Ardms Vasculature Abdomen Nikki

Front 1

What are the 3 brananches of the celiac axis?

Back 1

splenic artery
hepatic artery
left gastric artery

Netter 300

Front 2

What are the branches of the superior mesenteric artery?

Back 2

inferior pancreaticoduodenal artery
branches to the colon
ileal branches

Netter 301

Front 3

At what level do the renal arteries exit the aorta?

Back 3

L1-L2
just under the SMA

Front 4

The inferior mesenteric artery comes off the distal aorta and supplies the gut distal to what point?

Back 4

descending colon distal to the splenic flexure

Front 5

At what level does the aorta bifurcate into the common iliac arteries?

Back 5

L4
level of the umbilicus

Front 6

___% of AAAs occur below the renal arteries

Back 6

95%

Front 7

>___cm is considered a AAA

Back 7

3cm

Front 8

>___cm AAA should be referred for possible surgery

Back 8

5cm

Front 9

The aorta is measured ___ wall to ___ wall

Back 9

outer to outer wall

Front 10

In what view are AP measurements made?

Back 10

sagittal

An oblique slice in a transverse plane can lead to overestimation of the diameter

Front 11

In what view should a transverse measurement be obtained?

Back 11

For ARDMS, the left coronal view, because measurements in the axial view may not be in the long axis and are prone to overestimation

Front 12

T/F A mural thrombus is common in AAAs, especially larger AAAs.

Back 12

true

Front 13

What can be seen in a clot that can be mistaken for dissection, rupture, or impending rupture?

Back 13

cresentic areas of decreased echogenicity, which are areas of liquefied clot

Middleton 235 Fig 9-29

Front 14

What type of aneurysm is most common?

Back 14

the vast majority are fusiform

Middleton 234 Fig 9-28

Front 15

What type of anneurysm should raise suspicion for mycotic aneurysm or pseudoaneurysm?

Back 15

saccular

Middleton 235 Fig 9-30

Front 16

When evaluating a stent graft for leak, what should you look for?

Back 16

Use doppler to look for areas of blood flow outside the lumen but within the walls of the aneurysm

Middleton 235 Fig 9-31 (normal) Fig 9-32 (leak)

Front 17

Where do the renal veins enter the IVC?

Back 17

Laterally, near where the renal arteries exit the aorta

Netter 332

Front 18

What is the "nutcracker" effect?

Back 18

The L renal vein travels under the SMA and over the aorta, and can be pinched between the two.

Front 19

What is a normal variant for the course of the L renal vein

Back 19

it can travel posterior to the aorta

Front 20

Which gonadal vein drains into the renal vein and which enters the IVC directly?

Back 20

L gonadal vein enters the L renal vein
R gonadal vein enters the IVC directly

Netter 332

Front 21

Which 2 veins join to form the portal vein?

Back 21

SMV and splenic vein

Netter 311-312

Front 22

What is the normal diameter of the portal vein?

Back 22

13mm

Front 23

Normally, the portal vein and hepatic artery flow in the same direction. What is this called?

Back 23

hepatopetal flow

Front 24

The R renal artery travels anterior/posterior to the IVC?

Back 24

posterior

Front 25

What are indications for US evaluation of the abdominal vasculature?

Back 25

AAA
DVT
possible AV fistula after biopsy or femoral artery catheterization
mesenteric ischemia
portal hypertension

Front 26

A true aneurysm is lined by ___ layers. A false or pseudoaneurysm is lined by ___

Back 26

3
outer layers of the aortic wall or clot

Front 27

What is a dissecting aneurysm?

Back 27

Blood ruptures through the intima and reenters the main lumen distally, creating true and false lumens. It usually spans from the thoracic aorta to the abdomen

Front 28

Do AAAs more commonly rupture or dissect?

Back 28

rupture
dissection is rare

Front 29

What causes AAAs?

Back 29

atherosclerosis #1
trauma
syphilis
Marfan's syndrome
mycotic

Front 30

T/F A fresh clot in the IVC can be sonolucent

Back 30

true, this is why compression is used

Middleton 236 Fig 9-34 - echogenic throbmus

Front 31

What is the sonographic appearance of an IVC filter?

Back 31

echogenic with shadowing

Front 32

Name some causes of renal vein thrombus (4)

Back 32

renal transplant
nephrotic syndrome
renal tumors
trauma

Front 33

What are the clinical features of renal vein thrombus?

Back 33

flank pain
hematuria

Front 34

What is the sonographic appearance of a renal vein thrombus?

Back 34

Hypoechoic thrombus in a distended vein that may extend into the IVC
No Doppler signal is present

Front 35

Are most IVC thrombi primary or extensions of ovarian, renal, iliac, hepatic vein thrombi?

Back 35

extension

Middleton 237 Fig 9-35

Front 36

Name 3 non-thrombotic causes of echos in the IVC

Back 36

artifact, slow flowing blood, tumor

Doppler or motion on real-time imaging can help distinguish

Middleton 237 Fig 9-36

Front 37

Name 2 common locations for AV fistulas

Back 37

renal (after biopsy)
groin (after femoral artery puncture)
arm, for dialysis

Front 38

What are the causes of AV fistulas

Back 38

biopsy
trauma
surgery
malignancy
congenital

Front 39

What are the clinical findings of AV fistulas?

Back 39

painful swelling
bruit

Front 40

What are the sonographic findings of AV fistulas and shunts?

Back 40

color Doppler = turbulent pattern
pulsed doppler = to-and-fro pattern because there is a combination of arterial and venous signals

Front 41

What is a pseudoaneurysm?

Back 41

a contained ruptured blood vessel

Front 42

Pseudoaneurysm is a common complication of what procedure?

Back 42

femoral artery puncture

Front 43

What are the sonographic findings of pseudoaneurysm?

Back 43

a swirling blood collection adjacent to the injury site
a narrow neck connecting the pseudoaneurysm to the vessel lumen

Front 44

What is the treatment for a pseudoaneurysm?

Back 44

US-guided prolonged compression (1 hr) until neck is clotted off