Human Anatomy Quiz - Circulatory System

Peak Systolic Velocities of Arteries

• Normal velocities for all arteries are 80-120 cm/sec.
• On stenosis, SMA velocity is 230 cm/sec.
• On stenosis, renal artery velocity is 180 cm/sec.

Proximal and Distal Renal Artery Stenosis

• Proximal renal artery stenosis is due to [unspecified factors].
• Distal renal artery stenosis is due to [unspecified factors].

Resistance and Velocities in Arteries

• High resistance is associated with low velocities.
• Low resistance is associated with high velocities.

Aneurysm Causes

• True and pseudo aneurysms are caused by injury and previous surgeries.
• Pseudo aneurysms are caused by injury and prior surgery.

Dissecting Aneurysm Complications

• Focal aneurysm is the most common true aneurysm.

Aneurysm Spectral Window

• For any aneurysm, the spectral window on the pulse wave is absent.

Blood Flow Types in Arteries

• Laminar flow: Pulsatile flow, red color.
• Turbulent flow: Red and blue color.

Phasic Flow in Veins

• Phasic flow is characteristic of veins, appearing blue.

RBC Velocity in Blood Vessels

• Red blood cells (RBCs) move at equal velocities in the center of a blood vessel.
• In turbulent flow, RBCs move at different velocities.

Sea Gull Sign Components

• The three components in the sea gull sign are CA, CHA, and SA.
• CHA (common hepatic artery) goes towards the liver.
• SA (splenic artery) goes towards the spleen.

Branches of the Common Hepatic Artery

• CHA's first branch is GDA (gastroduodenal artery).
• CHA is also a common hepatic artery.
• SA (splenic artery) is also a part of this.

Lymph Nodes on Ultrasound

• Lymph nodes are not typically seen on normal ultrasounds.

Sandwich Sign Arteries

• SMA (superior mesenteric artery) is the upper bread in the sandwich sign.
• Aorta is the lower bread.

Lymph Nodes in Ultrasound

• Lymph nodes are visible in ultrasound scans during infection, inflammation, and abdominal lymphadenopathy.

Iliac and Femoral Arteries

• External and internal iliac arteries enter the inguinal canal and become femoral arteries (right and left).
• Internal iliacs are also called hypogastric arteries.

Aortic and Kidney Arteries

• Ovaries and testes receive blood directly from the aorta.
• Kidneys have their own arteries.
• Anterior and lateral branches include CA, SMA, IMA, and posterior branches include lumbar and sacral arteries.
• Right renal artery is lower and longer than the left renal artery.

Lumbar Arteries

• There are 8 lumbar arteries (4 pairs on each side: right and left).
• The appendicular artery is a branch of SMA (superior mesenteric artery).

SMA and Aorta Angle

• SMA and aorta create a 15-degree angle.
• They are parallel and approximately 2cm apart.

Celiac Artery Supply

• Celiac artery (CA) supplies blood to the liver, pancreas, spleen, and gallbladder.
• But it does not supply the intestines.

Aortic Ectasia

• Aortic ectasia is the condition where the aorta begins to dilate.
• It is the beginning of aortic aneurysm.

Aortic Measurement Accuracy

• AP diameter and width (side to side) measurements, measured as AP, are more accurate.
• Outer measurements for the aorta are also important.

Aortic Diameter

• Aortic diameter is the same at 2.5 cm or 25mm.

Aorta and the Transducer

• As the aorta travels down the body, the diameter decreases and it moves away from the transducer (it moves further from the transducer) so that the aorta is now closer to the spine.

Aorta and IVC Location

• The aorta lies to the left of the spine and IVC is on the right.

Aorta Pathology

• Common aorta pathology is aneurysm.

Blood Supply and Drainage

• Veins drain and arteries supply.

Aorta Location and Termination

• The aorta begins at the twelfth thoracic vertebra and ends at the fourth lumbar vertebra.

IVC and Tributaries

• IVC (inferior vena cava) diameter is greater than the aorta.
• The right and left iliac vessels combine to form the IVC at the 5th lumbar vertebra.

