Arteries

Question 0

How can you tell you’re imaging the IVC?

Answer 0

It will compress; it moves with the body

Question 1

How can you tell you’re imaging the aorta?

Answer 1

It will pulse; it moves with the heart

Question 2

Why is knowing the abdominal vessels important for scanning?

Answer 2

They provide landmarks for organ imaging

Question 3

What does the circulatory system do?

Answer 3

It transports gases and nutrients to the tissue and transports waste products away from the tissue

Question 4

In general, what does the network of vessels look like?

Answer 4

Arteries - arterioles - capillaries - venules - veins

Question 5

How do you measure the blood flow in an artery?

Answer 5

Place the gate and the wings with an angle of less than 60°

Make sure it is swept to either side a bit

Question 6

How do you measure blood flow in a vein?

Answer 6

Just place the gate

Question 7

What happens to blood flow when you fast for an exam?

Answer 7

Being NPO will affect blood flow; not eating will resist blood flow

Question 8

What are the 3 parts of a vessel wall?

Answer 8

Tunica intima, tunica media, tunica externa/adventitia

Question 9

Do arteries or veins have a thicker muscle layer?

Answer 9

Arteries have a thicker muscle layer than veins

Question 10

Describe 4 things about Tunica Intima…

Answer 10

Endothelial cells - lumen
Delicate connective tissue
Elastic tissue
Inner layer

Question 11

Describe 3 things about the Tunica Media…

Answer 11

Smooth elastic muscle
Middle layer
Helps regulate flow by controlling diameter

Question 12

Describe 3 things about the Tunica Externa/Adventitia…

Answer 12

Loose connective tissue
Smooth muscles and elastic tissue
Outer layer

Question 13

What is the vasa vasorum?

Answer 13

Small blood vessels that supply the walls of the aorta and vena cava

Question 14

List 5 things about arteries…

Answer 14

Blood away from heart
Smaller in diameter
Faster moving blood
Elasticity
No change in respiration

Question 15

List 7 things about veins…

Answer 15

Blood to the heart Slower moving blood
Collapsible Little elasticity
Large diameter Changes with respiration
Has valves

Question 16

What part of the body has the most valves?

Answer 16

The legs; makes sure blood flows the right way

Question 17

What are capillaries?

Answer 17

Small vessels connecting the arterial and venous systems

Question 18

What is passed through capillary walls?

Answer 18

Nutrients and waste

Question 19

What are the 6 major arteries?

Answer 19

Aorta, celiac axis, SMA, renal, IMA, common illiacs

Question 20

What is the name of the arteries and veins that lead to the lungs?

Answer 20

Pulmonary arteries and veins

Question 21

Describe 3 things about the aorta…

Answer 21

Trunk artery
Largest principle artery
Arises from the left ventricle

Question 22

What does the aorta do?

Answer 22

Distributes blood to organs and limbs

Question 23

How are arterial branches named?

Answer 23

Usually after the organ it is feeding

Question 24

What are the 5 different parts of the aorta?

