ABDOMEN Test (IVC, etc) Flashcards
(27 cards)
Venous - Inferior Vena Cava and Tributaries
- Formed at level of _____ lumbar vertebra by junction of _____ common iliac veins (RT and LT)
- IVC carries _____ blood AWAY from body into RA to be oxygenated
IVC and Major Systemic Tributaries
- _____ Veins
- _____ Veins
- Ascending _____ Veins
- _____ Veins
Portal Venous System
- _____ Veins: Right and Left
- _____ Vein
- _____ Mesenteric Vein
5th 2 deoxygenated Renal Gonadal Lumbar Hepatic Portal Splenic Superior
Position of IVC
- _____ to the spine
- ascends in the abdomen to the RT of the abdominal _____
- Posterior surface is closely related to RT _____ muscle, RT crus of _____ and RT _____ gland
- Anterior border closely related to the head of _____ and 2nd portion of _____
anterior aorta psoas diaphragm adrenal pancreas duodenum
IVC
IVC drains posterior abdominal _____, _____, _____, _____, _____ glands, a portion of the _____, the _____ limbs, and the _____
Size usually
wall kidneys ovaries testes adrenal diaphragm lower pelvis 2.5 increase decrease 3.7
IVC Sonographically
- _____, oval (transverse) shaped structure
- Waveform has a “_____” appearance because of the closeness to the pumping RA
- Slightly to _____ of midline
- IVC opens and collapses normally due to _____ and _____
- No branches seen on US near the _____ and _____ and _____
Anechoic W Right inspiration expiration heart liver diaphragm
Major IVC tributaries:
Lateral Tributaries
- Ascending _____ veins
- _____ veins
- _____ veins
- Right _____ (adrenal) vein
- _____ phrenic veins
Anterior Tributaries
-_____ veins
lumbar gonadal renal suprarenal inferior hepatic
Ascending Lumbar Veins
- Ascending _____ veins are branches of common iliac system
- Travel lateral to _____ and posterior to _____ muscle
- Superior to _____ crus, these veins are known as the azygos (right side) and hemi-azygos (left side) veins
- May be seen on US in the fetus in utero and mistaken for _____
- Is very ____ ……. much smaller than the NL IVC
lumbar spine psoas diaphragmatic IVC small
Gonadal Veins
Right _____ vein can be seen lateral and inferior to the RRV
- Right gonadal vein empties directly into _____
- Difficult to visualize on US
- Left gonadal vein usually drains into left _____ vein and less often into left adrenal vein
- May account for the fact that scrotal varicoceles are far more common on the _____ side than the right side
gonadal
IVC
renal
left
Renal Veins
- Bilateral; drain _____ of deoxygenated blood; empty into the IVC
- _____ and Horizontal to IVC
- Enters IVC on _____ border, bilaterally
- _____ slightly lower, normally, than LRV because of the liver superior to the Right kidney in the RUQ.
