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1

What takes blood out of liver and to the IVC?

Hepatic veins

2

T/F?

Transducer pressure can rupture an aneurysm.

True

3

Normal IVC measurement is

2.5 cm or 25mm

4

Aorta wall layers, inner to outer:

Tunica intima
Tunica media
Tunica adventitia

5

Define hepatopedal
Define hepatofugal

Normal; blood flow to to the liver
—pulse wave will be above the line
— this is what u want for PV
— color Doppler will appear red

Abnormal; blood flow away/out of liver
— pulse wave will be below the line
—color Doppler will appear blue

6

The celiac trunk branches into___

Hepatic artery (travels laterally to ao to enter the liver)

Splenic artery (tortuous and travels lateral to AO to the spleen)

Left gastric artery (not visible on US)

7

Normal IVC variants

Double ivc
Swapped locations
Absence of portions (rare)

8

Where is posterior cul de sac located?

Btw wall of uterus and rectum

Recto-uterine pouch
“Pouch of Douglas”

**most common area for fluid to build up**

9

Name some examples of aortic pathology

Stenosis
Grafts
Aortic dissection
Aneurysm

10

Which renal vein is longer than the other and why?

Left renal vein is longer than the right bc it has to cross over the aorta and the right renal vein does not

11

Normal IVC size

2.5 cm (25mm)

Increases and decreases with breathing and pressure but should not exceed 3.7 cm (37 mm)

12

What are the main functions of the aorta?

1) oxygenation
2)metabolism
3) maintaining blood pressure

13

Ivc branches/ tributaries:

Hepatic veins (left, middle, right)
Renal veins
Gonadal veins
Lumbar veins

14

responsible for melatonin (sleep cycle)

Pineal

15

Describe an artery

-Has a thicker tunica media (to withstand the pressure of the blood pumping)

-not compressible like veins are

-higher pressure

-takes oxygenated blood away from heart to organs

16

Gland responsible for calcium levels

Parathyroid

17

Which branch of the Peripheral Nervous System (PNS) is responsible for maintaining body’s energy?

Parasympathetic

18

Procedure used to drain fluid from peritoneal cavity

Paracentesis

19

3 membranes that line the skull and enclose the brain and spinal cord

Meninges

21

Which organs have a horizontal oblique orientation?

Liver, pancreas

22

What is a pulmonary embolism?

A blood clot that breaks off and travels through heart and to lungs

*** this is deadly

23

Normal Aortic measurements are:
Prox:
Distal:
Iliacs:
But should never exceed:

Prox 2cm
Distal 1.5cm
CIA 1cm
Shouldn’t exceed: 3cm

24

Where is the most common location to find an aneurysm?

Intrarenal

25

The urinary system is responsible for what 3 things?

Regulates blood volume
Regulates blood pressure
Production of RBCs

28

What is also known as omental bursa?

Lesser sac

29

Right portal being branches are:

Left portal vein branches are:

Right PV= anterior and posterior

Left PV= medial and lateral

30

Where does the aorta originate?

Left ventricle of heart

31

The ductus venous by passes what organ of the fetus?

Liver

32

Intraperitoneal organs

GLOSS

Gallbladder
Liver
Ovaries
Spleen
Stomach

33

Normal portal vein measurement is

13mm or 1.3 cm

34

Portal veins bring ____ blood ___ the liver, and hepatic arteries bring ____ blood ____ the liver.

Nutrient rich
To
Oxygen rich
To

35

Name the 4 sections of the ivc

Hepatic
Prerenal
Renal
Postrenal

36

Where is anterior cul de sac located?

Btw wall of bladder and uterus

Also called vesico-uterine pouch

37

The pulmonary artery takes ____ blood (to/away) the lungs and the pulmonary vein takes ___ blood ____ from the lungs.

Deoxygenated
To
Oxygenated
Away

38

Another name for hilum of liver is:

Porta hepitis

39

Where does the aorta originate?

