Inferior Vena Cava
Indication to scan the IVC include:
- Abdominal pain - Palpable mass - Follow Up Filter placement - Budd-Chiari Syndrome - thrombosis or obstruction of the IVC (ex: renal tumor) - Dilatation of the IVC and HVS (right side heart failure)
List the tributaries to the IVC:
- Right, left and middle hepatic veins - Suprarenal veins - Renal veins - Right gonadal vein (left gonadal vein empties into left renal vein) - Lumbar veins - Common Iliac veins
Transducer choice for scanning the IVC is:
2.5 - 6.5 MHz curvilinear
The landmark for the proximal IVC is:
Above unification below the renal veins
The renal veins course ________ to the renal arteries
Anterior
The landmark for the middle IVC is:
At the level of head of Pancreas or renal veins
The ultrasound appearance of veins are:
Echogenic muscular walls, anechoic, echo-free lumen
The IVC is an intraperitoneal organ. (T or F)
False. It is a retro-peritoneal organ
Flow with the hepatic veins are:
Hepatofugal Triphasic
Veins that are damaged and not working properly are called:
Incompetent
The ________ is the largest vein in the body.
Inferior Vena Cava (IVC)
The right gonadal vein empties directly into the:
Inferior Vena Cava (IVC)
The left gonadal vein empties into the _______, then to the IVC.
Left renal vein
The gonadal veins are referred to as _______ veins in the female.
Ovarian
The next main venous connection to the IVC, just below the hepatic veins are the:
Paired renal veins
IVC passes through a deep fossa on the _______ surface of the liver between the caudate lobe and bare area.
Posterior
IVC ascends the retro-peritoneum of the abdominal cavity and passes through the diaphragm to enter the ________ atrium.
Right
The IVC is located anterior to the spine and to the ___________ of the aorta.
Right
Patient positioning for IVC scanning is:
Supine or Left Lateral Decubitus (LLD)
The gonadal veins are referred to as _______ veins in the male.
Testicular
What has a right sided structure, thin wall, will collapse, not pulsatile, larger in size (4cm), usually respiratory variation (Valsalva maneuver), does touch the liver, hepatic veins are the only anterior branches, right renal artery is posterior to the IVC.
The IVC
What has a left sided structure, thick wall, not compressible, pulsatile, smaller in size (3cm), no respiratory variation, does not touch the liver, multiple anterior branches and has no vessel located posterior to the Aorta
The aorta
The landmark for the distal IVC is:
The hepatic veins
Common Iliac veins drain blood from:
The lower extremities and pelvis
The largest visceral tributaries to the IVC are:
The right, middle and left hepatic veins
The function of the IVC is:
To carry deoxygenated blood from the organs to the right atrium.
Common Iliac veins are located posterior to the Iliac arteries. (T or F)
True
In the abdomen, expiration decreases the diameter of the IVC. (T or F)
True
In the abdomen, inspiration increases the diameter of the IVC. (T or F)
True
Incompetent valves allow the blood to flow backwards. (T or F)
True
The IVC has a smaller amount of smooth muscle within its tunica media compared to the abdominal aorta. (T or F)
True
The right renal vein is shorter than the left renal vein. (T or F)
True
The left renal vein(LLR) courses between the Aorta(Ao) and Superior Mesenteric Artery(SMA) (longer), and the right renal vein(RRV) passes posterior to the Inferior Vena Cava (IVC) (longer)
True - The left gonadal vein drains into the left renal vein, and is therefore much longer than the right gonadal vein.
The three layers of the IVC are:
Tunica Intima (Innermost) Tunica Media (Middle layer) Tunica Adventitia (Outtermost)
IVC originates at the junction (confluence) of ________ anterior to the __________ lumbar vertebra, near the levels of the umbilicus.
Two common iliac veins Fifth
The size of the IVC is:
Up to 4cm in diameter
_______ is when the patient breathes in and bears down, it will cause the vein to widen, distend and stretch out.
Valsalva maneuver
_______ helps to maintain a uni-directional flow of blood in veins.
Valves
