70 Questions
Which imaging technique provides information about blood flow velocity, flow direction, presence of flow disturbance, or turbulence in the vasculature?
Duplex sonography
What is the term for flow direction away from the liver in the vasculature?
Hepatofugal
What type of vessels are characterized by low or reversed flow in diastole and supply organs that do not demand constant blood perfusion?
High-resistance vessels
What does spectral broadening in Doppler spectral waveforms indicate?
Increase in turbulence
Which system's vasculature is not described as a key focus in the objectives?
Cardiovascular
What type of imaging provides real-time visualization and pulsed Doppler capabilities used either simultaneously or sequentially for evaluating abdominal vascular disease?
Duplex sonography
Which artery originates from the anterior wall of the aorta, 1 to 2 cm inferior to the origin of the celiac axis?
Superior mesenteric artery
Which artery supplies blood to the jejunum, ileum, cecum, ascending and transverse colon, portion of the duodenum, and the pancreatic head?
Superior mesenteric artery
Which artery supplies blood to the descending and sigmoid flexures of the colon and the greater part of the rectum?
Inferior mesenteric artery
Which renal artery is longer than the other and divides into four or five branches before entering the hilum of the kidney?
Right renal artery
Approximately what percentage of the population has duplicated and/or accessory renal arteries?
20%
What are the abdominal arteries characterized as in terms of echogenic walls?
Anechoic
Which vessel supplies a high-resistance vascular bed?
Superior mesenteric artery
During fasting, what kind of vessel is the superior mesenteric artery?
High-resistance vessel
What happens to the superior mesenteric artery diastolic flow component postprandially?
Increases
Which part of the aorta supplies blood to low-resistance vessels that supply the liver, spleen, and kidneys?
Suprarenal abdominal aorta
What is the main blood supply of infrarenal aorta directed toward?
Lower extremities and lumbar arteries
Which arteries consistently demonstrated with ultrasound are branches of the abdominal aorta?
Renal arteries and common iliac arteries
The IVC's normal diameter is typically less than?
2.5 cm
Which vessel is formed by the confluence of the superior mesenteric and splenic veins?
Portal vein
Anatomic anomalies of the IVC include duplication and absence or relocation of portions of the vessel. Which is NOT an anatomic anomaly of the IVC?
Enlargement
Which vein is longer, courses anterior to the aorta, and receives the left gonadal and suprarenal veins?
Left renal vein
The hepatic veins empty into which vessel?
Inferior vena cava
Which vessel supplies the liver with blood through the left and right portal veins?
Portal vein
The diameters of abdominal veins vary with respiration. What is the normal diameter of the portal vein associated with expiration?
$13 mm$
Which vessel enters the porta hepaticis with the portal vein and common bile duct, and branches into the right and left trunks that supply the right and left lobes of the liver?
Hepatic artery
What does IVC stands for?
Inferior Vena Cava
Which vessel gives rise to multiple tributaries, with the renal veins being the most relevant to the vascular ultrasound examination of the hepatoportal and renal systems?
Inferior Vena Cava
Which vein receives blood from both renal veins?
Inferior Vena Cava
Where does the IVC lie medial to?
Left kidney
Which vessel provides blood supply to the liver and spleen through its branch vessels?
Celiac axis
Which vessel supplies the pancreas, small intestine, and colon?
SMA
Which vessels supply low-resistance organs like kidneys with high diastolic flow?
Renal arteries
Which vessel demonstrates forward diastolic flow in its Doppler velocity waveform?
Celiac artery
Which vessel demonstrates low diastolic flow in the fasting state and high diastolic flow postprandially?
SMA
Which vessel's Doppler spectrum waveform mimics that of SMA in the fasting state?
Inferior mesenteric artery
Which vessels' Doppler spectral waveform shows significant diastolic flow?
Renal arteries and its branches
Which system consists of the IVC and its tributaries, as well as the portal venous system?
Abdominal venous system
What creates a unique vascular partnership by supplying the liver with blood?
Hepatic artery and portal vein
Which vessel is formed by the confluence of the common iliac veins?
IVC
Which organ is supplied by the hepatic branch of the IVC?
Liver
Which artery provides blood supply to the liver and spleen through its branch vessels?
Celiac axis
Which artery supplies blood to the stomach, liver, spleen, and small intestine?
Celiac artery
From which major artery does the common hepatic artery originate?
Celiac artery
Which artery provides blood to the anterior and posterior segments of the stomach and esophagus?
