Chapter 9 The Vascular System Flashcards
1
Q
Tiny arteries and veins that supply the walls of blood vessels
A
vasa vasorum
2
Q
inner layer of the vascular system
A
tunica intima
3
Q
minute vessels that connect the arterial and venous systems
A
capillaries
4
Q
communication between two blood vessels without any intervening capillary network
A
anastomosis
5
Q
outer layer of the vascular system, contains the vasa vasorum
A
tunica adventitia
6
Q
middle layer of the vascular system; veins have thinner tunica media than arteries
A
tunica media
7
Q
arises from the posterolateral wall of the aorta, travels posterior to the IVC to suply the kidney
A
right renal artery
8
Q
arises from the celiac axis to supply the stomach and lower third of the esophagus
A
left gastric artery
9
Q
supplies the gallbladder via the cystic artery
A
right hepatic artery
10
Q
vascular structures that carry blood away from the heart
A
arteries
11
Q
arises from the celiac trunk to supply the liver
A
common hepatic artery
12
Q
supplies the stomach
A
right gastric artery
13
Q
branch of the common hepatic artery that supplies the stomach and duodenum
A
gastroduodenal artery
14
Q
arises inferior to the celiac axis to supply the proximal half of the colon and the small intestine
A
superior mesenteric artery
15
Q
the abdominal aorta bifurcates at the level of the umbilicus into these, which supply blood to the lower extremities
A
common iliac arteries
16
Q
arises from the anterior aortic wall at the level of the third or fourth lumbar vertebra to supply the left transverse colon, descending colon, sigmoid colon, and rectum
A
inferior mesenteric artery
17
Q
arises from the posterolateral wall of the aorta directly into the hilus of the kidney
A
left renal artery
18
Q
largest arterial structure in the body; arises from the left ventricle to supply blood to the head, upper and lower extremities, and abdominopelvic cavity
A
aorta
19
Q
small branch supplying the caudate and left lobes of the liver
A
left hepatic artery
20
Q
arises from the celiac axis to supply the spleen, pancreas, stomach, and greater omentum
A
splenic artery
21
Q
drains the spleen; travels horizontally across abdomen (posterior to the pancreas) to join the superior mesenteric vein to form the portal vein
A
splenic vein
22
Q
collapsible vascular structures that carry blood back to the heart
A
veins
23
Q
formed by the union of the superior mesenteric vein and splenic vein near the porta hepatis of the liver
A
portal vein
24
Q
drains the left third of the colon and upper colon and joins the splenic vein
A
inferior mesenteric vein
25
drains the proximal half of the colon and small intestine, travels (anterior to the IVC) to join the splenic vein to form the portal veins
superior mesenteric vein
26
three large veins that drain the liver and empty into the IVC at the level of the diaphragm
hepatic veins
27
leaves the renal hilum, travels anterior to the aorta and posterior to the superior mesenteric artery to enter the lateral wall of the IVC
left renal vein
28
largest venous abdominal vessel that conveys blood from the lbody below the diaphragm to the right atrium of the heart
IVC
29
leaves the renal hilum to enter the later wall of the inferior vena cava
right renal vein
30
disease of the arterial vessels marked by thickening, hardening, and loss of elasticity in the arterial walls
arteriosclerosis
31
condition in which the aortic wall becomes irregular from plaque formation
atheroscleroisis
32
tear in the intima or media of the abdominal aorta
dissecting aneurysm
33
permanent localized dilatation of an artery, with an increase of 1.5 times its normal diameter
aneurysm
34
periportal collateral channels in patients with chronic portal vein obstruction
cavernous transformation of the portal vein
35
circumferential enlargement of a vessel with tapering at both ends
fusiform aneurysm
36
weaking of the arterial wall
cystic medial necrosis
37
pulsatile hematoma that results from leakage of blood into soft tissue abutting the punctured artery with fibrous encapsulation and failure of the vessel wall to heal
pseudoaneurysm
38
transjugular intrahepatic portosystemic shunt
TIPS
39
most commonly results from intrinsic liver disease; however, also results from obstruction of the portal vein, hepatic veins, inferior vena cava, or prolonged congestive heart failure; may cause flow reversal to the liver, thrombosis of the portal system, or cavernous transformation of the portal vein
portal venous hypertension
40
communication between an artery and a vein
arteriovenous fistula
41
localized dilatation of the vessel
saccular aneurysm
42
thrombosis of the hepatic veins
Budd-Chiari syndrome
43
hereditary disorder of connective tissue, bones, muscles, ligaments, and skeletal structures
Marfan syndrome
44
permanent dilation of an artery that forms when tensile strength of the arterial wall decreases
true aneurysm
45
vessels that have high diastolic component and supply organs that need constant perfusion (i.e., internal carotid artery, hepatic artery, and renal artery)
nonresistive
46
flow toward the liver
hepatopetal
47
peak systole minus peak diastole divided by peak systole
resistive index
48
flow away from the liver
hepatofugal
49
vessels that have little or reversed fow in diastole and supply organs that do not need a constant blood supply (i.e., external carotid artery and brachial arteries)
resistive
50
increased turbulence is seen within the spectral tracing that indicates flow disturbance
spectral broadening
51
sonographer selects the exact site to record Doppler signals and sets the sample volume (gate) at this site
Doppler sample volume
52
The root of the aorta arises from the __________ outflow tract in the heart.
