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