Ch. 9 Abdominal Vasculature

embolism

a blockage caused by an abnormal mass (embolus) within the bloodstream that hinders circulation downstream, leading to tissue damage

small bowel ischemia

a condition resulting in interruption or reduction of the blood supply to the small intestines

false aneurysm

a contained rupture of a blood vessel that is most likely secondary to the disruption of one or more layers of that vessel's walls

atherosclerosis

a disease characterized by the accumulation of plaque within the walls of arteries

Marfan syndrome

a disorder of the connective tissue characterized by tall stature and aortic and mitral valve insufficiency

Transitional cell carcinoma (TCC)

a malignant tumor of the urinary tract that is often found within the urinary bladder or within the renal pelvis

saccular aneurysm

a saclike dilation of a blood vessel

Budd-Chiari syndrome

a syndrome described as the occlusion of the hepatic veins, with possible co-existing occlusion of the IVC

aneurysm

any dilation of a blood vessel, whether focal or diffuse

hepatopetal

blood flows toward the liver

Occlusion of the hepatic veins describes: a. marfan syndrome b. klinefelter syndrome c. morrison syndrome d. budd-chiari syndrome

budd-chiari syndrome

The first main visceral branch of the abdominal aorta is the:

celiac artery

What branch and its tributaries of the abdominal aorta appears as a "seagull" in the transverse plane?

celiac artery

Which of the following vessels would most likely yield a high-resistance flow pattern? a. celiac artery b. common hepatic artery c. renal artery d. fasting SMA

fasting SMA

The most common shape of an AAA is:

fusiform

What flow pattern would the postprandial SMA yield in small bowel ischemia?

high resistance

What should the postprandial flow pattern be within the SMA?

low resistance

The hepatic artery should demonstrate: a. high-resistance flow b. low-resistance flow

low-resistance flow

A disorder of the connective tissue characterized by tall stature and aortic and mitral valve insufficiency is: a. wilms syndrome b. meckel-gruber syndrome c. marfan syndrome d. kleinman syndrome

marfan syndrome

Which of the following statements about the abdominal Ao is NOT true? a. most aneurysms located within the abdominal Ao are false aneurysms b. the abdominal Ao is located just left of the midline c. the most common location of an AAA is infrarenal d. the abdominal Ao is considered to be retroperitoneal in location

most aneurysms located within the abdominal Ao are false aneurysms

An aneurysm associated with infection is termed:

mycotic

The IVC terminates at the: a. common iliac veins b. right atrium c. left atrium d. left ventricle

right atrium

All of the following are branches of the celiac axis EXCEPT: a. right gastric artery b. hepatic artery c. splenic artery d. left gastric artery

right gastric artery

In the sagittal plane, you recognize a circular, anechoic vascular structure posterior to the IVC. Which of the following would this structure be most likely? a. abdominal aorta b. left renal vein c. right renal artery d. SMA

right renal artery

Which vessel would be the shortest in length? a. right renal vein b. right renal artery c. left renal vein d. left renal artery

right renal vein

Enlargement of the IVC, with subsequent enlargement of the hepatic veins, is seen in cases of: a. Budd-Chiari syndrome b. Marfan syndrome c. Left-sided heart failure d. Right-sided heart failure

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-resistive flow pattern. This is indicative of: a. Crohn disease b. intussusception c. bowel obstruction d. small bowel ischemia

small bowel ischemia

Which vascular structure may be confused for the main pancreatic duct? a. hepatic artery b. left gastric artery c. SMA d. splenic artery

splenic artery

The main portal vein is created by the union of the: a. splenic vein and SMV b. SMV and IMV c. splenic vein and IMV d. splenic vein and gastroduodenal vein

splenic vein and SMV

Which of the following statements about the IVC is NOT true? a. the diameter of the IVC is variable b. respiration can affect the size of the IVC c. the IVC is located to the left of the abdominal Ao d. the IVC is considered retroperitoneal in location

the IVC is located to the left of the abdominal Ao

true aneurysm

the enlargement of a vessel that involves all three layers of the wall

low-resistance flow

the flow pattern characterized by persistent forward flow throughout the cardiac cycle

high-resistance flow

the flow pattern that results from small arteries or arterioles that are contracted, which produces an increase in the resistance to blood flow to the structure that is being supplied

