CHAPTER 9 - ABDOMINAL VASCULATURE

Low resistance flow

Renal arteries

Retroaortic left renal vein

The left renal vein can also travel posterior to the aorta in some persons which is termed a;

Hepatic Veins

The veins seen attaching to the IVC just below the diaphragm are the;

Low resistance

What should the postprandial flow pattern be wihtin SMA?

Inferior Mesenteric Artery

What vessel may attach to the splenic vein before reaching the portal confluence?

Fasting SMA

Which vessel would most likely yield a high resistance flow pattern?

3 cm

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

Aortic Dissection

An outpatient with a history of back pain and hypertension 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 diagnosis?

Low resistance flow

Celiac Artery

Sound Off

A common site for pseudoaneurysm development is within the groin at the level of the femoral artery following a heart catheterization

Pseudoaneurysm (false aneurysm)

A common site for pseudoaneurysm is within the groin at the level of the femoral artery following a heart catheterization. Swirling blood, neck connecting it to the vessel, perivascular hematoma.

Marfan Syndrome

A disorder of the connective tissue characterized by tall stature and aortic and mitral valve insufficiency is;

Myocotic

An aneurysm associated with infection is termed;

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Atherosclerosis is the most common cause of aneurysms in the US

Renal arteries

Because the aorta is located on the left side of the abdomen, the right renal artery is much longer than the left renal artery. low resistance flow. The right renal artery originates from the right anterolateral aspect of the aorta and travels posterior to the IVC. The left renal artery originates from the anterolateral aspect of the aorta and travels posterior to the left renal vein.

Right sided heart failure

Enlargement of the IVC, with enlargement fo the hepatic veins is seen in;

Hepatic artery Splenic artery Left gastric artery

Following are the branches of the celiac axis;

The abdominal aorta bifurcates into the common iliac arteries. The aorta has a thicker tunica media than the IVC. The third major branches of the abdominal aorta are the renal arteries.

Following are true about abdominal aorta;

Pulsatile, triphasic blood flow pattern

Hepatic Veins have a;

Right Renal Artery

In sagittal plane, you recognize a circular anechoic vascular structure posterior to the IVC. This structure is most likely;

Sound Off

In the sagittal plane, the right renal artery may be identified as an anechoic circle posterior to the IVC

Intimal Flap

Linear echo within the aortic lumen that extends from the celiac axis to the iliac arteries. Color doppler reveals flow throughout the aorta 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 present?

Postrenal Prepenal Hepatic

Sections of the IVC;

Low resistance flow

Splenic Artery

Gonadal arteries

The 4th branch. arise from the anterior surface of the abdominal aorta below the renal artery level, gender depended.

Left Renal Vein

The left gonadal vein drains directly into the;

Fusiform

The most common shape of an AAA is;

High Resistance

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

Inferior mesenteric artery

arises from the anterior aortic wall at the level of the third or fourth lumbar vertebra to supply the left transverse colon, descending colon, sigmoid colon, and rectum

Endovascular aortic stent graft repair (EVAR)

it is delivered to the aorta by accessing the common femoral artery. Treatment for AAA. several types; straight tube graft, bifurcated tube graft, uni-iliac graft. Triphasic flow

Common iliac arteries

measure between 8 mm and 10 mm. considered aneurysmal if diameter exceeds 2.0 cm.

Superior Mesenteric Artery

second main branch of the abdominal aorta. supplies blood to small intestines, some of the colon and the pancreas. located posterior to the splenic vein and pancreas and left lateral to the superior mesenteric vein. Left renal vein should be noted posterior to the SMA and anterior to the abdominal aorta.

iliac arteries

the aorta bifurcates at or near the level of the umbilicus. this point marks the origin of right and left common iliac arteries.

posterior to the pancreatic neck. it consists of the splenic vein, SMV and IMV

A junction referred to as the portal splenic confluence or portal confluence is located;

Suprarenal aorta= low resistance flow Infrarenal aorta=high resistance flow

Abdominal Aorta

Low resistance, hepatopetal flow

Common Hepatic Artery

High resistance flow

Common Iliac Artery

Sound Off

Distal abdominal aorta is typically high resistance whereas proximal aorta is considered low resistance

Common iliac artery

High resistance flow pattern

Budd-Chiari Syndrome

Occlusion of the hepatic veins decribes;

Abdominal aorta

Prox = 2.5 Mid = 2.0cm or less Distal= should not exceed 1.8cm

Greenfield inferior vena cava filter

Pt with likelihood of having a pulmonary embolus often require the placement of IVC filter also referred to as;

Fasting patient = high resistance flow postprandial (30-90 mins) = low resistance flow

Superior Mesenteric Artery

Right atrium

The IVC terminates at the;

Retroperitoneal in location and positioned anterior to the spine.

The abdominal aorta is considered to be;

Left Ventricle

The aorta originates at the;

2.5 cm

The diameter of the IVC should never exceed;

Celiac Artery

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

Low resistance flow

The hepatic artery should demonstrate

Tunica Intima

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

Sound Off

The left gonadal vein drains into the left renal vein whereas right renal vein drains directly into the IVC

Splenic vein and superior mesenteric vein

The main portal vein is created by the union of the;

Infrarenal

The most common location of an AAA is;

Tunica adventitia

The outer layer of a vessel is the;

SMA

The second main branch of the abdominal aorta is the;

Sound Off

The sonographic visualization of an intimal flap is indicative of aortic dissection

Posterior to the pancreatic body and tail.

The splenic vein is located

Endoleak

What abnormality would the failure of an EVAR to isolate an aneurysm from circulation most likely results in?

Celiac Artery

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

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?

Splenic Artery

Which vascular structure may be confused for the main pancreatic duct?

SMA

Which vessel show a different flow pattern after eating?

Right Renal Vein

Which vessel would be the shortest in lenght?