IR Cara's flashcards
(163 cards)
1
Q
Average size of aortic root
A
3.6cm
2
Q
Average size of distal descending aorta
A
2.4cm
3
Q
Bovine arch
A
common origin of brachiocephalic artery and left CCA (15%)
4
Q
What is the 3rd most common arch variant?
A
left CCA coming off the brachiocephalic proper (10%)
5
Q
What is the 4th most common arch variant?
A
4 separate origins (left vert off of arch) (5%)
6
Q
What side does the Artery of Adamkiewicz arise?
A
Left (70%) between T8-L1 (90%) aka great anterior medullary a.
7
Q
First branch off the SMA
A
inferior pancreaticoduodenal
8
Q
What makes the Arc of Riolan?
A
left colic (from IMA) to the middle colic (from SMA)
9
Q
Branches of the SMA
A
inferior pancreaticoduodenal, middle colic, right colic, ileo-colic (appendicular)
10
Q
Branches of the IMA
A
left colic, sigmoid branches, superior rectal (marginal artery)
11
Q
2 most common hepatic artery variants
A
right hepatic replaced off the SMA and left hepatic replaced off the left gastric
12
Q
Is there normally a vessel in the ligamentum venosum?
A
No, it s an accessory or replaced left hepatic arising from the left gastric
13
Q
How do you tell if it s a replaced right hepatic?
A
Proper right hepatic is anterior to right portal vein. Replaced right hepatic is posterior to the main PV
14
Q
Most common hepatic venous variant
A
Accessory right inferior hepatic vein (drains seg 6/7 into IVC)
15
Q
Branches of internal iliac artery (posterior division)
A
Iliolumbar, Lateral Sacral, Superior Gluteal (I Love Sex) + Inferior gluteal (sometimes)
16
Q
Branches of internal iliac artery (anterior division)
A
Umbilical, Obturator, Inf. vesicular/uterine, middle rectal, internal pudendal
17
Q
What is the first branch off the popliteal artery?
A
Anterior tibialis
18
Q
When does the CFA start?
A
inguinal ligament
19
Q
When does the SFA start?
A
once the CFA gives off the profunda femoris
20
Q
When does the popliteal artery start?
A
as the SFA exits the adductor canal
21
Q
When the popliteal artery end?
A
terminates as the ant tibial and tibioperoneal trunk
22
Q
When does the axillary artery start?
A
at the first rib
23
Q
When does the brachial artery start?
A
as it crosses the teres major
24
Q
When does the brachial artery end?
A
bifurcates tot he ulnar and radial arteries
25
What hand arch does the ulnar artery supply?
superficial arch
26
What hand arch does the radial artery supply?
deep arch
27
What supplies to the intraosseous branch?
ulnar artery (usually)
28
Arc of Buhler
collateral pathway from celiac to SMA (independent of GDA and inf. pancreatic)
29
Normal collateral pathway from celiac to SMA
celiac - GDA - sup pancreatic duodenal - inf pancreatic duodenal - SMA
30
Marginal artery of Drummond
SMA to IMA connection, continuous arterial circle/arcade along the inner border of the colon
31
IMA to Iliac normal collateral pathway
IMA - superior rectal - inferior rectal - internal pudenal - anterior branch of internal iliac
32
Winslow pathway
IMA to iliac collateral pathway seen in aorto-iliac occlusive dz (subclavian - int. thoracic/mammary - sup. epigastric - inf. epigastric - extenal iliac)
33
what vessels does the corona mortis connect?
obturator and ext. iliac
34
what abnormal vessel courses over the superior pubic rim?
corona mortis (injured during surgery or pelvic trauma)
35
Most gastric varices are formed by which vein?
left gastric/coronary
36
What vein drains the gastric cardia?
left gastric/coronary
37
What vein drains the gastric fundus?
posterior and short gastric
38
enlarged splenorenal shunts are associated with?
hepatic encephalopathy
39
where does a left SVC drain?
coronary sinus (92%) or left atrium (8%)
40
duplicated IVC associations
renal stuff - horse shoe and crossed fused ectopic + circumaortic renal collars
41
which limb is superior in circumaortic venous collar?
anterior limb
42
other name for azygous continuation
absence of the hepatic segment of the IVC
43
where do hepatic veins drain in azygous continuation?
directly into right atrium
44
azygous continuation association
polysplenia
45
persistent sciatic artery
continuation of the internal iliac
46
what abnormal vessel passes posterior to femur in the thigh?
persistent sciatic artery
47
external iliac is acutely occluded, but there s still a strong pulse in the foot
persistent sciatic artery
48
most common cause of aortic dissection + intramural hematoma
hypertension (70%)
49
floating viscera sign
IR sign in AA dissection, catheter placed in true lumen with branch vessels arising out of nowhere
50
most common cause of penetrating ulcer
atherosclerosis
51
IMH progression to dissection?