Answer 24

``` Root of the aorta - LVOT Ascending aorta Aortic arch Thoracic descending aorta Abdominal descending aorta - retroperitoneum ```

Question 25

Describe 3 things about the root of the aorta...

Answer 25

Leaves the left ventricle Three cusps on the aortic valve Coronary arteries arise from the cusps

Question 26

What happens if cusps are damaged?

Answer 26

A heart attack could occur

Question 27

Describe the ascending aorta...

Answer 27

Arches to form the aortic arch

Question 28

What arteries branch out from the aortic arch?

Answer 28

Brachiocephalic Left common carotid Left subclavian

Question 29

What 2 arteries branch off the brachiocephalic?

Answer 29

Right subclavian | Right common carotid

Question 30

Describe the descending aorta...

Answer 30

Enters the abdomen through the opening of the diaphragm

Question 31

Describe 3 things about the ascending aorta...

Answer 31

Largest artery in the body Slightly left of the vertebral column Diaphragmatic crura surround the aorta through the diaphragm

Question 32

What is the diaphragmatic crura?

Answer 32

Tendinous structures that extend inferiorly from the diaphragm to attach to the vertebral column Form a tether for muscular contraction; name is from their leg shaped appearance (crus is Latin for leg)

Question 33

What can the crus of the diaphragm be confused with?

Answer 33

The right renal artery

Question 34

What is the normal measurement of the abdominal aorta?

Answer 34

2-3 cm in diameter

Question 35

Describe 3 thing about the aorta from a scanning aspect...

Answer 35

Best anatomic landmark Patient lays in a supine position Longitudinally - it's a hallow tube anterior to the spine

Question 36

What might you need to do when scanning the aorta to get by air or gas?

Answer 36

Apply pressure and angle the transducer

Question 37

What techniques might you use to get a better image of the aorta?

Answer 37

Breathing or extend abdomen techniques

Question 38

Too high of gain might create what when scanning the aorta? What should the aorta look like?

Answer 38

Artifactual internal echoes Anechoic

Question 39

What symptoms might lead to an aortic scan?

Answer 39

Abdominal pain, pulsatile mass, AAA on film, F/U AAA, trauma, abdominal bruit

Question 40

What is the other position a patient can be in for an aortic scan?

Answer 40

Decubed; on side

Question 41

Describe 3 things about the aorta in transverse...

Answer 41

Circular structure Gradual tapering Becomes more anterior distally

Question 42

What is the measurement of the proximal aorta?

Answer 42

2.0-2.6 cm

Question 43

What is the measurement of the middle aorta?

Answer 43

1.6-2.4 cm

Question 44

What is the measurement of the distal aorta?

Answer 44

1.1-2.0 cm

Question 45

What is the measurement of the iliacs?

Answer 45

0.6-1.4 cm

Question 46

What are the aorta branches?

Answer 46

``` Phrenic arteries - lateral branch by diaphragm Celiac - 1st anterior branch SMA - 2nd anterior branch Renal arteries - lateral branch IMA - anterior near bifurcation ```

Question 47

Name the 5 paired arteries branches of the aorta...

