Abdominal arteries/veins, Aorta pathology/IVC
drain into the inferior vena cava
- hepatic - right adrenal - renal - gonadal - inferior phrenic - 4 lumbar - common iliac - median sacral
SMA velocity greater than_____ and a celiac artery velocity greater than ____ are predictors of a 70% stenosis.
275 cm/s; 200 cm/s
What does phrenic refer to?
Diaphragm
-Arises from anterior abdominal aorta 3-4 cm above bifurcation -courses inferiorly and slightly left - supplies blood to left third of transverse colon, sigmoid colon, and rectum (hind gut structures) -often obscured on US by bowel gas
IMA
which vessel is often obscured by bowel gas, but when visualized is best seen in longitudinal plane and is usually a collateral route for stenosis or occlusion? a.) IMA b.) SMA c.) left renal artery d.) splenic artery
IMA
Courses to the right of midline
IVC
Retroperitoneal - valveless - courses superiorly to the right of midline - formed by common iliac veins at L5 - right of aorta - increases in size on inspiration and valsalva - decreases on expiration
IVC
Where does the abdominal aorta bifurcate?
L4
Shortest artery off celiac axis (not seen by ultrasound)
Left gastric
What artery supplies foregut structures?
Left gastric
Dorsal branches of aorta
Lumbar, terminal
Are relaxed veins open or closed?
Open
Lateral branches of abdominal aorta
Phrenic, right and left renal, gonadal
the right hepatic artery feeds the __________ lobe of liver and the ____________ via the cystic artery
Right; gallbladder
you are imaging a patient with an anatomic variant called "replaced" hepatic artery. In this anatomic variant, the right hepatic artery originates from what artery? a.) celiac trunk b.) SMA c.) IMA d.) left hepatic artery
SMA
Supplies blood to neck, body, and tail of pancreas (not head)
Splenic artery
Where do the left gastroepiploic artery, pancreatic branches, and gastric branches stem from?
Splenic artery
Artery that feeds arm
Subclavian
Artery surrounded by a triangular shaped area of retroperitoneal fat
Superior mesenteric artery
Artery that lies left of the superior mesenteric vein
Superior mesenteric artery
Branches just inferior to celiac trunk off the aorta
Superior mesenteric artery
an ______ __________ ______ is caused by weakening of the vessel wall
abdominal aortic aneurysm
the inferior mesenteric artery will not be imaged on ultrasound in a(n) (acute or chronic?) setting
acute
the left renal vein is (anterior or posterior?) to the aorta and (anterior or posterior?) to the SMA
anterior; posterior
largest artery in the body
aorta- it carries oxegenated blood to the whole body from the heart
the main renal artery branches into segmental, interlobar, _____________, and _______ from hilum to periphery
arcuate; interlobular
after a kidney transplant, the renal artery will anastamose with the _________ iliac artery
external
a _________ aneurysm involves only 1 or 2 layers of the vessel and will show a yin yang pattern on Doppler
false (psuedoanuerysm)
arteries that arise anterolaterally from aorta just inferior to renal arteries - small and difficult to scan
gonadal arteries
- right drains into IVC just below RRV - left drains into LRV
gonadal veins (testicular, ovarian)
the gastroduodenal artery has a caudal course, anterolateral to the _______ of the pancreas
head
the cystic artery connects to the right ___________ artery
hepatic
the largest tributary vessels of the IVC are ___________ veins
hepatic
hepatic venous flow is (hepatofugal or hepatopedal?)
hepatofugal
Doppler of the portal vein has a waveform that is mildly undulating and (hepatofugal or hepatopedal?)
hepatopedal
the valsalva maneuver will (increase or decrease?) the diameter of the IVC
increase
the ___________ _________ artery will not be imaged on ultrasound in an acute setting
inferior mesenteric
the _________ hepatic artery FEEDS caudate lobe
left
the __________ hepatic vein separates the medial and lateral segments of the liver
left
what is the second branch off the aortic arch?
left common carotid artery
Supplies lesser curvature of stomach and lower esophagus
left gastric artery
which hepatic vein runs in the left intersegmental fissure of the liver?
left hepatic vein
What is the origin of the ascending aorta?
