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Abdominal Aorta waveform(s) ✔Correct Answer-Low resistance proximal, Higher resistance
beyond renals
Celiac Artery supplies ✔Correct Answer-Liver, spleen, stomach, & proximal small bowel
Branches of the Abdominal AO ✔Correct Answer-1st major-Celiac artery (trunk/axis)
2nd major-SMA
Renals
3rd major-IMA (after renals)
Celiac Axis ✔Correct Answer-Branches into Common Hepatic (to right), Splenic, & Left Gastric (off
left)
Common Hepatic Arteries ✔Correct Answer-Gives rise to the Gastroduodenal artery in PANC head
& divides into Rt & Lt Hepatics
Splenic Artery ✔Correct Answer-Branches left and posteriosuperior to PANC body/tail
SMA/IMA waveforms ✔Correct Answer-High resistance preprandial/Low resistance postprandial
SMA supplies ✔Correct Answer-Bowel from duodenum to prox small bowel
IMA supplies ✔Correct Answer-Bowel descending & rectosigmoid colon
Right Renal Artery ✔Correct Answer-Branches anterolateral, posterior to IVC
Left Renal Artery ✔Correct Answer-Branches posterolateral
Renal Artery waveform ✔Correct Answer-Low resistance
Portal vein is usually formed by the confluence of ✔Correct Answer-SMV & Splenic veins
*It also receives blood from the inferior mesenteric, gastric, and cystic veins
Portals walls/waveforma ✔Correct Answer-echogenic walls & phasic waveforms
Renal veins are formed by ✔Correct Answer-renal tributaries
Left Renal Vein ✔Correct Answer-Longer than Rt.; Receives suprarenal/Gonadal vein
Left Renal pathway ✔Correct Answer-Anterior to AO; Posterior to SMA
Right Renal Vein ✔Correct Answer-No tributaries; shorter
Hepatic Veins ✔Correct Answer-Hepatofugal flow; from liver to IVC
,Patient status for Abdominal Vascular Imaging ✔Correct Answer-NPO 8-12 hours
Ectasia ✔Correct Answer-Local diameter increase with small bulge
(20% increase for Ao <3cm)
AAA growth rate ✔Correct Answer-1-2mm/year until 3-4cm; 5 mm/yr >4cm
Aneurysm classification ✔Correct Answer-2-3cm; 3-4cm for AAA
AAA Intervention ✔Correct Answer-5.5cm (high risk for rupture-catastrophic)
Fusiform ✔Correct Answer-Concentric enlargement; All 3 layers intact
Saccular ✔Correct Answer-Eccentric enlargement; All 3 layers compromised; Less common (<1%);
Usually in Thoracic Ao
Types of Saccular AAA ✔Correct Answer-1-Cannula Placement
2-Mycotic aneurysm (bacterial infection Ao wall)
3-Vasculitis (Inflammatory process)
4-Penetrating ulcer rupture into media
Vasculitis/Aortitis ✔Correct Answer-Inflammatory process in wall of Ao beginning with outer
(adventitia) layer and moving inward; ie: Takayasu's
Dissection ✔Correct Answer-Intimal wall compromised resulting in 2 lumens
false>true; flow reversal
Type 1 (a/b) endoleak ✔Correct Answer-Leak in anastamosis of graft at (a) prox or (b) distal end
Type 2 endoleak ✔Correct Answer-Aorta branch vessel; exhibits retrograde flow; more dangerous
b/c internally bleeding
Type 3/4 endoleak ✔Correct Answer-(3) Junction of modular components; (4) Trans graft flow-graft
defect
Chronic Mesenteric Ischemia ✔Correct Answer-"Fear of Food" 95% of Bowel Ischemia cases
Atherosclerotic stenosis/occlusion in main mesenteric arteries: >70% stenosis in 2/3 of principle
mesenteric arteries
Ischemia diagnosis criteria via Moneta ✔Correct Answer-Celiac >200cm/s
SMA >275cm/s
Median Arcuate Ligament Syndrome (MALS) ✔Correct Answer-Arch impedes on Celiac during
EXPIRATION (non-compressed during inhalation)
Measurement(s) of Splenic Vein ✔Correct Answer-7-17 cm long; 5-10mm diameter
Portal vein diameter ✔Correct Answer-<13mm