Left ventricle

39

IVC associated tests:

Duplex Doppler
Color Doppler
Venography
MRI
CT

40

Which system is first to function during fetal development?

Cardiovascular

41

The anterior pituitary ____
While the posterior pituitary _____

Ant- releases hormones
Post- stores the hormones

43

The internal common iliac is also known as ___.

Hypogastric artery

44

Parts of the uterus from superior to inferior:

Fundus
Body
Cervix

45

Other names of posterior cul de sac:

Recto-uterine pouch
Pouch of Douglas

46

Name some IVC pathology

Blood clot, tumor invasion

46

Function of endocrine system

Maintains homeostasis by regulating body function including reproduction, growth and development, metabolism, blood glucose levels, stress response, ovulation

47

Normal aortic diameter

Prox:
Distal:
Iliacs:

Prox: 2cm (20mm)
Distal: 1.5cm (15mm)
Iliacs: 1cm (10mm)

48

____ produces bile, which is sent to ___ to be stored through the ___.

Liver
GB
Biliary system

49

During systole, valves are ___.

During diastole, valves are ___.

Open
Closed

50

What is homeostasis?

The maintenance of stability through the body’s self-regulating systems

53

IVC originates at

The junction of left and right iliac veins

Courses superiorly to right atrium

54

What percent of blood going into the liver is brought by the portal venous system?

65-75% (nutrient rich)

And about 25% (oxygenated blood) from hepatic artery

55

The greater sac is also known as ___

General cavity

58

First functioning system in embryonic development

Cardiovascular system

-heart and aorta form at the same time

58

What are the 3 layers of the aorta in order from deep to superficial

Deep to superficial

1) tunica intima
2) tunica media
3) tunica adventitia

59

What 2 muscles are located in the false pelvis?

Quadratus lumborum
Psoas major

60

Celiac artery branches:

Common hepatic artery
Splenic artery
Lt gastric artery

61

Endocrine system is also called

Neuroendocrine system

62

The Fallopian tubes lie in the superior part of the ____.

Broad ligament

63

Kidneys, common bile duct, portal vein, smv, and common iliac arteries all have a ____ orientation.

Vertical oblique

65

The body’s computer

Nervous System

-uses electrical signals to protect body from harm

66

“Master gland”

Pituitary gland

67

Gland responsible for protection against autoimmune (t cells)

Thymus

68

A transverse kidney, anterior to posterior, the vessels seen at hilum:

Vein
Artery
Ureter

69

The IVC returns deoxygenated blood to the ____ of the heart.

Right atrium

71

The anterior muscle layer includes ____ tissue and ___ muscle.

Subcutaneous
Rectus abdomina

72

Nervous system is divided into:

Central: brain and spinal cord

Peripheral nervous system: connects the CNS with the limbs and organs of body

72

List the intraperitoneal organs

GB, liver, ovaries, spleen, stomach

GLOSS

73

Describe veins

-have valves in center to prevent back flow of blood

-are compressible

-lower pressure

-brings blood away from organs back to the heart to become oxygenated

73

reads which hormones are needed in body

Hypothalamus

74

What is Morison’s pouch and what is it known for?

Located btw right kidney and liver

A common area for fluid to build up - ascites

75

Retroperitoneal organs

PUCKER

Pancreas
Ureters
Colon (ascending and descending only)
Kidneys
Esophagus
Rectum

75

4 types of aortic aneurysms

Sacular
Fusiform
Ruptured
Pseudo

75

What is the double fold of peritoneum that attaches intestines to posterior abdominal wall?

Mesentary

76

Peripheral nervous system is divided into:

Somatic- all conscious awareness of our externally environment (voluntary) and all movement (thru skeletal muscle)
Ex) touching hot stove

Autonomic nervous system- involuntary functions
Ex) digestion

76

responsible for estrogen, testosterone, and progesterone

Ovaries/testes

76

The spleen, bone marrow, and thymus are part of the _____ system.