max diam of 5cm is strongest predictor for dissection
52
true aneursym size
1.5 x normal diam
53
how can histoplasmosis cause SVC syndrome?
fibrosing mediastinitis
54
most common location of traumatic pseudoaneursym?
aortic isthmus (90%)
55
ascending aortic calcification
Takayasu and Syphilis
56
Size cut-offs of aorta
> 4cm ascending and transverse, >3.5 cm descending, > 3cm abd
57
Most common cause of aortic aneursym
atherosclerosis
58
cystic medial necrosis
Marfan
59
size for surgical repair of AAA
6cm
60
who gets sinus of valsalva aneurysm
Asian Men, usually right sinus
61
vascular findings in NF-1
aneurysms/stenosis lg vessels, renal artery stenosis/renovascular HTN (5% of NF1 kids)
62
vascular findings in NF-1
annuloaortic ectastia - aortic valve insufficiency, recurrent dissection, PA enlargement
63
tulip bulb
Marfan ascending aneursym
64
orbital finding in Loeys Dietz
hypertelorism (crazy wide eyes)
65
what procedures should be avoided in Ehlers Danlos
angio + percutaneous b/c of arterial dissection risk
66
vascular findings in Ehlers Danlos are similar to?
Marfan
67
"tree bark" intimal calcfications
syphilitic, saccular ascending aorta aneursym
68
what part of the bowel is involved in aortic-enteric fistula?
3rd and 4th portion of duodenum
69
AAA + increased ESR
inflammatory aneurysm
70
who gets inflammatory aneurysm?
young men who smoke
71
inflammatory aneursym spares the?
posterior wall
72
leriche syndrome
complete occlusion of the aorta
73
triad of leriche
ass claudication, absent femoral pulses, impotence
74
triad of mid aortic syndrome
HTN, claudication, renal failure
75
who gets mid aortic syndrome
children, young adults (intrauterine insult with fragmentation of the elastic media)
76
infantile aortic coarctation
pre-ductal, blood supply to descending aorta is PDA
77
how does adult aortic coarctation present?
(Ductal), differential arm/leg BP
78
association of aortic coarctation
Bicuspid aortic valve (80%), Turners (15-20%)
79
pseudocoarctation
looks like coarc, but NO pressure gradient, collateral formation, or rib notching
80
order of involvement in thoracic outlet syndrome
nerve (95%) - subclavian vein - subclavian artery
81
most common cause of thoracic outlet syndrome
compression by anterior scalene muscle
82
paget schroetter
thoracic outlet syndrome + subclavian vein thrombosis
83
who gets paget schroetter
athletes (pitchers, weightlifters)
84
can you stent the subclavian vein in paget schroetter?
no, it gets crushed. you have to do surgery.
85
3 causes of PA aneursyms/psa
iatrogenic/swan ganz, Behcets, Chronic PE
86
hughes-stovin
recurrent thrombophlebitis + PA aneursym formation/rupture
87
rasmussen aneursym
PA pseudoaneursym 2/2 pulmonary TB
88
PA aneursym in a congenital heart kid
patch aneursym from RVOT repair in TOF
89
most common location of chronic mesenteric ischemia
splenic flexure (watershed of SMA and IMA)
90
arterial vs. venous acute mesenteric ischemia
arterial = thin wall, non-dilated, diminished enhancement; venous = thick wall, dilation, fat stranding
91
true splenic artery aneursyms
HTN, portal HTN, cirrhosis, liver tx, pregnancy
92
false splenic artery aneuryms
pancreatitis
93
mimic of splenic a. aneursym
islet cell pencreatic tumor (hypervascular). don t biopsy!
94
median arcuate ligament syndrome
compression of celiac a. by median arcuate ligament
95
how to treat median arcuate ligament syndrome?
surgical release
96
typical presentation for median arcuate ligament?
20-40 years old, worse with expiration
97
Heyde syndrome
colonic angiodysplasia + aortic stenosis
98
other name for osler weber rendu
hereditary hemorrhagic telangiectasia
99
common imaging for osler weber rendu
multipic hepatic and pulmonary AVMs
100
how to osler weber rendu patient die?
stroke or brain abscess (pulmonary AVM)
101
most common cause of renal artery stenosis
atherosclerosis (75%)
102
2nd most common cause of renal artery stenosis
FMD
103
renovascular HTN in young women
FMD
104
string of beads
FMD
105
treatment for FMD
angioplasty WITHOUT stenting
106
nutcracker syndrome
smashing left renal vein as it slides under the SMA
107
nutcracker syndrome
left flank/abd pain and hematuria
108
what other vein is involved in nutcracker (besides left renal)
left gonadal vein (drains into left renal), left testicle pain in men, LLQ pain in women
109
testicular varicocele side
LEFT 98% (left vein is longer and drains into renal vein at acute angle)
110
what is the bad buzzword for varicocele?