Portal Confluence and Portal Vein

• The location of the portal confluence (where the portal vein originates).
• The main portal vein runs obliquely into the liver.

Portal Vein Branches

• The right portal vein has anterior and posterior branches.
• The left portal vein branches are medial and lateral.

Portal Vein Image Placement

• The portal vein is posterior to the common bile duct and the common hepatic artery on a sagittal image.

Mickey Mouse Sign and Color Doppler

• The portal vein shows the Mickey Mouse sign in transabdominal ultrasound imaging.
• The common hepatic artery (CHA) is red on color Doppler.
• The common bile duct (CBD) and the portal vein are also red on color Doppler.

Hepatic Vein Flow

• Hepatofugal flow (flow away from the liver) in hepatic veins appears blue on color Doppler.
• Hepatopetal flow (flow towards the liver) is in the portal vein and is red on color Doppler.

Portal Vein Diameter

• Normal portal vein diameter is 13 mm or 1.3 cm, or less.
• Anything larger than this indicates portal hypertension.

Portal Vein Signs

• Fish tail sign is associated with RPV (right portal vein), and T sign with LPV (left portal vein).
• MPV (main portal vein) + CBD (common bile duct) + CHA (common hepatic artery) form the mickey mouse sign.

Percentage of Blood

• 70% of the blood flow to the liver is through the portal vein.

Hepatic Arteries

• The remaining 30% of blood flow to the liver is supplied by the hepatic arteries.
• Portal vein blood is nutrient-rich, originating from the intestines.
• Hepatic arteries are oxygen-rich.
• Hepatic veins carry deoxygenated blood.

Venous Blood Flow

• Venous blood flow involves the superior mesenteric vein (SMV), inferior mesenteric vein (IMV), right and left portal veins, hepatic veins, and the inferior vena cava (IVC),
• Involving the right side of the heart.

Bunny Sign Components

• IVC, middle hepatic vein, and the left hepatic vein are components of the bunny sign.
• Rt hepatic vein is not a part of the bunny sign.

Hepatic Vein Waveform

• Hepatic vein waveforms are triphasic and below the baseline, without pulsatilities, on pulsed wave (PW).

IVC Pathology

• Common IVC pathology is thrombus, while common aorta pathology is aneurysm.

Renal Vein Drainage

• Left renal veins drain into the inferior vena cava (IVC).
• Right renal veins drain into the IVC.
• Left renal veins drain the gonads, adrenals, and kidneys,

Thrombus Symptoms

• Common symptoms of thrombus include lower extremity leg edema and subcutaneous hemorrhages.

Caput Medusae

• Caput Medusae refers to dilated veins around the umbilicus.
• This is associated with portal hypertension and ascites.

Portal Hypertension Spleen Enlargement

• With portal hypertension, the spleen enlarges. This is confirmed with a yes, it is enlarged.

Portal Flow Direction

• In portal hypertension, the flow of blood away from the liver (hepatofugal flow) is seen.

Maythurner Syndrome

• Maythurner syndrome affects the left side.

Common Iliac Artery Compression

• The right common iliac artery can compress the left common iliac vein.

Renal Vein Thrombosis

• Renal vein thrombosis can cause enlargement of the kidneys, gonads, and adrenals on the affected side.

Budd-Chiari Syndrome

• Obstruction in the hepatic vein results in Budd-Chiari syndrome.

Suprahepatic Flow Obstruction

• If hepatic veins fail to drain into the IVC, this is a suprahepatic obstruction.
• Color Doppler shows no blood flow and no PW.

Infrahepatic Flow Obstruction

• If the IVC on the right side of the heart fails to drain, it's an infrahepatic obstruction .
• Color Doppler shows both color flow and PW.

Ultrasound Image Components

• An ultrasound image shows the liver, gallbladder, common bile duct, portal vein, hepatic artery, and IVC(inferior vena cava) and aorta.

Test your knowledge about the human circulatory system with this quiz. From the journey of the aorta to the portal vein's characteristics, explore various aspects and common pathologies. Assess your understanding of anatomy and physiology through these targeted questions.