Lymphatic

79

Lumen is

Where blood flow occurs within the aorta

79

True or false

The right real artery is longer than the left renal artery.

True

Bc the right renal artery travels posterior to ivc and then meets with the rt kidney whereas the left renal artery has a direct route to the lt kidney.

79

Procedure for pleural effusion

Thoracentesis

80

Which renal artery is longer and runs posterior to ivc?

Right

81

The stomach is ___ to the pancreas.

Anterior

82

Which veins increase in diameter as they approach the IVC?

Hepatic

83

A collection of glands that secrete hormones (chemical messengers)

Endocrine system

84

T/F?

Visceral peritoneum is the outer layer attached to abdominal wall.

False

Parietal is the outermost layer

85

What is responsible for directing the secretion of hormones?

Hypothalamus

85

The prostate gland is perforated by the ___ & ___.

Urethra
Ejaculatory duct

88

3 protective layers of CNS (meninges)

Pia mater- innermost
Arachnoid- middle layer
Dura mater- outer layer

88

Gland responsible for adrenaline

Adrenal gland

88

responsible for insulin, digestive enzymes

Pancreas

89

Name all of the branches on the aorta and their location

Prox aorta
-Celiac trunk (anterior)

Mid Ao-
Sma (anterior)

Renal arteries (lateral)

Gonadal arteries (oblique lateral)

Inferior mesentaric artery

Inferior phrenic

Suprarenal arteries

89

Autonomic nervous system is divided into:

Sympathetic division: responds to stress or danger
—(increased heart rate, breathing, blood pressure)

Parasympathetic division: maintains and restores body’s energy
—(reduces output of adrenaline, decreases heart rate and breathing rates, lower blood pressure)

90

Portal venous system brings blood from the ___, ___, and ____ to the ____.

Spleen
GB
GI tract
Liver

91

Ureters
Renal veins
Renal arteries

Name them in order from anterior to posterior

Renal veins
Renal arteries
Ureters

91

The pancreas extends from the ____ of the spleen.

Hilum

94

A normal CBD measurement is ___

6 mm or 0.6cm

95

Portal veins have more ____ in the walls, which is why they appear more hyperechoic.

Collagen

96

Gland responsible for metabolism

Thyroid

97

The second branch of the anterior abdominal aorta is

SMA

98

What are gonadal arteries

Ovarian arteries
Testicular arteries

99

Left common iliac arteries bifurcate into

Left internal (hypogastric)
Left external iliac arteries

100

Stretching of the aorta

Aortic aneurism

101

Plaque forming within lumen of aorta (can cause blood clots)

-can be catastrophic

Atherosclerosis

102

Separation of layers of tunica media and tunica intima, very likely to lead to aortic rupture

Aortic dissection

103

Diseases of the aorta tend to be

Asymptomatic until they are catastrophic

104

LVOT stand for

Left ventricular output tract

105

Thoracic and abdominal cavities are separated by

Diaphragm

106

Place in the diaphragm where aorta passes

Aortic hiatus

-interior to that is the abdominal aorta
-aorta passes posteriorly to diaphragm

107

Hypogastric artery sends blood to

Pelvic area

108

Gonadal arteries branch ____to the aorta and ____ to renal arteries

Laterally
Inferior

109

The sma travels .....

Anterior to aorta and parallel inferiorly along the aorta while staying anterior

110

Suprarenal artery is

Adrenal artery

111

Left renal vein is ____ to sma and ____to aorta

Posterior
Anterior

112

Left renal artery is ___ to ivc

Posterior

113

T/F

The splenic artery is very tortuous.

True (very curvy, not straight)

114

The common hepatic artery bifurcated into

Proper hepatic- liver

Gastroduodenal artery- passes through the head of the pancreas

115

What makes up the “seagull”?

