
right atrium
which vascular structure may be confused for the main pancreatic duct?
splenic artery
What are the layers of the aorta from inner to outer?
tunica intima, tunica media, and tunica adventitia/externa