"non-decompressible", can be related to neoplasm in men >40
111
which side is the bad side of varicocele?
RIGHT, raises concern for RCC, retroperitoneal fibrosis, or adhesions if new in adult
112
2 kind of uterine AVMs
congenital and acquired
113
how do you treat aquired uterine AVM?
embolization
114
May Thurner
DVT of L CIV 2/2 compression of the left common iliac vein by the overlying right common iliac artery
115
presentation of May Thurner
swollen left leg (L CIV DVT)
116
most common peripheral arterial aneursym
popliteal
117
association of popliteal artery aneursym
30-50% will have AAA
118
how often is popliteal artery aneursym bilateral?
50-70%
119
most dreaded complciation of popliteal artery aneurysm?
acute limb from thrombosis and distal embolization
120
what causes popliteal entrapment?
compression by medial head of the gastrocnemius (less common the popliteus)
121
presentation of popliteal entrapment
normal pulses that decrease with plantar flexion or dorsiflexion of foot
122
3 looks of hypothenar hammer on angio?
corkscrew configuration or superficial palmar arch, occlusion of ulnar artery, or pseuodaneursym off the ulnar artery
123
klippel-trenaunay triad
port wine nevi, bony or soft tissue hypertrophy (local gigantism), and a venous malformation
124
what abnormal vessel is pathognomic of klippel-trenaunay
marginal vein of Servelle (superficial vein in the lateral calf and thigh)
125
Kasabach Merritt
infant with a rapidly growing vascular tumor is responsible for thrombocytopenia, microangiopathic hemolytic anemia and consumptive coagulopathy.
126
How is Parkes-Weber different from Klippel-Trenaunay?
In contrast to children who have Klippel-Trenaunay syndrome, kids with PWS have arteriovenous malformationsthat can cause heart failure.
127
Normal ABI + abnormal values
1 = normal, 0.5-0.3 = claudication, <0.3 = rest pain
128
re-stenosis of stent 3-12 months after angioplasty
probably from intimal hyperplasia (the bane of endovascular intervention)
129
who gets Takayasu
young Asian girls (15-30)
130
vasculitis involving the aorta
Takayasu
131
what happens to the aortic wall in Takayasu
wall thickening + wall enhancement (acute phase)
132
what vasculitis love old men?
Giant Cell
133
vessels involved in giant cell?
temporal artery and arm pit vessels
134
cogan syndrome
kid with eye and ear sx +/- aortitis
135
is polyarteritis nodosa more common in men or women?
PAN is more common in a MAN
136
most common vessels involved in PAN
renal (90%), cardiac (70%), GI (50-70%)
137
most common imaging of PAN
kidneys with microaneurysms or kidney with areas of infarct
138
kidney abnormality in meth users?
"speed kidney", renal microaneursyms similar to PAN
139
Kawasaki
calcified coronary artery aneursym (shown on CXR)
140
most common vascultitis in children
Kawasaki (HSP also common)
141
3 ANCA + vasculitides
Wegeners, Churg Strauss, Microscopic polyangiitis
142
4 ANCA - vasculitides
HSP, Behcets, Buergers
143
Wegeners
nasal septum erosions, cavitary lung lesions
144
Churg Strauss
transient peripheral lung consolidations
145
microscopic polyangiitis
diffuse pulmonary hemorrhage
146
HSP
kids, intussusception, massive scrotal edema, MF bowel wall thickening
147
Behcets
PA aneursyms (Turkish, mouth and genital ulcers)
148
Buergers
male smoker. hand angio showing finger occlusions.
149
buzzword for buergers
"auto-amputation"
150
Segmental arterial mediolysis
multiple abdominal splanchnic artery saccular aneurysms
151
cystic adventital disease
multiple mucoid filled cysts develop in the outer media and adventitia in the pop artery of young men
152
normal ICA/CCA ratio
2
153
normal ICA end diastolic velocity
<40
154
normal carotid artery velocity
125 cm/s
155
PSV + EDV in 50-69% ICA stenosis
PSV = 125-230 cm/s, EDV = 40-100, ICA/CCA PSV ratio = 2-4
156
PSV + EDV in >70% ICA stenosis
PSV = > 230 cm/s, EDV = > 100, ICA/CCA PSV ratio = >4
157
unilateral tardus parvus carotid artery
innominate artery stenosis
158
bilateral tardus parvus cardotid artery
aortic stenosis
159
loss of diastolic flow in the CCA
ICA occlusion, high resistance waveform like ECA
160
bilateral CCA reversal of diastolic flow
aortic regurgitation
161
pulsus bisferiens
double systolic peak in the CCA seen in aortic regurgitation
162
classic doppler finding in aortic stenosis
bilateral tardus parvus waveform in the CCAs
163
temporal tap
method for sonographers to tell the external from internal carotid artery