Body is celiac trunk

Right wing is common hepatic artery
Left wing is splenic artery

116

Structure that anchors the diaphragm

-can be seen anterior in prox aorta

Crus of diaphragm

117

What lobe of liver is seen in sag abdominal aortic scan?

Left lobe

118

Aorta starts out ___ to body, but it moves ____ as it travels down the body.

Posterior
Anteriorly

119

Sma supplies blood to

Small intestine
Ascending colon
Part of transverse colon

120

Sma is surrounded by

Echogenic fatty halo

121

Splenic vein is ___ to left kidney

Superior

122

Portal splenic confluence becomes ____ which can be found at ___ of liver on the ___ lobe of liver.

Portal vein
Hilum
Right

123

Veins have ___ to keep blood from going backward, while ____ do not.

Valves
Arteries

124

Largest artery in body

Aorta

125

Largest vein in body

Ivc

126

Oxygen exchange in arteries and veins take place at _____

Capillary level

127

Vasoconstriction is

Constriction of veins, this is how BP is maintained

128

____ drains blood from left lobe of the liver into the IVC

Left hepatic vein

129

2 main body cavities

Dorsal and ventral

130

Dorsal cavity contains

Cranial cavity and spinal cavity

131

Ventral cavity is divided by

The diaphragm

Divided into thoracic and peritoneal

132

Portion of peritoneum that covers the organs

Visceral peritoneum

133

Portion of peritoneum lining the cavity that forms a closed sac

Parietal peritoneum

134

Double layer of peritoneum that extends from the stomach to the adjacent abdominal organs

Omentum

135

Attaches to the anterior surface of the transverse colon

Greater omentum

136

Attaches the lesser curvature of the stomach and first part of duodenum to the porta hepatis

Lesser omentum

137

Where hepatic artery and main PV enter the liver and where the biliary ducts exit

Porta hepitis (hilum of liver)

138

____ is posterior to stomach and lesser omentum, area where fluid can build up

Greater sac

139

Located posterior to the stomach

Lesser sac also called omental bursa)

140

Division of ventral and peritoneal cavities that extends superiority from the iliac crests to pelvic diaphragm inferiorly

Pelvic cavity

141

Name the orientation of the structure:

Aorta

Vertical

142

Name the orientation of the structure:

Common hepatic duct

Vertical oblique

143

Name the orientation of the structure:

Common carotid artery

Vertical

144

Name the orientation of the structure:

Kidneys

Vertical oblique

145

Name the orientation of the structure:

Uterus

Vertical

146

Name the orientation of the structure:

Portal vein

Vertical oblique

147

Name the orientation of the structure:

Common bile duct

Vertical oblique

148

Name the orientation of the structure:

Renal arteries and veins

Horizontal

149

Name the orientation of the structure:

Thyroid isthmus

Horizontal

150

Name the orientation of the structure:

Splenic vein

Horizontal

151

Name the orientation of the structure:

Pancreas

Horizontal oblique

152

Name the orientation of the structure:

Liver

Horizon oblique

153

When in a longitudinal view to the pancreas, why does the tail appear to curve?

Tail is going deeper (posteriorly) towards spleen

-that’s why we oblique the transducer angling to pt’s left shoulder in order to get long view of pancreas

154

What orientation would u need to be in to view the isthmus of the thyroid?

Trans

155

How would u know if you were looking at the inferior level of the right lobe of liver?

You would see right kidneys and gallbladder

156

__ and ___ run thru head of pancreas

Gastroduodenal artery (anterior)

Common bile duct (posterior)

157

Formed by a double fold of peritoneal

-blood vessels and lymphatics run along this

Mesentary

158

The fundus of the gallbladder is the ___ section and the neck of the ___ section

Wider transverse cross section
Smaller transverse cross section

159

Joining btw 2 things

Anastomosis

160

Fluid found in abdominopelvic area

Ascites

161

Subphrenic means

Below diaphragm

162

Area btw right kidney and liver

Morrison’s pouch

-anechoic if fluid build up has occurred

163

Infracolic

Below colon

-fluid can collect here

164

Paracolic

Around colon

-fluid can collect here

165

Axial means

Transverse cross section

166

Area not encased in peritoneal cavity

-most liver is encased but small portion is not

Bare area

167

Para means

To the side of

168

If the fluid has collected, when the patient is laying supine, what orientation would the fluid be sitting?

