Chapter 13: Abdominal Vasculature

The risk of rupture in an abdominal aortic aneurysm measuring 6.0cm in diameter is approximately:

15% of abdominal aortic aneurysms measuring 6.0 cm in diameter will rupture within 5 years.

An asymptomatic patient presents with a history of an abdominal aortic aneurysm. The findings in this sonogram are most suspicious for which of the following conditions?

A complex aortic aneurysm demonstrating smooth wall margins is identified in an asymptomatic patient. The anechoic area represents the lumen of the aorta, and the complex area represents chronic changes in intraluminal thombus.

The arrow is demonstrating which of the following vascular structures?

A cross sectional image of a vascular structure is identified posterior to the IVC. This most likely represents the right renal artery.

A fusiform aneurysm is best described as:

A fusiform aneurysm is characterized by a uniform dilatation of the arterial walls. An arterial dilatation characterized by a focal outpouching of one arterial wall describes a saccular aneurysm

Which of the following aneurysms is associated with a recent history of bacterial infection?

A mycotic aneurysm is usually caused by a recent bacterial infection.

The presence of a palpable "thrill" within an artery is suspicious for a(n):

A palpable vibration within an artery is highly suspicious for an arteriovenous fistula.

Dilatation of an artery caused by damage to one or more layers of the arterial wall describes a(n):

A pseudoaneurysm is defined as a dilatatioin of an artery caused by damage to one or more layers of the arterial wall.

The anechoic structure lying anterior to the IVC and posterior to the liver most likely represents the:

An anechoic structure is identified adjacent to the main lobar fissure in the region of the gallbladder fossa.

Which of the following branches of the abdominal aorta is identified by arrow B?

An anechoic tubular structure is branching from the anterior aspect of the abdominal aorta. Arrow B identifies the superior mesenteric artery, a common sonographic landmark.

A dilatation of an artery when compared with a more proximal segment describes which of the following abnormalities?

An ectatic aneurysm is a dilatation of an artery when compared with a more proximal segment. In cases of abdominal aortic aneurysms, the ectatic dilatation does not exceed 3.o in diameter.

Which of the following conditions most commonly coexists with a popliteal aneurysm?

Approximately 25% of patients with a popliteal aneurysm demonstrate a coexisting abdominal aortic aneurysm

Duplication of the main renal arteries is demonstrated in approximately:

Approximately 33% of the population will demonstrate duplication of the main renal arteries.

The amount of blood supplied to the liver from the portal venous system is approximately:

Approximately 70% of the blood supplied to the liver is from the portal venous system, whereas the hepatic artery supplies 30%.

Which of the following visceral branches of the abdominal aorta is identified by arrow A?

Arrow A identifies a proximal anterior branch of the aorta. The celiac axis is the first visceral branch of the abdominal aorta.

Which of the following vascular structures is identified by arrow B?

Arrow B identifies a vascular structure located posterior to the body of the pancreas and is surrounded by a thick hyperechoic rim.

Development of an abdominal aortic aneurysm is most commonly caused by:

Arteriosclerosis is the most common predisposing factor for developing an abdominal aortic aneurysm. Pathological thickening, hardening, and loss of wall elasticity allow the weakened arterial walls to stretch.

A patient presents with a history of pulmonary embolism. A sagittal image of the IVC demonstrates an intraluminal mass. On the basis of the clinical history, the mass is most suspicious for a(n):

Based on a history of pulmonary embolism, the echogenic mass is most suspicious for a thrombus.

Berry-shaped aneurysms primarily affect which of the following arteries?

Berry aneurysms are small saccular aneurysms primarily affecting the cerebral arteries. The carotid and vertebral arteries are considered extracranial structures.

Which of the following controls will decrease artifactual echoes only within the abdominal aorta?

Decreasing the time gain compensation at the level of the abdominal aorta will decrease the artifactual echoes only within the abdominal aorta.

Development of an arteriovenous fistula may be caused by:

Development of an arteriovenous fistula may be congenital or caused by trauma, surgery, inflammation, or a neoplasm.

Direct extension of thrombus into the IVC is most likely caused by thrombus originating in the:

Direct extension of thrombus into the IVC most commonly originates from the lower extremity but may also originate from the iliac, renal, hepatic, or right gonadal veins.

Which of the following veins courses in an oblique plane between the right and left lobes of the liver?

Hepatic veins course between the segments of the liver toward the IVC. The middle hepatic vein divides the liver into right and left segments

Hypovolemic shock is a clinical finding in patients with a history of:

Hypovolemic shock is a clinical findings in patients with a history of ruptured aortic aneurysm. Marfan syndrome is associated with aortic dissection.

Patients with Marfan syndrome have a predisposing risk factor for developing a(n):

Marfan syndrome is a musculo-skeletal condition that affects the elastic fibers in the media of the aorta, increasing the risk for developing an aneurysm.

