Test 2: Renal and Mesenteric Flashcards
(162 cards)
What are the mesenteric vessels?
- Celiac
- Common hepatic
- Splenic
- SMA
- IMA
What are the two vessel that form the celiac axis?
The common hepatic and splenic.
What is the first major branch of the abdominal aorta?
The celiac axis.
Where does the celiac axis arise from?
It arises off anteriorly, about 1-2 cm below the diaphragm.
What 5 things does the celiac axis supply?
- Stomach
- Duodenum
- Liver
- Pancreas
- Spleen
Where does the superior mesenteric artery arise from?
- It arises approx. 1-2 cm below the celiac axis.
- Runs anterior and parallel to the aorta.
What 4 things does the SMA supply?
- Pancreas
- Duodenum
- Small intestine
- Colon
What is the most distal branch?
Inferior mesenteric artery.
Where is the IMA located?
- Usually located approx. 1-3 cm proximal to aortic bifurcation.
- Arises from the anterior surface of the aorta at 1 o’clock.
What does the IMA supply?
- The colon
Approx. how many people are affected by common anatomical variants in the mesenteric vessel?
Approx. 20% of general population.
What is the most common (17%) mesenteric vessel variant?
Right hepatic artery originates from an artery other than celiac artery.
What are the 4 most common mesenteric anatomical variants?
- Replaced right hepatic artery originating from the SMA (10-12%)
- Replaced common hepatic originating from the SMA (2.5%)
- Common hepatic originating from the aorta (2%)
- Common origin of celiac and SMA (<1%)
What should be done for patient preparation?
- NPD after midnight
- Supine with head slightly elevated
What are some normal mesenteric doppler waveforms in the aorta?
High resistance
What are some normal mesenteric doppler waveforms in the celiac?
Low resistance
What are some normal mesenteric doppler waveforms in the SMA?
High resistance IF fasting.
What are some normal mesenteric doppler waveforms in the renals?
Low resistance.
What are some normal mesenteric doppler waveforms in the IMA?
High resistance IF fasting.
What are some indications for chronic mesenteric ischemia?
- Abdominal pain/cramping associated with eating
- Abdominal bruit
- Post-prandial pain
- Unintended weight loss
In IAC Protocol, what vessels must be assessed?
- Abdominal aorta
- Celiac axis
- Common hepatic artery
- Splenic artery
- SMA origin
- Proximal SMA
- IMA
What must be documented in a mesenteric duplex: IAC protocol?
- Highest PSV
- Document patency of celiac and SMA
- Document any conditions of the aorta or great vessels
What is the mesenteric duplex IAC protocal in the celiac artery and what should be documented?
- Document patency
- Look for high velocities or distrubed flow in the celiac, splenic or hepatic artery.
- Note common hepatic flow direction
- Measure PSV in celiac, splenic and hepatic arteries.
- Document any flow distrubances
- If stenotic abnormal flow signals are found in the proximal celiac axis, have the patient take a deep breath and hold his breathwhile you take another sample in the celiac axis.
What is the mesenteric duplex protocol for the SMA?
- Document patency
- Look for high velocities or distrubed flow along as much of the artery as can be seen.
- Measure PSV in vessels and in any stenotic areas: assess post stenotic flow pattern.


