Abdominal Sonography Review: Quiz: #9: ABDOMINAL VASCULATURE

An AAA is present when the diameter of the abdominal aorta exceeds: 10 mm 2.5 mm 3 cm 2 mm

3 cm

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 most likely diagnosis? Aortic rupture Chronic aortic aneurysm Aortic dissection Aortic rupture

Aortic dissection

What branch and its tributaries of the abdominal aorta appears as a "seagull" in the transverse plane? SMA Hepatic artery Celiac artery Common iliac artery

Celiac artery

The left gonadal vein drains directly into the: IVC Superior mesenteric vein Left renal vein Left iliac vein

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 Left renal artery Right renal vein Right renal artery

Left renal vein

What vessel travels directly anterior to the left renal artery? Left renal vein Hepatic artery Right renal vein Superior mesenteric vein

Left renal vein

The hepatic artery should demonstrate: High-resistance flow Low-resistance flow

Low-resistance flow

A disorder of the connective tissue characterized by tall stature and aortic and mitral valve insufficiency is: Wilms syndrome Meckel-Gruber syndrome Marfan syndrome Kleinman syndrome

Marfan syndrome

Which of the following statements about the abdominal aorta is not true? Most aneurysms located within the abdominal aorta are false aneurysms. The abdominal aorta is located just left of the midline. The most common location of an AAA is infrarenal. The abdominal aorta is considered to be retroperitoneal in location.

Most aneurysms located within the abdominal aorta are false aneurysms.

An aneurysm associated with infection is termed: Recanalized Saccular Fusiform Mycotic

Mycotic

All of the following are branches of the celiac axis except: Right gastric artery Hepatic artery Splenic artery Left gastric artery

Right gastric artery

Which of the following vessels show a different flow pattern after eating? Celiac artery Splenic artery Renal artery SMA

SMA

Which vascular structure may be confused for the main pancreatic duct? Hepatic artery Left gastric artery SMA Splenic artery

Splenic artery

The main portal vein is created by the union of the: Splenic vein and superior mesenteric vein Superior mesenteric vein and inferior mesenteric vein Splenic vein and inferior mesenteric vein Splenic vein and gastroduodenal vein

Splenic vein and superior mesenteric vein

Which of the following statements about the IVC is not true? The diameter of the IVC is variable. Respiration can affect the size of the IVC. The IVC is located to the left of the abdominal aorta. The IVC is considered retroperitoneal in location

The IVC is located to the left of the abdominal aorta.

Which of the following is not true about the abdominal aorta? The abdominal bifurcates into the common iliac arteries. The proximal aorta is situated more anterior than the distal aorta. The aorta has a thicker tunica media than the IVC. The third major branches of the abdominal aorta are the renal arteries.

The proximal aorta is situated more anterior than the distal aorta.

The outer wall layer of a vessel is the: Tunica media Tunica intima Tunica rugae Tunica adventitia

Tunica adventitia

The inner wall layer of a vessel, closest to the passing blood, is the: Tunica media Tunica intima Tunica rugae Tunica adventitia

Tunica intima

The veins seen attaching to the IVC just below the diaphragm are the: Renal veins Superior mesenteric vein Hepatic veins Celiac axis

Hepatic veins

The aorta originates at the: Left atrium Right atrium Left ventricle Right ventricle

Left ventricle

The IVC terminates at the: Common iliac veins Right atrium Left atrium Left ventricle

Right atrium

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

Right-sided heart failure

The diameter of the IVC should never exceed: 1.5 cm 2.5 cm 3.5 cm 8 mm

2.5 cm

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 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 represent? Calcific thrombus Intimal flap EVAR Aortic filter

Intimal flap

Occlusion of the hepatic veins describes: Marfan syndrome Klinefelter syndrome Morrison syndrome Budd-Chiari syndrome

Budd-Chiari syndrome

Which of the following would most likely yield a high-resistance flow pattern? Celiac artery Common iliac artery Splenic artery Right renal artery

Common iliac artery

Clinical findings of an AAA include all of the following except: Lower extremity pain Back pain Abdominal bruit Elevated hematocrit

Elevated hematocrit

Which of the following would have a pulsatile, triphasic blood flow pattern? Renal veins Hepatic veins Gonadal veins Common iliac veins

Hepatic veins

What should the postprandial flow pattern be within the SMA? High resistance Low resistance

Low resistance

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? Abdominal aorta Left renal vein Right renal artery SMA

Right renal artery

The second main branch of the abdominal aorta is the: SMA Celiac artery Renal arteries Hepatic artery

SMA

What abnormality would the failure of an EVAR to isolate an aneurysm from circulation most likely results in? Endoleak Aortic dissection Pulmonary embolism Deep venous thrombosis

Endoleak

Which of the following vessels would most likely yield a high resistance flow pattern? Celiac artery Common hepatic artery Renal artery Fasting SMA

Fasting SMA

The most common shape of an AAA is: Saccular Bulbous True Fusiform

Fusiform

What vessel may attach to the splenic vein before reaching the portal confluence? Left renal vein Inferior mesenteric vein Right renal vein Celiac vein

Inferior mesenteric vein

The first main visceral branch of the abdominal aorta is the: SMA Celiac artery Renal arteries Hepatic artery

Celiac artery

Which of the following is not a section of the IVC? Postrenal Pancreatic Prerenal Hepatic

Pancreatic

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

High resistance

Which vessel would be the shortest in length? Right renal vein Right renal artery Left renal vein Left renal artery

Right renal vein

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: Crohn disease Intussusception Bowel obstruction Small bowel ischemia

Small bowel ischemia