left venticular
53
The ____________ passes anterior to the tihird part of the duodenum and posterior to the neck of the pancreas, were it joins the splenic vein to form the main portal vein.
superior mesenteric vein
54
The ___________ supplies the gallbladder via the cystic artery and the liver.
right hepatic artery
55
The aorta continues to flow in the _________ cavity anterior and slightly ______ of the vertebral column.
retroperitoneal, left
56
The _________ trunk is the first anterior branch of the aorta, arising 1 to 2 cm inferior to the diaphragm.
celiac
57
The _________ flows from the kidney posterior to the superior mesenteric artery and anterior to the aorta to enter the later wall of the IVC.
left renal vein
58
The diameter of the abdominal aorta measures approximately ________ cm, tapering to ____ cm after it proceeds inferiorly to the bifurcation into the iliac arteries.
2 to 3 , 1.0 to 1.5
59
The __________ is the second anterior branch, arising approximately 2 cm from the celiac trunk.
superior mesenteric artery
60
Portal veins become _______ as they progress into the liver from the porta hepatis.
smaller
61
The _________ courses from the aorta posterior to the IVC and anterior to the vertebral column in a posterior and slightly caudal direction to enter the hilum of the kidney.
right renal artery
62
The __________ courses along the upper border of the head of the pancreas, behind the posterior layer of the peritoneal bursa, to the upper margin of the superior part of the duodenu, which forms the lower boundary of the epiploic foramen.
gastroduodenal artery
63
Three arterial branches arise from the superior border of the aortic arch to supply the head, neck, and upper extremities: the __________, ____________ and ________.
brachiocephalic, left common carotid, left subclavian arteries
64
The ________ is formed posterior to the pancreas by the union of the superior mesenteric vein and splenic veins at the level of L2.
portal vein
65
The ________ artery takes a somewhat tortuous course horizontally to the left as it forms the superior border of the pancreas.
splenic
66
The portion of the femoral artery posterior to the knee is the __________.
popliteal artery
67
The __________ originate in the liver and drain into the IVC at the level of the diaphragm.
hepatic veins
68
List the five sections into which the aorta is divided.
1) root of aorta
2) ascending aorta and arch
3) descending aorta
4) abdominal aorta & abdominal aortic branches
5) bifurcation of the aorta into iliac arteries
69
List the four branches of the aorta that supply other visceral organs and the mesentery.
1) celiac trunk
2) superior mesenteric arteries
3) inferior mesenteric arteries
4) renal arteries
70
Describe the function of the circulatory system.
To transport gases, nutrient materials, and other essential substances to the tissues and subsequently transport wast products from the cells to the appropriate sites for excretion.
71
List the characteristics of a vein.
Veins contain special valves that prevent backflow and permit blood flow only in one direction- toward the heart. Numerous valves are found within the extremities, especially the lower eextremities, because flow must work against gravity. Venous return is also aided by muscle contraction, overflow from the capillary beds, gravity, and suction from negative thoracic pressure.
72
Describe how Doppler is used to distinguish the presence or absence of flow in a vessel from nonvascular structures.
Doppler ultrasound frequently is used to differentiate vessels from nonvascular structures. To distinguish CBD from HA look for absence of flow in CBD. To distinguish HA from SA look for direction of flow. To differentiate an aneurysm from a pancreatic pseudocyst look for slow flow in the aneurysm.
73
A flow disturbance (increased velocity or obstuction of flow) may result from the formation of an atheroma, AV fistula, ______, or aneurysmal dilation.
pseudoaneurysm
74
Describe the technique that should be used to image the IVC.
Patient should be instructed to hold his or her breath; this causes the patient to perform a slight Valsava maneuver thoward the end of inspiration, which dialates the IVC. The IVC may expand 3 to 4 cm in diameter with this maneuver.
75
Nonresistive vessels have a high _______ component and supply organs that need constant perfusion, such as the internal carotid artery, the hepatic artery, and the renal artery.
diastolic
76
Resistive vessels have very little or even reversed flow in diastole and supply organs that do not need a constant blood supply, such as the ________ carotid and the iliac and brachial arteries.
external
77
Explain how to differentiate the IVC from the aorta.
