Abdominal vasculature/wall & GI tract

An AAA is present when the diameter of the abdominal aorta exceeds:

3 (cm)

What vessel may attach tot he splenic vein before reaching the portal confluence? A. Left renal vein B. Inferior mesenteric vein C. Right renal vein D. Celiac vein

B. Inferior mesenteric vein

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. LRV c. RRA d. SMA

C. RRA

Name hernia: Occur when tissue becomes trapped and cannot easily be moved back into place. Can lead to a bowel obstruction or strangulation

Incarcerated hernia

Name hernia: Result of a post surgical weakening of the abdominal wall

Incisional hernia

Name Dx: Acute or chronic collections of blood lying either within the muscle or between the muscle and its sheath

Rectus sheath hematomas

Name what can be a result of the following: -direct trauma -pregnancy -cardiovascular and degenerative muscle disease -surgical injury -anticoagulation therapy -steroids -extreme exercise

Rectus sheath hematomas

Name Dx: -acute, sharp, persistent non-radiating pain -asymmetry between the rectus sheath muscles -anechoic to hypoechoic mass with scattered internal echoes -appearance depends on stage of bleed -primarily cystic with some debris and blood clots

Rectus sheath hematomas *blood begins to organize & clot, mass becomes more solid in appearance

T or F? Thoracentesis can be performed for diagnostic or therapeutic uses

T

Th second main branch of the abdominal aorta is the: a) SMA b) celiac artery c) renal arteries d) hepatic artery

a) SMA

Which of the following vessels show a different flow pattern after eating? a) SMA b) celiac artery c) renal arteries d) hepatic artery

a) SMA

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

a) right renal vein

What vessel can be often noted coursing between the SMA and the abdominal aorta in the transverse scan plane? a. LRV b. LRA c. RRV d. RRA

a. LRV

What vessel travels directly anterior to the LRA? a. LRV b. hepatic artery c. RRV d. SMV

a. LRV

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

a. endoleak

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

a. most aneurysms located within the abdominal aorta are false aneurysm

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 k

a. right gastric artery

What is the largest artery in the body?

aorta *originates at left ventricle of heart

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

b) celiac artery

The diameter of the IVC should never exceed: a. 1.5 cm b. 2.5 cm c. 3.5 cm d. 8 mm

b. 2.5 cm

Which of the following would most likely yield a high-resitance flow pattern? a. celiac artery b. common iliac artery c. splenic artery d. RRA

b. common iliac artery

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

b. hepatic veins

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 the linear echo most likely present? a. calcific thrombus b. intimal flap c. EVAR d. aortic filter

b. intimal flap *trust your gut!!!

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

b. pancreatic

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

b. right atrium

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

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

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

b. tunica intima

The left gonadal vein drains directly into the: a. IVC b. SMV c. LRV d. LIV

c. LRV

An outpatient with a history of back pain and hypertension presents to the ultrasound department for an AAA. You visualize a 6 (cm) infrarenal aortic aneurysm with an echogenic structure noted gently swaying in the aortic lumen. What is most likely diagnosis? a. aortic rupture b. chronic aortic aneurym c. aortic dissection d. aortic rupture

c. aortic dissection

What branch and its tributaries of the abdominal aorta appears as a "seagull" in the transverse plane? a. SMA b. hepatic artery c. celiac artery d. common iliac artery

c. celiac artery

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

c. hepatic veins

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

c. marfan syndrome

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 ovc is considered retroperitoneal in location

c. the ivc is located to the left of the abdominal aorta

Occlusion of the hepatic veins describes: a. marfan syndrome b. klinefelter syndrome c. morrison syndrome d. budd-chiari syndrome

d. budd-chiari syndrome

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

d. elevated hematocrit

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

d. fasting SMA

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

d. left ventricle

An aneurysm associated with infection is termed: a. recanalized b. saccular c. fusiform d. mycotic

d. mycotic

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

d. right sided heart failure

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

d. 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

d. splenic artery

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

d. tunica adventitia

What can occur when the rectus abdominis muscles separate during pregnancy from being stretched?

diastasis recti

What is a common condition in pregnant and postpartum people?

diastasis recti

The ___ inguinal hernia is located medial to the inferior epigastric vessels.

direct inguinal hernia

Name hernia: Occur due to a weakness on the midline of the upper abdominal wall on a line between the breast bone and umbilicus

epigastric hernia

Name pleural effusion: -caused by increased capillary permeability -inflammation -pneumonia -cancer -pulmonary embolism

exudative Embolsim->Exudative

Name hernia: Occurs within the femoral canal adjacent to the femoral vein just below the groin crease, usually associated with pregnancy

femoral hernia *valsalva

The most common shape of an AAA is:

fusiform

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

high resistance

The ___ inguinal hernia is located lateral to the inferior epigastric vessels and follows the inguinal canal descending from the abdomen to the scrotal fossa.

indirect inguinal hernia

Name hernia: Occurs when tissue, such as part of the intestine, protrudes through a weak spot in the abdominal muscles in the inguinal area. This is the most common abdominal wall hernia and it occurs more often in men than woman

inguinal hernia 2 types: direct & indirect

These rectus abdominus muscle shealths join at the midline to form the ___ ___, which is a complete partition of this compartment.

linea alba (LA)

The hepatic artery should demonstrate:

low resistance flow

What should the postprandial flow pattern be within the SMA?

low resitance

Name hernia: Typically protrudes through the pelvic cavity through an opening in the pelvic bone (obturator foramen). Because of the lack of visible bulging this hernia can be very difficult to diagnose

obturator hernia

Name Dx: Accumulation of fluid within the pleural space. Can be exudative or transudative. -often asymptomatic -dyspnea -pleuritic chest pain

pleural effusion

Name term: -2 longitudinal oriented muscles -extends from zyphoid process to pubic bone -encased in shealth anteriorly and posteriorly

rectus abdominus muscles

Name hernia: Occurs at the edge of the rectus abdomoinus muscle (RAM) through Spigelian fascia, which is lateral to the midline of the abdomen

spigelian hernia

The main portal vein is created by the union of the:

splenic vein & SMV

Name hernia: Occur when the blood flow has been CUT OFF to the trapped tissue

strangulated hernia

Name procedure: -performed with patient sitting at edge of bed, leaning over bedside table, back rounded -lidocain used to numb area -pleural fluid aspirated slowly, should not exceed 1.5 liters per day to avoid hypotension and pulmonary edema -coughing occurs as lung re-expands -visceral and parietal pleurarub together as fluid removes -PAINFUL

thoracentesis

What is a procedure to aspirate fluid from the plueral space of the chest?

thoracentesis

Name pleural effusion: -caused by increase hydrostatic pressure and decreased plasma onotic pressure -heart failure most common cause -liver failure (cirrhosis) -pressure infiltrating -renal failure (nephrotic syndrome)

transudative effusions

Name hernia: Occurs near the umbilicus due to the natural weakness of the abdominal wall from the umbilical cord

umbilical hernia