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Flashcards in IVC Deck (104):
1

What is the purpose of the IVC?

To transport deoxygenated blood back to the heart and lungs to oxygenate it again

2

What does the venous system contain within the lumen of the vessel that helps the blood move forward?

blood clots
stems
valves
gates

valves

3

If the valves in the venous system are leaking or damaged, what do we call the flow of blood in those vessels when it goes in reverse or backwards?

antegrade
retrograde
rouleaux flow
reverse flow

retrograde

4

T or F? The venous system usually demonstrates pulsatile flow.

false

5

What happens to the venous system if the valsalva maneuver is utilized?

distends and dilates
collapses
becomes pulsatile
forms blood clots

distends and dilates

6

Which vessels join to form the common iliac veins?

external and internal iliac veins

7

The IVC lies ____ to the right kidney and ____ to the liver.

medial
posterior

8

What would be a reason(s) to ultrasound the IVC?

look for thrombus
look for tumor invasion
both a and b
none of the above

both a and b

9

What is rouleaux flow?

fast flow
reversed flow
aggregate of RBC's
no flow at all

aggregate of RBC's

10

The 4 sections of the IVC are

hepatic
pre-renal
renal
post-renal

11

If a tumor is seen in the renal veins, what other vessel would you interrogate?

IVC
Aorta
Gonadal Veins
SMA

IVC

12

Where do the hepatic veins originate?

Liver

13

What vessel(s) drain all of the blood out of the liver?

hepatic veins

14

The RHV empties the RLL, and the LHV empties the LLL. What does the MHV empty?

caudate lobe

15

T or F? The hepatic veins decrease in diameter as they approach the IVC.

False

16

What is the name of the blood flow if it is flowing AWAY from the liver?

hepatofugal

17

What is the opposite of hepatofugal flow?

hepatopedal

18

What other vein enters the LRV instead of the IVC and the left gonadal vein?

left suprarenal vein

19

What does the right gonadal vein drain into?

IVC
Aorta
left gonadal vein
hepatic veins

IVC

20

The major abdominal venous system consists of

IVC (from the common iliac veins to the diaphragm)
Splenic Vein
IMV
SMV
Hepatic Veins
Renal Veins
Portal Veins

21

The PHA shares a partnership with the venous circulatory supply of the liver, which is the

MPV

22

T or F? Venous vessels will demonstrate tube-like structures with well-defined, echogenic walls and an echofree lumen.

True

23

T or F? The walls of ARTERIES and PV STRUCTURES will be more echogenic than the thinner walled VEINS.

True

24

T or F? A vein lumen open and close with respiration.

True

25

The name of the maneuver that produces a variable response in the venous system, allowing dilation and distention with breathing in and out is

Valsalva Maneuver

26

The IVC normally courses through the ____, and lies to the ____ of the AO and is ____ to the vertebral processes.

retroperitoneum
right
anterolateral

27

The IVC lies ____ to the right kidney and ____ to the liver.

medial
posterior

28

The IVC moves ____ as it courses towards the heart.

laterally
superiorly
anteriorly
posteriorly

anteriorly

29

The IVC is normally anechoic, but internal echoes sometimes appear in the IVC and are referred to as ____ AKA _____.

red cell aggregation
Rouleaux Formation

30

T or F? Slow flow is thought to enhance rouleaux formation?

True

31

The hepatic section of the IVC is where

the hepatic veins (HVs) empty into the IVC

32

The pre-renal section of the IVC is located

inferior to the hepatic veins (HVs), but superior to the renal veins

33

The renal section of the IVC is where

the renal veins (RVs) and the multiple tributaries are located

34

The post-renal section of the IVC extends just ____ to the renal veins (RVs) until the bifurcation

inferior

35

A tumor invasion most commonly occurs in the ____ and extends to into the ____.

renal veins (RVs)
IVC

36

The most common tumor involving the IVC is

Renal Cell Carcinoma

37

The hepatic veins (HVs) originate in the ____ and empty into the ____, superior to the locations of the ____.

liver
IVC
renal veins (RVs)

38

The right and left hepatic veins (RHVs and LHVs) empty the ____ ____ of the ____, and the middle hepatic vein (MHV) drains the ____.

right and left lobes of the liver, respectively
caudate lobe

39

T or F? The hepatic veins (HVs) exhibit pulsatility. Why?

True
it is a reflection of cardiac and respiratory activity

40

Flow going away from the liver is called

hepatofugal

41

Caudate lobe veins drain directly into the ____ and are occasionally seen on US.

IVC

42

T or F? Suprarenal veins (SRVs)/Adrenal veins (AVs) are normally seen with US.

False

43

The renal veins (RVs) return blood from the ____ and empty into the _____, immediately _____ to the level of the renal arteries (RAs).

kidneys
IVC
superior

44

The LRV courses anterior to the AO, and lies between the aortic wall and the SMA - this is called ____, often causing the LRV to appear dilated prior to this point. Explain what this is.

Nutcracker Syndrome

It is the engorgement of the LRV due to its compression by the SMA and AO

45

Why is the RRV well demonstrated with US?

Because of the overlying hepatic tissue forms an acoustic window

46

The Right Gonadal Vein comes off the ____, while the Left Gonadal Vein comes off the _____.

IVC
left renal vein (LRV)

47

The RRV *MAY* receive the _____ vein.

right suprarenal

48

Are the gonadal veins usually seen with US?