- LRV seen coursing from _____ side of body anterior to aorta (between SO and SMA to enter the IVC on lateral surface
kidneys lateral lateral RRV Left
Renal Veins
_____ renal vein courses anterior to aorta and posterior to SMA
May appear enlarged near renal hilum due to compression at _____
Left
aorta
Renal Veins
_____ renal vein seen anterior to right renal artery as it branches from lateral aspect of IVC; continues in this position to right renal hilum
Renal veins have _____ flow variations
Right
phasic
Renal veins
_____ not considered to be abnormal unless its diameter lateral to aorta is 50% greater than its proximal diameter over the aorta
May be abnormally dilated in cases of portal _____ hypertension due to development of gastrorenal or splenorenal collaterals
Renal veins have _____ flow variations
LRV
venous
phasic
Hepatic Veins
3 hepatic veins (_____,_____, and _____) are anterior branches of the IVC
Responsible for draining the blood from the _____
The MHV, LHV and a foreshortened RHV, along with the IVC, form the sonographic “_____ Bunny” sign
Hepatic veins in the liver can be seen to _____ in dimension as they approach to diaphragm and the IVC
right middle left liver playboy increase
Hepatic Veins
are interlobar and intersegmental in the _____
-courses between the different _____ lobes and segments
Provide landmarks for identification of the various _____ lobes and segments
liver
hepatic
hepatic
_____ courses within the main lobar fissure dividing the liver into right and left lobes
_____ courses within right intersegmental fissure dividing right lobe of liver into anterior and posterior segments
_____ hepatic vein courses within the left intersegmental fissure dividing the left lobe of the liver into medial and lateral segments
MHV
RHV
Left
The hepatic veins have a _____ Doppler pattern due to the pulsations of the right atrium of the heart
Sagittal IVC at diaphragm and liver….. _____ draining into IVC
pulsatile
LHV
Portal Venous System
Refers to the vessels involved in drainage of capillary beds of GI tract and _____ into the capillary bed of the liver
Blood flow to the liver is unique in that it receives both _____ and _____ blood
The portal venous system is responsible for providing 50%-60% - 3/4 of the blood supply to the _____; the remainder of blood to liver comes from hepatic artery
PVS drains the organs of _____ tract, _____, _____ and _____
spleen oxygenated deoxygenated liver GI GB Pancreas Spleen
PVS
Begins with:
Main Portal Vein (MPV/PV) which is at the junction or confluence of the _____ mesenteric (SMV) and _____ vein (SV) posterior to the neck of the pancreas
Superior
Splenic
Portal Vein
The Portal vein is shown posterior to the head of the _____
The _____ is shown sandwiched between the aorta and splenic vein
The _____ renal vein (LRV) is also shown anterior to the aorta and posterior to the SMA
pancreas
SMA
Left
MPV/PV courses obliquely and anteriorly towards the porta _____ of the liver, passing anteriorly to the IVC
At the porta hepatis (gate + liver = transverse fissure of liver PV and HA enter liver, HDs leave), the MPV divides into _____ and _____ branches
hepatis
right
left
Portal Venous System
Portal Vein; Right and Left
LPV is _____
LPV divides left lobe into _____ and _____ segments
LPV then divides even more into branches which course _____
MPV, after entering liver divides into _____ and _____
_____ portal vein (RPV) typically larger than the left portal vein (LPV)
as RPV enters the liver it divides into Rt _____ PV and Rt _____ PV branches, which travel in an intrasegmental course
smaller medial lateral intrasegmentally RPV LPV Right anterior posterior
Portal Venous System
Portal Vein; Right and Left
The portal vein are _____ in direction meaning forward flow toward the liver
Doppler flow is _____ due to respiration and cardiac hemodynamic effects
hepatopedal
phasic
Portal Venous System
Portal-Systemic Connections
Numerous connections exist between _____, it tributaries and PV system
_____ play an important role; in the event of PV obstruction, allow blood flow to bypass that system and arrive at the heart via an alternate anastomotic route
IVC
anastomoses
Portal Venous System
Portal-System Connections
A common anastomotic is between _____ and _____ veins; supplied by the coronary vein, which, when enlarged, can be seen to arise and ascend superiorly from the splenic vein
_____ vein, and other intestinal veins can form collateral between the portal and systemic venous systems
A notable collateral is the para-_____ vein
-May recanalize to form a connection with the _____ portal vein
When present, the paraumbilical vein can be followed sonographically from the _____ through the ligamentum teres to the LPV
Splenorenal shunts may develop between the _____ and _____ branches
esophageal gastric hemorrhoidal umbilical left umbilicus LRV SV
Portal Venous System
Splenic Vein
Courses medially from the _____ hilum and passes along the posterior-superior aspect of the _____
Terminates at the neck of the _____ where it is joined by the SMV, becomes the venous confluence then forming the PV
Blood flow is toward the _____
_____
splenic pancreas pancreas liver hepatopedal