The pulsatile aorta is easily differentiated from the IVC because the IVC travels in a horizontal course with it proximal portion curving slightly anterior as it pierces the diaphragm to empty into the right atrial cavity. The aorta, on the other hand, follows the curvature of the spine, with its distal portion lying more posterior, before bifurcating into the iliac vessels.
78
__________ is a pattern of blood flow, typically seen in large arteries, in which most cells are moving at the same velocity across the entire diameter of the vessel. In other vessels the different velocities are the result of friction between the cells and arterial walls.
Plug flow
79
Doppler only records accurate velocity patterns when the beam is _______ to the flow.
parallel
80
The flow pattern of the proximal abdominal aorta above the renal arteries shows a high _________ peak and a relatively low __________ component.
systolic, diastolic
81
The main renal artery has a(n) ________ impedance (nonresistive) pattern with significant diastolic flow - usually 30% to 50% of peak systole.
low
82
During rejection, the vascular impedance ________, resulting in a decrease or even reversal of the diastolic flow.
increases
83
The portal vein shows a relatively ________ flow at low velocities, which may vary slightly with respirations.
continuous
84
Cavernous transformation of the portal vein demonstrates ________ collateral channels in patients with chronic portal vein obstruction.
periportal
85
With a recanalized __________ vein, the main portal vein and the left portal vein show normal flow, but the flow in the right portal vein is reversed.
umbilical
86
The most common causes of aneurysms are ___________, and __________.
atherosclerosis, arteriosclerosis
87
The large aneurysm may rupture into the peritoneal cavity or retroperitoneum, causing __________ and a drop in _________.
intense back pain, hematocrit
88
The normal measurement for an adult abdominal aorta is less than 3 cm, measuring from _________ to _________ walls.
outer layer, outer layer
89
Thrombus usually occurs along the _______ to ________ wall.
anterior, anterolateral
90
A ____________ is a pulsatile hematoma that results from the leakage of blood into the soft tissue abutting the punctured artery, with subsequent fibrous encapsulation and failure of the vessel wall defect to heal.
pseudoaneurysm
91
What are the clinical findings in a patient with a dissecting aneurysm?
Typical patient is 40 to 60 yrs and hypertensive; males predominate over females. Patient is know to have aneurysm, and sudden, excruciating chest pain radiating to the back may develop because of dissection. Patients may go into shock very quickly. CT is generally ordered to obtain most info in shortest amount of time.
92
Describe the three locations where a dissection of the aorta may occur.
Type I begins at the aorta and may extend the entire length of the arch, descending to the aorta and into the abdominal aorta. This is the most dangerous. Type III begins at the lower end of the descending aorta and extends into the abdominal aorta. Type II may occur secondary to cystic medial necrosis to the inherited disease of Marfan's syndrome.
93
Describe other pseudopulsatile abdominal masses that may simulate an aortic aneurysm.
Masses other than an aortic aneurysm that can simulate a pulsatile abdominal mass include retroperitoneal tumor, huge fibroid uterus, or para-aortic nodes. Next to an abdominal aneurysm the most common for a pulsatile abdominal mass is enlarged retroperitoneal lymph nodes.
94
In patients with right ventricular failure, the IVC does not collapse with ________,
expiration
95
Describe the complications of IVC thrombosis.
Complete thrombosis of the IVC is life threatening. Patients present with leg edema, low back pain, pelvic pain, gastrointestinal complaints and renal and liver abnormalities.
96
The most common origin of pulmonary emboli is venous thrombosis from the ______ extremities.
lower
97
Describe the differences between arteries and veins.
Arteries are hallow elastic tubes that carry blood away from the heart. They are enclosed within a sheath that includes a vein and a nerve. Smaller arteries contain less elastic tissue and more smooth muscle than larger arteries. Elasticity of larger arteries is important for maintaining a steady blood flow. Veins are hallow collapsible tubes with a diminished tunica media that carry blood toward the heart. The veins appear collapsed because they have little elastic tissue or muscle within their walls. Veins have larger total diameter than arteries and move blood more slowly.
98
Describe how blood is transported from the artery and returned by the veins.
Blood is carried away from the heart b arteries, and is returned from the tissues to the heart by the veins. Arteries divide into smaller branches, the smallest which are arterioles. These lead to capillaries, which as minute vessels that branch and form a network where exchange of materials takes place. After blood passes through capillaries it is collected in small veins or venules. Small veins unite to form larger vessels and return blood back to heart for circulation.
99
Define capillaries and describe their function.
Capillaries are minute, hair sized vessels connecting the arterial and venous systems. Their walls have only one layer. The cells and tissues of the body receive their nutrients from fluids passing through capillary walls, at the same time, waste products from the cells pass into the capillaries. Arteries don't always end in capillary beds; some en in anastomoses, which are end-to-end grafts between different vessels that equalize pressure over vessel length and also provide alternative flow channels.