Left gastric artery
From which major artery does the proper hepatic artery originate?
Common hepatic artery
Which major artery supplies blood to the intestines from the jejunum to the distal two-thirds of the transverse colon?
Superior mesenteric artery
Which major artery is located along the lesser curvature of the stomach?
Left gastric artery
Which major artery courses along the superior border of the pancreatic neck and head?
Proper hepatic artery
Which major artery is located posterior to the left renal vein, SMA, splenic vein, pancreas body/tail, and celiac artery?
Splenic artery
In vascular duplex sonography, which imaging techniques have been complemented by color, power, and harmonic and real-time compound imaging for examination of the hepatoportal, mesenteric, and renal vascular systems?
Gray-scale and pulsed Doppler
What is the average diameter of the celiac artery in the abdominal arterial system?
0.70 cm
Which vessel characteristically tapers slightly from its proximal to distal segments in the abdominal arterial system?
Aorta
What is the normal measurement range for the average diameter of the inferior vena cava in the abdominal venous system?
25 to 35 mm
Which imaging modality is being explored for use in selected vascular cases in extended, advanced practice?
3- and 4-dimensional and volume imaging
What does the systolic window refer to in a Doppler spectral display?
Relatively signal-free area between the arterial Doppler shift signal and the baseline during the systolic portion
Which vessels supply organs that do not demand constant blood perfusion and are characterized by low or reversed flow in diastole?
Hepatic veins
Where does the abdominal aorta terminate in the body?
At the body of the fourth lumbar vertebra
"Outstanding technical advancements" have facilitated the extension of vascular duplex sonography into which vessels of the abdomen?
"Outstanding technical advancements" have facilitated extension into deep vessels of the abdomen
What type of imaging was initially used for noninvasive evaluation of the superficial arteries and veins?
Gray-scale imaging and pulsed Doppler
What can cause dilation of the inferior vena cava on ultrasound?
Congestive heart failure
Which condition can lead to increased diameter of the hepatic veins?
Cirrhosis
How does deep inspiration affect the inferior vena cava on ultrasound?
Causes dilation
What is the typical appearance of the hepatic veins on ultrasound?
Anechoic structures
From which approach can the hepatic veins be most often insonated?
Subcostal approach
What may occasionally be visualized as the 'bunny sign' when insonating the hepatic veins from a subcostal approach?
Two branches instead of three
What can lead to dilation of the inferior vena cava on ultrasound?
Tricuspid regurgitation
Which condition can lead to increased diameter of the hepatic veins within the liver parenchyma?
Cirrhosis
How does deep inspiration affect the inferior vena cava on ultrasound?
Causes dilation
What is the typical appearance of the hepatic veins on ultrasound?
Anechoic structures
Study Notes
- The text discusses the location and visualization of various abdominal aorta branches using ultrasound.
- The aorta, which can be tortuous, is located anterior to the spine and is bordered by the celiac artery, splenic artery, and superior mesenteric artery (SMA), among others.
- The celiac artery, located left of the aorta, is tortuous and divides into three major branches: the left renal artery, common hepatic artery, and left gastric artery. It supplies blood to the stomach, liver, spleen, and small intestine.
- The common hepatic artery, originating from the celiac artery, courses along the superior border of the pancreatic neck and head. It gives rise to the gastroduodenal artery, then becomes the proper hepatic artery, and eventually enters the porta hepatis.
- The proper hepatic artery branches into the right and left hepatic arteries, which divide into segmental and subsegmental hepatic artery branches. These branches course parallel to the bile ducts and portal vein branches within the liver.
- The left gastric artery, located along the lesser curvature of the stomach, sends branches to the anterior and posterior segments of the stomach and esophagus.
- The splenic artery, tortuous and located posterior to the left renal vein, SMA, splenic vein, pancreas body/tail, and celiac artery, supplies blood to the spleen and the inferior portion of the duodenum.
- The superior mesenteric artery, which originates from the right of the aorta, courses superiorly and provides blood to the intestines from the jejunum to the distal two-thirds of the transverse colon.
- The text also mentions various structures in the abdomen, such as the diaphragm, inferior vena cava (IVC), and the pancreas, among others.
Test your knowledge of the anatomy and position of the inferior vena cava in the human body. Explore the structure and relations of the IVC in the retroperitoneum, its proximity to organs such as the liver and kidney, and its pathway to the heart.
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