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Questions and Answers
What is the sonographic appearance of the appendix in transverse view?
What is the sonographic appearance of the appendix in transverse view?
bullseye
How does the sonographic appearance of the appendix appear in a sagittal view?
How does the sonographic appearance of the appendix appear in a sagittal view?
finger-like projection
The right portal vein bifurcates into anterior and posterior branches that divide the right lobe of the liver into anterior and posterior segments. It is _____ than the left portal vein.
The right portal vein bifurcates into anterior and posterior branches that divide the right lobe of the liver into anterior and posterior segments. It is _____ than the left portal vein.
larger
Which layer of a blood vessel is the innermost layer?
Which layer of a blood vessel is the innermost layer?
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What are the tiny veins and arteries that supply the greater blood vessel itself called?
What are the tiny veins and arteries that supply the greater blood vessel itself called?
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The diaphragm divides the abdominal aorta into the descending thoracic aorta and descending abdominal aorta.
The diaphragm divides the abdominal aorta into the descending thoracic aorta and descending abdominal aorta.
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The abdominal aorta bifurcates at the umbilicus into the right and left _____ arteries.
The abdominal aorta bifurcates at the umbilicus into the right and left _____ arteries.
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Match the following arteries with their objectives:
Match the following arteries with their objectives:
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Study Notes
Abdominal Vasculature
- Blood vessels have 3 layers:
- Tunica adventitia: outermost layer, encapsulates the blood vessel in a thin fibrous wall, contains vasa vasorum (tiny veins and arteries) and nerves
- Tunica media: middle layer, composed of smooth muscle and external elastic membrane
- Tunica intima: innermost layer, composed of endothelium, basement membrane, lamina propria, and internal elastic membrane
Abdominal Aorta
- Located in the retroperitoneal cavity, anterior and left of the IVC and spine
- Originates from the left ventricle of the heart
- Posterior to the diaphragm, which divides the aorta into the descending thoracic and abdominal aorta
- Bifurcates into the right and left iliac arteries at the umbilicus
- Normally ≤ 3 cm in diameter, tapering to a narrower diameter as it descends
Branches of the Abdominal Aorta
- Celiac trunk: the 1st branch of the abdominal aorta, originates from the anterior aorta 1-3 cm below the diaphragm
- Separates the proximal and distal abdominal aorta
- 3 branches:
- Common hepatic artery (CHA)
- Splenic artery (SA)
- Left gastric artery
- Superior mesenteric artery: the 2nd branch of the abdominal aorta, originates from the anterior aorta 1-2 cm below the celiac trunk
- Runs parallel to the anterior aorta and posterior to the pancreas
- Normally 6 mm in diameter
- Right and left renal arteries: branches of the abdominal aorta that supply the kidneys
- Originate from the lateral walls of the aorta
- Right renal artery is longer than the left due to proximity to the right kidney
- Gonadal arteries: branches of the abdominal aorta that supply the reproductive organs
- Difficult to visualize with ultrasound due to small size
- Inferior mesenteric artery: the last branch of the abdominal aorta before it bifurcates into the right and left iliac arteries
- Originates from the anterior lateral side of the aorta, 4 cm away from the bifurcation
- Limited visualization on ultrasound due to small size
Abdominal Veins
- Inferior vena cava (IVC):
- Located in the retroperitoneal cavity, anterior to the spine, posterior to the intestines and the caudate lobe of the liver, and to the right of the aorta
- Passes through the diaphragm and terminates in the right atrium of the heart
- Formed by the convergence of the common iliac veins
- Hepatic veins: the 1st branches of the IVC
- Located just superior to the renal veins
- Hepatofugal flow: blood moves away from the liver
- 3 branches:
- Right branch
- Middle/intermediate branch
- Left branch
- Normally 4-7 mm in diameter
- Pulsatile Doppler waveforms
- Renal veins:
- Located just inferior to the renal arteries
- The LRV is longer than the RRV due to proximity
- No pulsatility in Doppler waveforms
- Objective: drain deoxygenated blood from the kidneys back into the IVC
- Superior mesenteric vein (SMV) and splenic vein (SV):
- Join to form the portal vein
- Drain the proximal portion of the large intestine and portions of the small intestine
Portal Venous System
- Portal veins have hyperechoic borders on a 2D image
- Main portal vein (MPV or PV):
- Originates from the junction of the SMV and SV, posterior to the pancreas and just to the right of the midline
- Bifurcates at the porta hepatis into right and left portal veins
- Normally < 13 mm in diameter
- Right portal vein (RPV):
- Runs centrally and horizontally in the right lobe of the liver
- Bifurcates into anterior and posterior branches that divide the right lobe of the liver into anterior and posterior segments
- Left portal vein (LPV):
- Runs in the left lobe of the liver
- Branches divide the left lobe of the liver into medial and lateral segments
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Description
Week 1 review of abdominal vasculature, covering the 3 layers of a blood vessel and their components.
