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
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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
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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?