Fluid would lie dorsal the patient’s body

169

Most common area for fluid to collect

Posterior cul de sac
Recto-uterine pouch
“Pouch of Douglas”

170

Area where fluid can collect that is btw the uterus and rectum

Pouch of Douglas

171

Area where fluid can collect located btw wall of uterus and bladder

Anterior cul de sac
Vesico-uterine pouch

172

2 main area where fluid can collect when patient is supine

**most dependent potion

1) Hepatorenal pouch (Morrison’s)

2)Recto-vesical pouch (man)
Recto-uterine pouch (woman)

173

Once you scan past the ivc in prox long, what are u seeing?

Right lobe of liver

174

____ acts as a great acoustic window

Water

175

Formed by the confluence of splenic vein and smv

Main PV

176

Vessels that supply blood to liver

Splenic vein
Smv
Imv

177

The liver functions to:

1)
2)
3)

Metabolize blood
Gain nutrients
Detoxify and filter toxins

178

___ and ___ run alongside corresponding Heptic artery branches

RT PV
LT PV

179

Courses inferior to superior as it drains blood from large intestine

Smv

Imv from intestine

180

Which portal triad would we see at the porta hepitis?

CBD, HA, and PV

-this so the one we want to see when finding PV

-extra hepatic

181

If we see the Common Hepatic Duct, Right Hepatic artery and portal vein, are in intrahepatic or extrahepatic?

Intrahepatic

182

Caudate lobe is ___ to IVC

Anterior

Ligamentum vinosum separates caudate and left lobe
——— landmark for lt hep vein

183

Normal blood flow
Flows into the liver/towards transducer

Wave is above the baseline

Hepatopedal

184

Wave below baseline
-blood flow away from transducer
Abnormal blood flow

Hepatofugal

185

T/F?

A hepatic vein pulse wave would be mostly below the baseline but also extend above the line.

True, bc it is close the heart

186

Left lobe is ____ to ivc

Anterior

187

Main draining source of liver

Left hepatic vein

188

Fluid on top of liver can be described as

Subphrenic fluid

189

Rhythmic pulse
Peak= systole (heart contracts)
Drop= diastole (heart relaxes)

Normal arterial blood blow

190

Continuous wave of blood flow above the baseline

Normal PV blood flow

191

Drain blood from adrenal glands

Suprarenal veins

-superior portion of kidneys
-rt suprarenal drains directly into ivc
-lt suprarenal drains into left renal vein then ivc

192

Left gonadal and left Suprarenal veins empty into

Left renal vein

193

Right gonadal and right suprarenal drain directly into

Ivc

194

T/F?

There are valves in the IVC, which help move blood back to the heart

False

No valves, respiration’s move blood

195

Anterior to portal vein are what 2 things?

CBD and HA

- run side by side
-must use color to distinguish and prove

196

What makes up the “bunny sign”?

Left ear- Middle hep vein
Right ear- left hep vein
Face- ivc

197

What makes up the “reindeer sign”?

Antlers-Right hep vein, Middle hep vein,
Left hep vein

Head- ivc

198

Right renal artery runs ____ to ivc

Posterior

199

Ivc runs directly ____ to caudate lobe

Posterior

200

Blood clot formed in a vessel

Thrombus

201

What is TIPS?

Transjugular intrahepatic portosystemic shunt

-helps blood to flow from PV to HV
-used on patients with liver disease and portal hypertension

202

When dye is injected into vessels and take x rays as it moves thru veins

Venography