Blood supply to liver ✔Correct Answer-75% from Portal VEIN; 25% from Hepatic ARTERY
,Portal vein carries ____________ to the liver ✔Correct Answer-Nutrients
Hepatic artery carries ______________ to the liver ✔Correct Answer-Oxygen
Portal Hypertension ✔Correct Answer-Extrahepatic, Hyperdynamic, Intrahepatic (more common)
Extrahepatic Portal HTN ✔Correct Answer-Prehepatic (Portal/splenic vein thrombus, Extrinsic
compression of Potral vein)
Posthepatic (IVC/Hepatic vein obstruction)
Hyperdynamic Portal HTN ✔Correct Answer-AV malformation causing arterial portal fistulas
Intrahepatic (within liver) ✔Correct Answer-Presinusodial (less common)
Postsinusoidial (more common)
Cirrhosis/Venoclusive disease
Small liver, large spleen, ascites
LaPlace's law ✔Correct Answer-Larger vessel radius, larger wall tension to compensate for extra
pressure
Hydrostatic pressure ✔Correct Answer-Gravitational
Large vessels serve as ✔Correct Answer-Pressure reservoirs
Vasodilation ✔Correct Answer-Stretch to absorb
Vasoconstriction ✔Correct Answer-shrink/squeeze
Energy and stenosis ✔Correct Answer-Prox- PE↑, KE↓(highest total energy)
Within-PE↓, KE↑ (lower TE, Bernouille's)
Distal-PE↑, KE↓ (lowest total energy)
A-Early Systole (Forward flow to periphery)
B-Peak Systole (Store PE)
C-Late Systole (Temporary reversal-Peripheral resistance)
D-Early Diastole (Forward-reduced resistance)
E-Late Diastole (Vessel Recoil/Vasoconstrict/PE turns KE) ✔Correct Answer-
Brain ✔Correct Answer-Supplied by ICA & Vertebrals
2% of Body's weight
15% CO
20% Total blood supply
3-8 minutes of oxygen deprivation results in ✔Correct Answer-cellular death
Bovine Arch ✔Correct Answer-Common origin of Lt. CCA and Innominate
ICA ✔Correct Answer-Terminates into MCA/ACA and feeds the brain, forehead, eyes, & nose-70-
80% from CCA
, ECA ✔Correct Answer-Does not feed brain unless needed as collateral circulation
ECA supplies ✔Correct Answer-Neck, face, scalp
ECA Branches ✔Correct Answer-Superior Thyroid
Ascending Pharyngeal
Lingual
Facial
Occipital
Posterior Auricular
Maxillary
Superficial Thyroid
Vertebral supply ✔Correct Answer-Medulla/Inferior cerebellum
Basilar supply ✔Correct Answer-Pons/superior anterior cerebellum
Circle of Willis has atleast ____ variations with the most common being ___________________
✔Correct Answer-9; the absence of one or both communicating arteries
What portion of the population has an incomplete CofW? ✔Correct Answer-50%
What portion of the population has a complete Cof W? ✔Correct Answer-20-25%
Anatomic interrogation ✔Correct Answer-B-mode/2D best
Physiologic/hemodynamic interrogation ✔Correct Answer-Spectral/Doppler best
Hemorrhagic Stroke ✔Correct Answer-Bleed; HTN
Ischemic Stroke ✔Correct Answer-Oxygen interruption; Blood clot/emboli from Atherosclerosis
Which stroke is known to be the 3rd leading cause of death? ✔Correct Answer-Ischemic Stroke
Small perforating artery obstruction ✔Correct Answer-Occurs in elderly/diabetics
Transient Ischemic Attack (TIA) ✔Correct Answer-HTN; Up to 24 hours; Unilateral symptoms-
Contralateral hemipharesis
Reversible Ischemic Neurological Defects (RIND) ✔Correct Answer-Atherosclerosis; more then 24
hours; Unilateral symptoms-Contralateral hemipharesis
Vertebrobasilar Insufficiency (VBI) ✔Correct Answer-Obstruction of posterior circulation;
Elderly/diabetic/poorly controlled HTN; Bilateral symptoms (DROP ATTACKS)
Cerebrovascular Accident (CVA) ✔Correct Answer-Complete stroke with permanent lasting
neurological deficits
Plaque descriptions ✔Correct Answer-1-Fatty streak
2-Fibrous (soft) plaque
3-Complicated lesions