left ventricle of heart
______________ is known as swollen lymph nodes
lymphadenopathy
arteries have a thicker _______ layer compared to veins
media
the middle hepatic vein divides the ________ LLL from the _______ RLL
medial; anterior
with chronic _________ ischemia, symptoms are not present until 2-3 vessels are occluded
mesenteric
the _______________ hepatic vein DRAINS the caudate lobe
middle
-stenosis
narrowing
velocity doppler of 70-100 cm/s is (low, high, normal?)
normal
Hilum of the liver is called
porta hepatis
the cystic vein drains into the _____________ vein
portal
- transports blood from GI tract, gallbladder, pancreas, and spleen to the liver - formed by splenic veins and SMV at head of pancreas - walls are echogenic - provides 70-80% of blood supply to liver
portal venous system
IVC is (anterior or posterior?) to the main portal vein, caudate lobe, and head of pancreas
posterior
the uncinate process is (posterior or anterior?) to the SMA and SMV
posterior
this picture represents which type of aneurysm? - waveform would be biphasic
psuedoanuerysm
- lateral branch of aorta that arise 1-2 cm below SMA -supplies blood to kidneys, adrenal glands and perirenal fat and body wall -branch into segmental, interlobar, arcuate and interlobular -best visualized in transverse
renal arteries
course anterior to RA - drain into IVC at right angles - left is longer than right
renal vein
the ________ hepatic vein separates the posterior lobe of liver from the anterior lobe
right
the ________ renal artery is porterior to the IVC
right
symptoms of a ______________ include: - excruciating abdominal pain - shock - expanding abdominal mass (filling with blood)
rupture
_____________ aneurysms are associated with Berry aneurysms
saccular
the ____________ artery courses the anterior boarder of the pancreas
splenic
the short gastric artery and left gastroepiploic artery are branches of the _____________ vein
splenic
Largest branch of celiac trunk difficult to image
splenic artery
Terminates at splenic hilum
splenic artery
which of the following does not drain directly into the IVC? a.) renal vein b.) right hepatic vein c.) common iliac vein d.) splenic vein
splenic vein
which vein courses in a transverse plane and is inferior to the body of the pancreas?
splenic vein
supplies midgut structures
superior mesenteric artery
what vessel in anterior to the uncinate process and posterior to the neck of the pancreas
superior mesenteric artery
______________ appears as a homogeneous echogenic mass in the lumen of the IVC
thrombus
a (true or false?) aortic aneurysm involves all three layers of the vessel
true
three layers of arteries and veins
tunica intima, tunica media, tunica adventitia (externa)
Hollow elastic tubes that carry blood away from the heart
Artery
Courses to the left of midline
Aorta
bulbous, saccular, and dumbbell are three descriptors of what?
AAA
the __________ diameter is the most important measurement of the aorta
AP
Begins at T-12 and ends at L-4
Abdominal aorta
Passes to the left in front of trachea and bends dorsally
Aortic arch
Artery also known as innominate
Brachiocephalic
Major branches of aortic arch
Brachiocephalic, left common carotid, left subclavian
Proximal
Closer to heart
How many sections is the abdominal aorta divided into?
Five - root; ascending aorta & arch; descending aorta; abdominal aorta/branches; bifurcation into iliac arteries
Which is larger in diameter? Vein or artery?
Vein
What happens to a vein during expiration?
Vein lumen narrows; thoracic pressure increases; abdominal pressure decreases
What happens to vein during inspiration?
Vein lumen widens; thoracic pressure decreases; abdominal pressure increases
Which vessel responds to breathing?
Veins
Where do arterioles lead to?
capillaries
the IVC lies along the posterior surface of what lobe of liver?
caudate
_________ artery compression syndrome is also known as median arcuate ligament compression syndrome
celiac
symptoms for _________ compression syndrome include: - post prandial epigastric pain - weight loss - abdominal bruit with expiration
celiac
Seagull in transverse
celiac axis
Where does the left gastric artery originate from?
celiac trunk
Anterior branches of abdominal aorta
celiac trunk, superior mesenteric artery, inferior mesenteric artery
occlusion
closure of a blood vessel due to blockage
Where does the right gastric artery originate from?
common hepatic artery
What arteries branch off celiac trunk?
common hepatic, splenic, left gastric
a venous collateral vein that arises from the portal vein is the __________ vein a.) coronal b.) coronary c.) esophageal d.) rectal
coronary
a ___________ aneurysm with show an intimal flap
dissecting