tunica intima (interna)

the inner wall layer of a vessel

tunica media

the middle, muscular layer of a vessel

Wilms tumor

the most common solid malignant pediatric abdominal mass; a malignant pediatric renal mass that may also be referred to as nephroblastoma

tunica adventitia (externa)

the outer layer of the arterial walls

Which of the following is NOT true about the abdominal Ao? a. the abdominal Ao bifurcates into the common iliac arteries b. the proximal Ao is situated more anterior than the distal Ao c. the Ao has a thicker tunica media than the IVC d. the 3rd major branches of the abdominal Ao are the renal arteries

the proximal Ao is situated more anterior than the distal Ao

false lumen

the residual channel of a vessel created by the accumulation of a clot within that vessel

true lumen

the true or original channel within a vessel

The outer wall layer of a vessel is the:

tunica adventitia

The inner wall layer of a vessel, closest to the passing blood, is the:

tunica intima

IVC filter

vascular filter placed in the IVC to prevent pulmonary emboli

postprandial

after a meal

The diameter of the IVC should never exceed:

2.5 cm

An AAA is present when the diameter of the abdominal aorta exceeds:

3cm

An outpatient with a history of back pain and HTN presents to the ultrasound department for an abdominal aortic sonogram. Sonographically, you visualize a 6 cm infrarenal aortic aneurysm with an echogenic linear structure noted gently swaying in the aortic lumen. What is the most likely diagnosis? a. Ao rupture b. chronic Ao aneurysm c. Ao dissection d. Ao rupture

Ao dissection

The second main branch of the abdominal Ao is the:

SMA

Which of the following vessels show a different flow pattern after eating? a. celiac artery b. splenic artery c. renal artery d. SMA

SMA

mycotic aneurysm

an aneurysm caused by infection

thrombus

blood clot

pulmonary embolism (PE)

blood clot that has traveled to the lungs and is obstructing the pulmonary arterial circulation; most often the result of a DVT

Which of the following would most likely yield a high-resistance flow pattern? a. celiac artery b. common iliac artery c. splenic artery d. right renal artery

common iliac artery

Clinical findings of an AAA include all of the following except: a. lower extremity pain b. back pain c. abdominal bruit d. elevated hematocrit

elevated hematocrit

What abnormality would the failure of an EVAR to isolate an aneurysm from circulation most likely result in? a. endoleak b. Ao dissection c. PE d. DVT

endoleak

AAA

enlargement of the diameter of the abdominal aorta to greater than 3 cm

pseudoaneurysm

false aneurysm; a contained rupture of a blood vessel that is most likely secondary to the disruption of one or more layers of that vessel's walls

The veins seen attaching to the IVC just below the diaphragm are the: a. renal veins b. SMV c. hepatic veins d. CA

hepatic veins

Which of the following would have a pulsatile, triphasic blood flow pattern? a. renal veins b. hepatic veins c. gonadal veins d. common iliac veins

hepatic veins

What vessel may attach to the splenic vein before reaching the portal confluence? a. left renal vein b. inferior mesenteric vein c. right renal vein d. celiac vein

inferior mesenteric vein

A patient presents to the sonography department with a history of Marfan syndrome. The sonographic evaluation reveals a linear echo within the aortic lumen that extends form the celiac axis to the iliac arteries. Color Doppler reveals flow throughout the Ao on both sides of the linear echo. The patient has had no surgeries, and there is no AAA. What does the linear echo most likely represent? a. calcific thrombus b. intimal flap c. EVAR d. Ao filter

intimal flap

The left gonadal vein drains into the:

left renal vein

What vessel can be often noted coursing between the SMA and the abdominal aorta in the transverse scan plane?

left renal vein

What vessel travels directly anterior to the left renal artery? a. left renal vein b. hepatic artery c. right renal vein d. SMV

left renal vein

The Ao originates at the: a. left atrium b. right atrium c. left ventricle d. right ventricle

left ventricle

endovascular aortic stent graft repair

nonsurgical method for treating abdominal aortic aneurysms

intimal flap

observation of the intimal layer of a vessel as a result of a dissection

Which of the following is not a section of the IVC? a. postrenal b. pancreatic c. prerenal d. hepatic

pancreatic

fusiform

shaped like a spindle; wider in the middle and tapering toward the ends