Penny Review: Abdominal Vasculature

An AAA is present when the diameter of the abdominal aorta exceeds: a) 10 mm b) 2.5 mm c) 3 cm d) 2 mm

3 cm

An outpatient with a history of back pain and hypertension presents presents to the US department for an ABD AO US. 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? a) aortic rupture b) chronic aortic aneurysm c) aortic dissection d) aortic rupture

aortic dissection

The first main visceral branch of the abdominal aorta is the: a) SMA b) celiac artery c) renal arteries d) hepatic artery

celiac artery

What branch and its tributaries of the abdominal aorta appears as a seagull in the transverse plane? a) SMA b) Hepatic artery c) celaic artery d) comon iliac artery

celiac artery

A patient presents to the US department with a hx Marfan Syndrome. The sonographic evaluattion reveals a linear echo within the aortic lumen that extends from the celiac axis to the iliac arteries. Color doppler reveals flow through out 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? a) calcific thrombus b) intimal flap c) EVAR d) aortic filter

intimal flap

Which vessel would be the shortest length? a) right renal vein b) right renal artery c) left renal vein d) left renal artery

right renal vein

Occlusion of the hepatic veins describe : a) Marfan syndrome b) klinefelter syndrome c) Morrison syndrome d) Budd-Chiari syndrome

Budd-Chiari syndrome

What vessel may attach to the splenic vein before reaching the portal confluence? a) left renal vein b) IMV c) right renal vein d) celiac vein

IMV

Which of the following vessels show a different flow patter after eating ? a) celaic artery b) splenic artery c) renal artery d) SMA

SMA

Which of the following would most likely yield a high resistance flow pattern? a) celiac artery b) common iliac artery c) splenic artery d) right renal artery

common iliac artery

Clinical findings of an AAA include all of the following except: a) lower extremity pain b) back pain c) abdominal bruit d) elevated hematocrit

elevated hematocrit

What abnormality would the failure of an EVAR to isolate an aneurysm from circulation most likely results in ? a) endoleak b) aortic dissection c) pulmonary embolism d) DVT

endoleak

Which of the following vessels would most likely yield a high resistance flow pattern? a) celiac artery b) common hepatic artery c) renal artery d) fasting SMA

fasting SMA

The most common shape of an AAA: a) saccular b) bulbous c) true d) fusiform

fusiform

The veins seen attaching to the IVC just below the diaphragm are the: a) renal veins b) SMV c) hepatic veins d) celiac axis

hepatic veins

Which of the following would have a pulsatile triphasic blood flow pattern? a) renal veins b) hepatic veins c) gonadal veins d) common iliac veins

hepatic veins

What flow pattern would be the postprandial SMA yeild in small bowel ishemia ? a) high resistance b) low resistance

high resistance

The left gonadal vein drains directly into the: a) IVC b) SMV c) left renal vein d) left iliac vein

left renal vein

What vessel can be often noted coursing between the SMA and the AA in the transverse scan plane ? a) left renal vein b) left renal artery c) right renal vein d) right renal artery

left renal vein

What vessel travels directly anterior to the left renal artery ? a) left renal vein b) hepatic artery c) right renal vein d) SMV

left renal vein

The aorta originates at the: a) left atrium b) right atrium c) left ventricle d) right ventricle

left ventricle

What should the postprandial flow pattern be within the SMA? a) high resistance b) low resistance

low resistance

The hepatic artery should demonstrate: a) high resistant flow b) low resistant flow

low resistant flow

Which of the following statements about the abdominal aorta is not true ? a) most aneurysms located within the abdominal aorta are false aneurysms b) the abdominal aorta is located just left of the midline c) the most common location of an AAA is infarenal d) 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: a) recanalized b) saccular c) fusiform d) mycotic

mycotic

Which of the following is not a section of the IVC? a) postrenal b) pancreatic c) prerenal d) hepatic

pancreatic

The IVC terminates at the : a) common iliac veins b) right atrium c) left atrium d) left ventricle

right atrium

All of the following are branches of the celiac axis except : a) right gastric artery b) hepatic artery c) splenic artery d) left gastric artery

right gastric artery

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 ? a) abdominal aorta b) left renal vein c) right renal artery d) SMA

right renal artery

Enlargement of the IVC with subsequent enlargement of the hepatic veins is seen in cases of: a) budd chiari syndrome b) Marfan syndrome c) left sided heart failure d) right sided heart failure

right sided heart failure

A patient presents with unexplained abdominal pain for vascular assessment of the SMA. Sonographically you note that the patients SMA yields a persistent high resisitive flow pattern. This is indicative: a) Crohn disease b) intussusception c) bowel obstruction d) small bowel ischemia

small bowel ischemia

Which vascular structure may be confused for the main pancreatic duct ? a) hepatic artery b) left gastric artery c) SMA d) splenic artery

splenic artery

The main portal vein is created by the union of the : a) splenic vein and SMV b) SMV and IMV c) splenic vein and IMV d) splenic vein and gastroduodenal vein

splenic vein and SMV

Which of the following statements about the IVC is not true? a) the diameter of the IVC is variable b) respiration can affect the size of the IVC c) the IVC is located to the left of the abdominal aorta d) 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? a) the abdominal bifurcates into the common iliac arteries b) the proximal aorta is situated more anterior than the distal aorta c) the aorta has a thicker tunica media than the IVC d) the third major branches of the AA are the renal arteries

the proximal aorta is situated more anterior than the distal aorta

The outer wall layer of a vessel is the : a) tunica media b) tunica intima c) tunica rugae d) tunic adventitia

tunica adventitia

The inner wall layer of a vessel closest to the passing blood is the: a) tunica media b) tunica intima c) tunica rugae d) tunica adventitia

tunica intima

The diameter of the IVC should need exceed ? a) 1.5 cm b) 2.5 cm c) 3.5 cm d) 8 mm

2.5 cm

The second main branch of the AA is the : a) SMA b) celiac axis c) renal arteries d) hepatic artery

SMA

A disorder of the connective tissue characterized by tall stature and and aortic and mitral valve insufficiency is : a) wilms syndrome b) meckel gruber syndrome c) marfan syndrome d) kleinman syndrome

marfan syndrome