An infiltrating neoplasm within the IVC most commonly originates from which of the following structures?

Neoplasms from the kidney extend into the renal vein and may infiltrate the IVC.

Which of the following statements most accurately descries the left renal vein?

Normal compression from the mesentery may cause dilatation of the left renal vein. Renal veins demonstrate a spontaneous phasic flow pattern.

The contour of a mycotic aneurysm is most commonly described as:

Saccular-shaped aneurysms are most often caused by an infection or trauma.

The IVC is considered enlarged after the diameter exceeds:

The IVC usually measures less than 2.5 cm and is considered enlarged after the diameter exceeds 3.7 cm.

The main portal vein bifurcates at the hepatic hilum into the

The MPV bifurcates at the hepatic hilum into the right and left portal veins.

The abdominal aorta usually bifurcates into the right and left common iliac arteries at the level of the

The abdominal aorta bifurcates into the right and left common iliac arteries at the level of the fourth lumbar vertebra.

The celiac axis branches into which of the following arteries?

The celiac axis branches into the common hepatic, left gastric, and splenic arteries.

The first visceral branch of the abdominal aorta is the

The celiac axis is the first visceral branch of the abdominal aorta. The celiac artery courses approximately 1 to 3 cm before trifurcating into the splenic, left gastric, and common hepatic arteries.

A 65-year-old local farmer presents with a history of leukocytosis and an enlarging, pulsatile abdominal mass. The anterior, posterior, and lateral borders of the distal aorta are outlined by the calibers. On the basis of the clinical history, the sonogram is most likely demonstrating which of the following pathologies?

The clinical history includes: luekocytosis and an enlarging pulsatile abdominal mass. The distal aorta measures 5 cm in height and 6 cm in width. Complex intraluminal echoes are also identified. Based on the clinical history, the sonographic findings are most suspicious for a mycotic abdominal aortic aneurysm.

The common iliac artery is considered enlarged after the diameter exceeds:

The common iliac artery is considered enlarged after the diameter exceeds 2.0 cm in diameter.

The IVC generally measures less than:

The diameter of the IVC generally measures less than 2.5 cm and is considered enlarged after the diameter exceeds 3.7 cm

The normal diameter of the main portal vein should not exceed:

The diameter of the MPV should not exceed 1.3 cm in diameter in adults older than 20 years, 1.0 cm in diameter between 10 and 20 years of age, and 0.85 cm in diameter younger than 10 years.

A true aortic aneurysm is defined as a dilatation of the abdominal aorta:

The diameter of the abdominal aorta much reach a minimum diameter of 3.0 cm to be considered a true abdominal aortic aneurysm

Which of the following vessels lies between the duodenum and the anterior portion of the pancreatic head?

The gastroduodenal artery lies between the superior portion of the duodenum and the anterior aspect of the pancreatic head.

Which of the arteries gives rise to the gastroepiploic artery?

The gastroepiploic artery is a branch of the splenic artery.

The gonadal arteries arise from the

The gonadal arteries arise from the anterior aspect of the

Which of the following structures is located anterior to the IVC?

The head of the pancreas lies anterior to the IVC.

Which of the following arteries supplies the left transverse colon, the descending colon, and the sigmoid?

The inferior mesenteric artery supplies the left transverse colon, descending colon, upper rectum, and sigmoid.

Which of the following vessels course anterior to the abdominal aorta and posterior to the SMA?

The left renal vein courses anterior to the aorta and left renal artery and posterior to the superior mesenteric artery. The splenic vein courses anterior to the SMA.

The left renal vein receives tributaries from which of the following veins?

The left renal vein receives the left suprarenal vein superiorly and the left gonadal vein inferiorly.

Normal diameter of the splenic vein should not exceed:

The normal diameter of the splenic vein should not exceed 1.0 cm.

Which of the following vascular structures courses posterior to the IVC?

The right renal artery is a common sonographic landmark coursing posterior to the IVC

Which of the following vascular structures is most commonly mistaken as a dilated pancreas duct?

The splenic artery is a tortuous branch of the celiac axis and is most commonly mistaken as a dilated pancreatic duct.

Which of the following vascular structures is identified by arrow A?

The vascular structure identified by arrow A courses in a transverse plane, anterior to the superior mesenteric artery and posterior to the body of the pancreas and is surrounded by a thick hyperechoic. These findings are most consistent with the superior mesenteric artery.

Arrow A is most likely identifying which of the following vascular structures?

Vessel A is located in the upper abdomen and courses in a transverse plane, posterior to the liver toward the right renal hilum. Arrow A is most likely the right renal vein.

The anechoic area identified by arrow B is most consistent with which of the following vascular structures?

Vessel B courses in a sagittal plane directly posterior to the liver.