Week 1 - Abd Vasc Flashcards by FWU Enterprise

What sort of flow does the abdominal aorta demonstrate suprarenally?

Forward flow during diastole

Low resistance

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What sort of flow does the abdominal aorta demonstrate infrarenally?

Triphasic waveform

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What flow does the celiac axis demonstrate?

Low resistance

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What are the branches of the celiac axis?

Left gastric artery
Splenic artery
Common hepatic artery

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What waveform does the SMA demonstrate? (fasting & post prandial)

Fasting state- high resistance w/ low diastolic flow

Post prandial- lower resistance w/ forward flow

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What waveform does the renal arteries demonstate?

Low resistance

Constant forward flow during cardiac cycle

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What’s the diameter of the aorta?

2.0-2.5 cm

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What’s the diameter of the celiac artery?

0.7 cm

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What’s the diameter of the SMA?

0.6 cm

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What’s the diameter of the IMA?

0.3 cm

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What’s the diameter of the renal arteries?

0.4-0.5 cm

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What waveform does the proximal IVC demonstrate?

W flow
Pulsatile flow
Results from intraabdominal pressure associated w/ respiration & regurgitation of blood from rt. atrium

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What waveform does the distal IVC demonstrate?

Phasic flow

Less affected by the heart

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What waveform does the hepatic veins demonstrate?

W flow
Pulsatile
Three phases– 2 towards heart, 1 away
Hepatofugal flow

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The hepatic flow pattern is similar to what vessel?

IVC

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What creates the W shape waveform in the hepatic veins?

Changes in the central venous pressure, respiration and compliance of liver parenchyma

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What is the waveform of the portal veins?

Minimally phasic
Low peak & mean velocities
Hepatopetal flow

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How much of the blood to the liver is supplied by the PV?

70%

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What is the typical velocity of the PV?

20-30cm/s

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What is the waveform of the renal veins?

Phasic flow

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What is the size of the IVC?

2.5-3.0 cm

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What is the size of the hepatic veins?

4.0-6.0 mm

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What is the size of the portal veins?

13 mm

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What is the size of the splenic vein?

4.0-6.0 mm

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What is the size of the SMV?

6.0-7.0 mm

What is the size of the renal veins?

4.0-6.0 mm

What is ectasia?

Diffuse dilation of less than 50% of the normal aorta diameter

What is annuloaortic ectasia?

Dilatation or an enlargement of the ascending aorta, the aortic annulus and or/a loss of function of the aorta

What is atherosclerosis?

A disease of the arteries characterized by the deposition of plaques of fatty material on their inner walls

AAA is a dilatation of more than __________ x the normal diameter at the level of the renals.

1.5

The abdominal aorta should not exceed:

3.0 cm

What's the average normal measurement of the suprarenal aorta:

2.5 cm

What's the average normal measurement of the aorta at the level of the renals:

2 cm

What's the average normal measurement of the infrarenal aorta:

1.5 cm

What's the average normal measurement of the common iliacs:

1 cm

When a AAA reaches a diameter of 4-4.5 cm, the patient should be monitored:

Every 6 months

When a AAA reaches a measurement over 4.5:

Patient should be referred for elective surgical options (not mandatory)

When is surgical repair indicated for the aneurysm?

When it exceeds 5.5cm or grows more than 0.6-0.8 cm per year

What are the common causes of a AAA?

``` Hypertension Atherosclerosis Infection Trauma Hereditary or acquired connective tissue disorders ```

What is a pseudoaneurysm?

Communication between the arterial lumen and overlying connective tissue resulting from arterial rupture. A blood filled cavity forms outside the vessel wall and seals the leak as it thromboses

An aneurysm or even pseudoaneurysm can demonstrate what sign?

Yin Yang

What is a dissection?

Rupture of the intima of the aorta which separates from the media with a column of blood between the two layers.

What are sonographic findings of an aortic dissection?

Identification of an intimal flap in the aortic lumen (flaps w/ arterial pulsations) Doppler demonstrating flow (opposite flow)

A rupture is a complication of a dissection. True or false

True-- look for hematoma in soft tissue adjacent to dissected area.

What is the triad of symptoms for aortic stenosis on exertion?

Angina Syncope Dyspnea

Where do we see a tardus parvus waveform?

Distal to a stenosis

If you have an aortic stenosis, where would you see a tardus parvus waveform?

Iliac arteries

What's the classic presentation of a ruptured AAA?

Back/abdominal pain Hypotension Pulsatile abdominal mass

AAA rupture rate risk increases when the aorta diameter exceeds ________.

6 cm

What does EVAR stand for? What is it?

Endovascular Aneurysm Repair Treatment for AAA (endograft) Provides a route/path for blood to flow and excludes the aneurysm sac

What is an endoleak?

When blood flows into the aneurysmal sac

What are the 4 classifications of endoleaks?

1- attachment site leak (improperly seal @ prox or distal end) 2- retrograde flow through collateral branches (lumbars or mesenterics) 3- flow into the aneurysm secondary to an inadequate seal between components of the device. Or a tear in the graft 4- Flow through the fabric of the graft

What surveillance is done after a EVAR?

3-6 months- postoperative year 6-12 months - following year Life long surveillance CT angiography may also be done

What is FMD?

Heterogenous group of vascular lesions characterized by an idiopathic, non inflammatory and non-atherosclerotic angiopathy of small and medium sized arteries Wall becomes hyperplastic which narrows the lumen Women 30-50yrs

Which vessels does FMD most often affect?

Renals & ICA (systemic and cereberovascular vessels)

FMD shows several sonographic findings. What are they?

Color aliasing Asymmetrical size (affected kidney increases in size and then eventually decreases) Abnormal spectral waveforms- high PSV w/ little/no EDV Tardus parvus intrarenally High resistive flow

What pattern does FMD show with Doppler?

String of beads pattern

Is FMD of the renal arteries unilateral or bilateral?

Usually bilateral

What are some causes of an IVC thrombus?

Extrinsic compression from tumors, lymph nodes, AAA and polycystic kidneys DVT Renal tumors Retroperitoneal fibrosis

Bilateral leg swelling indicates what?

IVC thrombus

What is the most common cause of an IVC thrombosis?

Presence of an unretrieved IVC filter

What RA/AO ratio is acceptable?

<3.5

What is the formula for the resistive index?

RI=PSV-EDV/PSV

RI <0.8 is normal. True or false

False-- <0.7

RI >0.9 in a transplant = rejection. True or false

True

Week 1 - Abd Vasc Flashcards

(65 cards)