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
