Sectional Anatomy Test 2 - Aorta and IVC

lateral branches of aorta

-Phrenic arteries -Left and right renal arteries -Gonadal arteries

3 anterior branches of aorta

1. Celiac Artery/Trunk (Celiac axis) 2. Superior Mesenteric Artery 3. Inferior Mesenteric Artery

5 sections of the aorta

1. Root of the aorta 2. Ascending Aorta 3. Descending aorta 4. Abdominal aorta 5. Bifurcation of the aorta into iliac arteries

Aorta consists of ______ muscle layers

3

Use __________ MHz transducer for IVC scan.

3.0-3.5

_________MHz transducer is used to view the aorta

3.0-3.5

Size of the aorta is normal up to _______ in diameter

3cm

IVC size is variable and normal up to _____.

4cm

The aorta is divided into ____ sections.

5

Patient should fast for _______ hours for IVC scan.

6-8

Patient should fast for _________ hours before a study of the aorta.

6-8

Outer layer of IVC

Adventitia

Outer muscle layer of aorta

Adventitia

On a sonogram, the inside of the aorta appears _____________

Anechoic

The inside of the IVC appears __________ on a sonogram.

Anechoic

In a transverse view, the IVC will be seen as a round __________ structure __________ to the spine.

Anechoic, anterior

The left renal vein runs __________ to the aorta.

Anterior

Towards the bifurcation, the aorta becomes more __________

Anterior

As a normal variant, the aorta may include an _______ _________ ______ close to the CA trunk.

Anterior pulmonary branch

The abdominal aorta descends _______ to the spine, just to the ____ of midline

Anterior, left

The IVC ascends through the retroperitoneum, _________ and just to the _________ of the spine.

Anterior, right

The aorta is the largest ______ in the body.

Artery

The IVC passes between which areas of the posterior liver?

Bare area and Caudate lobe

1st anterior branch; branches into the left gastric artery, common hepatic artery, and splenic artery.

Celiac artery (CA) trunk (celiac axis)

-Pulsatile abdominal mass -Abdominal pain radiating to the back -Abdominal bruit (abnormal sound when listening with a stethoscope) -Follow up of previously identified abnormality

Clinical indications for scanning the aorta

The IVC is a ___________ vein.

Collapsible

Branches into the proper hepatic artery and gastroduodenal artery

Common hepatic artery

The IVC will ___________ in size during expiration.

Decrease

The aorta ___________ in diameter towards the bifurcation.

Decreases

This portion of the IVC extends from the area just superior to the renal vein tributaries to the right atrium of the heart; includes the hepatic vein tributaries located just below the diaphragm.

Distal IVC

On a sonogram, the walls of the aorta appear ____________

Echogenic (bright)

The walls of the IVC appear ________ on a sonogram.

Echogenic (bright)

-Arise inferior to the renal arteries and course along the psoas muscle to the respective gonadal area. -Not usually visualized with ultrasound

Gonadal arteries

The IVC will ____________ in size during inspiration.

Increase

-3rd anterior branch - inferior to the SMA and renal arteries and just superior to the bifurcation. - Divides into several small arteries that supply the transverse and descending colon. -Difficult to visualize.

Inferior mesenteric artery (IMA)

What is the inferior vena cava?

Inferior portion of the body's largest vein

Inner layer of IVC

Intima

Inner muscle layer of aorta

Intima

- Right and left renal veins - Gonadal veins

Lateral Tributaries of IVC

Located a few centimeters inferior to the SMA, it courses left lateral anterior to the spine and posterior to the tail of the pancreas

Left renal artery (LRA)

The aorta originates at the ____ _______ of the heart then ascends _________ to the pulmonary artery.

Left ventricle, posterior

The aorta arches to the ____ then descends _________ to the diaphragm into the retroperitoneum.

Left, posterior

We get an anterior to posterior measurement of the aorta in _______________

Longitudinal

What does the IVC drain?

Lower extremities and abdomen

Middle layer of IVC

Media

Middle muscle layer of aorta; contains elastic and helps hold the strength of the aorta

Media

This portion of the IVC is seen at the level of the renal vein tributaries, posterior to the head of the pancreas.

Medial (mid) IVC

Branches from the left hepatic artery

Middle hepatic artery

-Duplication -Total or partial absence -May be shortened -Visceral transposition; lying to the left of the aorta -Starts on the right but crosses to lie to the left of the aorta -Joins with the azygous vein and enters the superior vena cava

Normal variants of IVC

Supply the undersurface of the diaphragm; superior to the celiac trunk- not usually visualized with ultrasound

Phrenic arteries

Prior to the IVC entering the heart, its passes through a deep fossa on the __________ portion of the ______.

Posterior, Liver

Divides into right and left hepatic arteries

Proper hepatic artery

This portion of the IVC starts at its origin at the common iliac veins and goes to the area just inferior to the renal vein tributaries.

Proximal IVC

What does the IVC do?

Returns deoxygenated blood from the tissues to the heart for oxygenation and recirculation.

Sometimes the aorta may lie to the ________ of the IVC. This is a normal variant.

Right

The abdominal aorta bifurcates into

Right and left common iliac arteries

After passing through the diaphragm, the IVC enters the _______ _______ of the heart

Right atrium

Located a few centimeters inferior to the superior mesenteric artery (SMA), it courses anterior to the spine and posterior to the inferior vena cava.

Right renal artery (RRA)

The ______ renal artery is longer than the _______ renal artery

Right, left

The IVC will collapse momentarily if a patient does what ?

Sniffs

- 2nd anterior branch - Runs posterior to the neck/body of the pancreas. -Just inferior to the CA (celiac axis) -Divides into several small arteries that supply the ascending portion of the colon and largest portion of the small intestine.

Superior mesenteric artery (SMA)

Patient is usually in _________ position for IVC scan.

Supine

Patients will begin aortic scan in the _______ position

Supine

How do the aorta and IVC differ DURING and exam?

The IVC will vary in size (collapsible)

Like the aorta, the IVC can be __________.

Tortuous (twist ,turn)

Both renal arteries are best visualized in a __________ scanning plane.

Transverse

To see the short axis or axial view you use a ___________ scanning plane.

Transverse

We get a width measurement of the aorta in _____________

Transverse

Bring blood from the body to the IVC

Tributaries

- 3 anterior hepatic veins - Left and Right Renal veins - Left and Right common iliac veins

Tributaries of IVC

The IVC originates at the junction of the

Two common iliac veins.

The abdominal aorta is __________ oriented in the body.

Vertically

Because of the pressure of blood flow is much ________ in the IVC than the aorta, the walls are much ________.

lower, thinner

The aorta supplies ________,_________, and _________ __________ of the body with oxygen and nutrient-rich blood.

organs, bones, connective structures

What does the Superior Vena Cava (SVC) drain?

the head, neck, thoracic cavity, and upper extremities

It is normal for the aorta to _______, ________, or _________.

twist, turn, bend