No

49

The left gonadal vein (LGV) opens into the ____ and the right gonadal vein (RGV) drains directly into the ____, just ____ to the RRV.

left renal vein (LRV)
IVC
inferior
RRV

50

The veins that provide an alternate pathway for venous return in the case of IVC obstruction are called

azygos and hemi-azygos veins

51

The azygos vein is located on the ____ side.

RIGHT

52

The right crus can be mistaken for either the ____ or ____ if care is not taken to follow vessels to see if they arise from the AO or empty into the IVC.

RRA
RRV

53

RVs are generally ____ to RAs, but crossing over can occur. How can you check this?

anterior
using pulsed wave or color doppler is helpful

54

T or F? The IVC is easily displaced.

True

55

Tumors in the RVs will most likely invade the ____.

IVC

56

The HVs originate in the liver and end at the ____.

IVC

57

What 2 veins enter the LRV besides the IVC?

LGV (left gonadal vein)
LSV (left suprarenal vein)

58

Where does the RGV (right gonadal vein) drain into?

the IVC

59

Does the portal venous system enter the IVC?

No

60

The portal venous system is made of (4)

Portosplenic Confluence
MPV
RPV (and branches)
LPV (and branches)

61

T or F? The SV is less tortuous than the SA.

True

62

The SV begins at the

hilum of the spleen

63

What does the splenic vein drain (3)?

spleen
part of the pancreas
stomach

64

The SV passes _____ to the _____, across the posterior abdominal wall, _____ to the SA and _____ to the body and tail of the pancreas.

transversely
right
inferior
posterior

65

What 2 vessels are used as landmarks to locate the pancreas? Which one is the main one?

SA
SV - main one

66

In general, the SV is located _____ to the pancreatic body and tail.

posterior

67

The SA is tortuous but usually follows the _____ border of the pancreatic body and tail.

anterior

68

What is the name of the ligament that crosses over the CA?

median arcuate ligament

69

What 3 veins make up the portosplenic confluence?

SV
SMV
IMV

70

What vessel supplies the liver with 80% of its blood supply and originates behind the pancreatic neck?

MPV

71

What makes up the Mickey Mouse image?

the porta hepatis in oblique view
MPV, CHD, PHA

72

What is the porta hepatis?

an area of the liver hilum, made up of 3 vessels

73

What are the 3 vessels that make up the porta hepatis? And what is the silly phrase to remember this?

MPV
PHA
CHD

mashed, potatoes, and corn

74

What is the "Steerhead Sign"?

the medial and lateral branches of the LPV

75

What does the PHA divide into?

RHA and LHA

76

The CHA changes into the ____ after it divides into the GDA.

PHA

77

What vessel does the RHA give rise to?

cystic artery

78

From where does the cystic vein originate, giving a branch to the ____ lobe before entering the ____ lobe of the liver.

RPV
Caudate lobe
Right

79

The IMV joins the _____ and drains into the ____ part of the large intestines, as well as the area along the _____, _____ area, and the _____ colon.

SV
inferior
rectum
sigmoid
descending

80

The SMV originates at the _____, where the ileum and small intestine join the _____ of the large intestine.

ileocecal valve
cecum

81

The SMV courses _____ towards the midline.

superiorly

82

The SMV joins the _____ and _____, and these two vessels become the _____.

SV
IMV
portal-splenic confluence

83

The portal-splenic confluence continues to course _____ and become know as the _____.

laterally
MPV

84

The MPV is made up of the (3)

SMV
IMV
SV

85

The MPV ascends _____ to the _____, passing behind the _____ portion of the duodenum, CBD, PHA, and GDA, as well as _____ to the IVC.

obliquely
right
superior
anterior

86

The branches of the _____ supply 20% of the liver's blood.

HAs

87

The MPV begins _____ the neck of the pancreas.

behind

88

The origin of the _____ is used as a landmark for the pancreatic neck.

MPV

89

The MPV courses ______ and ______ for about 5-6cm before it enters the liver through the _____, and then divides into the ______ and ______.

superiorly
laterally
porta hepatis
RPVs and LPVs

90

The Mickey Mouse Sign of the Porta Hepatis is seen in an ______ scanning plane.

oblique

91

The LPV is _____ (shorter/longer) than the RPV and has a _____ (bigger/smaller) diameter than the RPV.

longer
smaller

92

The LPV gives branches to the _____ before entering the _____ lobe of the liver.

caudate lobe
left

93

The origin of the LPV is the _____ and courses _____.

MPV
medially

94

The _____ vein originates from the RPV and gives a branch to the ______ lobe before entering the ______ lobe of the liver.

cystic
caudate
right

95

The RPV courses laterally to the ______ and then divides into branches called the ______ and ______ segments.

right
anterior
posterior

96

The PVs can be distinguished from other structures because ______, and this is because of

their walls are highly echogenic
the high collagen content in the walls

97

The CHA arises from the CA and bifurcates into the ______ and ______.

GDA
PHA

98

Just prior to the bifurcation of the CHA, it passes ______ to the MPV.

anterior

99

The ______ begins at the bifurcation and ascends to the porta hepatis of the liver within the folds of the ______ ligament.

PHA
hepatoduodenal

100

The PHA divides within the porta hepatis into the ______ and ______.

RHAs and LHAs

101

The RHA gives rise to the ______.

cystic artery

102

The cystic artery supplies the (3)

GB
hepatic ducts
part of the CBD

103

T or F? Both the MPV and PHA should be the same color doppler because the blood flow is going in the same direction.

True

104

When can the IMV be seen with ultrasound?

When it dilates from portal HTN