Answer 47

``` Suprarenal Renal Gonadal Lumbar Common iliacs ```

Question 48

Name the 3 unpaired branches of the aorta...

Answer 48

Celiac axis SMA IMA

Question 49

Name 3 anterior branches of the aorta...

Answer 49

Celiac axis SMA IMA

Question 50

Name 2 lateral branches of the aorta...

Answer 50

Renal | Common iliacs

Question 51

What does the phrenic arteries supply?

Answer 51

The diaphragm

Question 52

What does the cystic artery supply?

Answer 52

The gallbladder

Question 53

Th celiac axis originated how many cm below the what?

Answer 53

2 cm below the diaphragm

Question 54

The celiac axis is superior to what organ?

Answer 54

The pancreas

Question 55

What does the celiac axis spilt into?

Answer 55

Common hepatic artery Splenic artery Left gastric artery

Question 56

What type of blood flow does the celiac axis have?

Answer 56

Low resistance

Question 57

Is blood flow in the celiac axis affected by eating?

Answer 57

No

Question 58

What does the common hepatic artery travels along?

Answer 58

The superior border of the head of the pancreas

Question 59

What does the common hepatic artery branch into?

Answer 59

The proper hepatic artery (LT/RT hepatic arteries) and the gastroduodenal artery

Question 60

What organ does the proper hepatic artery enter?

Answer 60

The liver

Question 61

What organs does the gastroduodenal artery supply?

Answer 61

The pancreas and the duodenum

Question 62

What is an easy way to find the gastroduodenal artery when scanning?

Answer 62

It is the anterior eye of the worm (pancreas)

Question 63

What is the circular structure that creates the posterior eye of the worm (pancreas)?

Answer 63

Common bile duct

Question 64

The common hepatic artery then divides again into what?

Answer 64

The left hepatic artery and right hepatic artery

Question 65

What does the left hepatic artery supply?

Answer 65

Caudate and left lobe of liver

Question 66

What does the right hepatic artery supply?

Answer 66

The right lobe and the gallbladder via the cystic artery

Question 67

The splenic artery is the _________ branch of the celiac axis.

Answer 67

Largest

Question 68

How does the splenic artery travel out from the celiac axis?

Answer 68

Tortuous course superior and posterior to the body and proximal tail of the pancreas

Question 69

What does the splenic artery supply?

Answer 69

The spleen, pancreas, and fundus of the stomach

Question 70

What kind of blood flow is in the splenic artery?

Answer 70

Low resistance

Question 71

Left gastric artery is the ________ branch of the celiac axis.

Answer 71

Smallest

Question 72

How does the left gastric artery travel?

Answer 72

Anterior and cephalad

Question 73

What does the left gastric artery supply?

Answer 73

The stomach and the pylorus

Question 74

What creates the "seagull" sign when scanning in transverse?

Answer 74

The celiac axis, splenic artery, and common hepatic artery

Question 75

The superior mesenteric artery is about how far below the celiac axis?

Answer 75

1-2 cm

Question 76

How does the superior mesenteric artery run?

Answer 76

Parallel to the aorta and posterior to the neck/body of the pancreas

Question 77

What does the superior mesenteric artery supply?

Answer 77

The small intestine and the proximal colon

Question 78

What does the superior mesenteric artery look like when scanning longitudinally?

Answer 78

Tubular structure coursing parallel to the anterior aorta

Question 79

What does the superior mesenteric artery look like when scanning transversely?

Answer 79

Circular structure anterior to the aorta and posterior to the pancreas body

Question 80

What can you easily see the superior mesenteric artery when scanning?

Answer 80

It has a halo surrounding it; highly reflective echoes

Question 81

Superior mesenteric artery preprandial has what kind of blood flow?

Answer 81

High resistance flow

Question 82

Superior mesenteric artery postprandial has what kind of blood flow?

Answer 82

Low resistance blood flow

Question 83

What does high resistance blood flow look like spectrally?

Answer 83

It will sharply peak then beat back up

Question 84

What does low resistance blood flow look like spectrally?

Answer 84

It will peak then on the way down it will create a hump

Question 85

What does the internal carotid supply blood to? What kind of flow is present?

Answer 85

Feeds the brain Low resistance flow

Question 86

What does the external carotid supply blood to? What kind of flow is present?

Answer 86

Feeds the face High resistance flow

Question 87

What kind of blood flow is present when the stomach is full? How about empty?

Answer 87

Full = low Empty = high

Question 88

When dealing with the SMA/IMA, what is intestinal angina?

Answer 88

Medical condition in which lack of blood causes severe chest pains

Question 89

The inferior mesenteric artery originates how far above the bifurcation?

Answer 89

3-4 cm

Question 90

How does the inferior mesenteric artery travel and what does it supply?

Answer 90

Inferiorly to supply the descending colon, sigmoid colon, and rectum

Question 91

What impedes on seeing the inferior mesenteric artery when scanning?

Answer 91

Gas artifacts impede visualization

Question 92

What kind of blood flow does the inferior mesenteric artery have?

Answer 92

Low resistance

Question 93

Renal arteries are how far inferior of the SMA?

Answer 93

1-3 cm

Question 94

The right renal artery travels how?

Answer 94

Posterior to the IVC Movie star artery

Question 95

The left renal artery travels how?

Answer 95

Anterior to the psoas muscle

Question 96

What do the renal arteries supply?

Answer 96

Kidneys, adrenals, ureters

Question 97

Describe 3 things about the right renal artery...

Answer 97

Longer Posterior to IVC Posterior to the vein before entering the hilum

Question 98

Describe 2 things about the left renal artery...

Answer 98

Shorter | Courses directly to the hilum

Question 99

Which artery is shorter? Right or left renal artery?

Answer 99

Left renal artery

Question 100

What is the best way to see the renal arteries?

Answer 100

In transverse and use color Doppler

Question 101

What kind of blood flow does the renal arteries have?

Answer 101

Low resistance flow

Question 102

What is stenosis?

Answer 102

Narrowing of the artery

Question 103

Renal artery stenosis usually mean what?

Answer 103

Hypertension or renal tumor

Question 104

What is a fistula?

Answer 104

A weird connection between and artery and a vein

Question 105

Describe 3 things about a renal arteriovenous fistula...

Answer 105

Congenital or acquired Cluster of tubular structures Weird connection between an artery and vein

Question 106

Common iliac arteries can be seen where?

Answer 106

At the bifurcation of the aorta

Question 107

What is the measurement of the common iliac arteries in transverse?

Answer 107

Less than 1.2 cm

Question 108

What does the common iliac arteries supply blood to?

Answer 108

Legs and pelvis

Question 109

Internal iliac supplies?

Answer 109

The pelvis and buttocks

Question 110

External iliac supplies?

Answer 110

The legs