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56 Cards in this Set
- Front
- Back
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What are the 3 vascular systems of the abdomen?
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1. The arterial system
2. The venous system 3. The portal venous system |
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What is another name for the portal venous system?
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The hepatic portal system
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Towards what structure does blood flow in the portal venous system?
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The liver
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What 3 veins converge to form the portal system?
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1. Splenic vein
2. Superior mesenteric vein 3. Inferior mesenteric vein |
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In what body system do the veins which constitute the portal flow originate?
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Digestive system
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Where does blood flow after it leaves the portal system?
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Into the liver, then the hepatic veins, then the IVC
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What % of blood supplied to the liver is delivered by
1. The portal system 2. The hepatic artery |
1. About 80%
2. About 20% |
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Which of the 3 veins comprising the portal system transports the most blood?
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The splenic vein
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Where does the blood in the SMV and IMV originate?
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The intestines
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Where does the blood in the splenic vein orignate?
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The spleen and stomach
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Where does the splenic vein originate, and what path does it follow?
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Starting from the hilum of the spleen, it traverses the posterior border of the pancreas, anterior to the SMA.
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What vessels join with the splenic vein?
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First, the inferior mesenteric vein (IMV), then superior mesenteric vein (SMV)
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Where does the joining of the splenic vein and SMV occur?
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Posterior to the pancreatic neck, and anterior to the uncinate process.
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What is the name for the vein formed by the joining of the splenic vein and SMV?
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The portal vein (aka main portal vein)
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What is the approximate length of the portal vein, from the portal confluence until it enters the hilum of the liver?
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5 - 7 cm
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When the portal vein enters the liver, what does it branch into?
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1. The right portal vein
2. The left portal vein |
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What are the 2 branches of the right portal vein?
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1. The right anterior portal vein
2. The right posterior portal vein |
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What are the 2 branches of the left portal vein?
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1. The left medial portal vein
2. The left lateral portal vein |
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Between which structures, and in which direction, does the splenic vein flow?
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From the spleen to the pancreas, transversely from left to right
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Which of the following drain directly into the IVC?
1. Splenic vein 2. SMV 3. IMV |
None do.
1, 2. The splenic vein and SMV join to from the portal vein, which drains into the liver. 3. The IMV drains into the splenic vein somewhere between the spleen and pancreas. |
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In what direction does the SMV travel?
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It travels superiorly, parallel to the IVC.
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In what direction does the IMV travel?
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It travels superiorly, parallel to the IVC.
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In what direction does the main portal vein travel as it courses from the pancreas to the liver, and how does it traverse the IVC?
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It travels obliquely from left to right, and traverses the IVC anteriorly.
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What is the name for the fissure at which the main portal vein enters the liver?
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The porta hepatis
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What does:
1. "porta" mean? 2. "hepatis" mean? |
1. "porta" means "gate"
2. "hepatis" means "liver" |
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Where is the porta hepatis located?
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At the liver hilum
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Other than the main portal vein, what else enters the liver at the porta hepatis?
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The hepatic artery
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What leaves the liver at the porta hepatis?
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The common bile duct
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What are the distinguishing characteristics of the blood supplied to the liver at the porta hepatis by the
1. main portal vein? 2. hepatic artery? |
1. The main portal vein supplies nutrient-rich blood.
2. The hepatic artery supplies oxygen-rich blood. |
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What function is served by the common bile duct?
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It provides a pathway for bile to leave the liver.
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What diagnosis do sonograhers make regarding the main portal vein?
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Portal vein hypertension
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What measurement do sonograpers make to determine whether or not portal vein hypertension is present?
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The diameter of the lumen of the main portal vein
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What is the normal (non-hypertensive) diameter of the portal vein?
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< 13 mm
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What is the distinguishing sonographic appearance of the porta hepatis?
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There isn't any - you don't see anything special, it's just the area where the portal vein enters the liver.
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What is the name applied to the main portal vein, the hepatic artery, and the common hepatic duct, taken together as a group?
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The portal triad
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As seen in a transverse view, what is the orientation of the components of the portal triad with respect to each other?
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The common hepatic duct is anterior and to the patient's right (lateral to the hepatic artery)
The hepatic artery is anterior and to the patient's left (medial to the common hepatic duct). The portal vein is posterior, between the other two. |
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How many portal triads are there throughout the liver?
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Multiple. This term can be use any time you have branches of the portal vein, hepatic artery, and hepatic duct traveling together. But the one place where the main vessels of each of these enter and leave the liver is considered the main portal triad.
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Which is usually larger, the left portal vein or the right portal vein?
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The right portal vein
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Do the left and right portal veins course intrasegmentally or intersegmentally?
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Intrasegmentally
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How can we determine whether main portal vein blood flow is going into the liver, as expected?
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By using color Doppler
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How can we determine the velocity of the flow?
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By using spectral Doppler
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With a Doppler color bar, how is flow toward the transducer represented?
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By the top color in the color bar
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With a Doppler color bar, how is flow away from the transducer represented?
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By the bottom color in the color bar
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With spectral Doppler, how is flow away from the transducer represented?
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By activity below the baseline
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With spectral Doppler, how is flow toward the transducer represented?
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By activity above the baseline
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What is a colloquial name for the portal triad?
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The "Mickey Mouse sign"
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What comes together to form the common hepatic duct?
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The left hepatic duct and the right hepatic duct
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What is the name of the duct that drains the gall bladder?
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The cystic duct
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What is the difference between the "common hepatic duct" and "common bile duct"?
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The difference is based upon the point at which the cystic duct joins the common hepatic duct on its way to the pancreas. Upstream of that point, it is called the common hepatic duct. Downstream of that point, it is called the common bile duct.
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What enzyme causes the gall bladder to contract?
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cholecystokinin
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What are the terms "common hepatic duct" and "common bile duct" sometimes used interchangeably?
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Because it is not always possible to determine the exact point at which the name changes (where the cystic duct joins the common hepatic duct)
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Where might the cystic duct join the common hepatic duct?
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Anywhere along its course, including right at the pancreas
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What 2 terms are sometimes used to represent the "common hepatic duct" and "common bile duct", which avoids the issue of determining where the cystic duct joins the common hepatic duct?
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1. Bile duct
2. Common duct |
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What happens to the caliber of the hepatic veins as they course toward the IVC?
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It increases
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What happens to the caliber of the portal vein as it approaches the porta hepatis?
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It increases
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Will the hepatic vein flow pattern appear pulsatile or non-pulsatile, compared to a vein in the lower extremeties? Why?
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Pulsatile, because it is close to the heart.
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