Term
|
Definition
| most cephalic branch of aorta |
|
|
Term
| common hepatic and splenic |
|
Definition
| celiac trunk bifurcates into what 1 to 3 cm from origin? |
|
|
Term
|
Definition
| another branch not visible with ultrasound of the celiac is what? |
|
|
Term
|
Definition
| what makes a "seagull" or "T" shape on ultrasound? |
|
|
Term
|
Definition
| the celiac axis has what flow pattern? |
|
|
Term
due to abundance of possible
collateral routes |
|
Definition
| Even though there is an occlusion of celiac the CHA and SA may appear normal why? |
|
|
Term
|
Definition
| Left limb of "T" of celiac axis |
|
|
Term
|
Definition
| posterosuperior margin of the pancreatic body and tail |
|
|
Term
|
Definition
| terminates at splenic hilum in a series of branches |
|
|
Term
| low resistant; turbulent flow due to tortuosity |
|
Definition
| flow pattern of splenic artery |
|
|
Term
|
Definition
| right limb of "T" on celiac |
|
|
Term
|
Definition
| superior border of pancreatic head |
|
|
Term
|
Definition
| Common hepatic artery branches into what? |
|
|
Term
|
Definition
| after common hepatic branches into GDA it branches into what? |
|
|
Term
| low resistant; continuous forward flow through diastole |
|
Definition
| flow pattern of common hepatic artery |
|
|
Term
|
Definition
| anterior surface of aorta |
|
|
Term
| high resistance with sharp systolic peaks |
|
Definition
| flow pattern of fasting SMA |
|
|
Term
| low resistant; broad systolic peaks and continuous diastolic flow |
|
Definition
| flow pattern of non-fasting SMA; 30-90 min after eating |
|
|
Term
|
Definition
| only vessels that change flow pattern with eating |
|
|
Term
|
Definition
| transports blood from bowel and spleen to liver |
|
|
Term
|
Definition
| begins at junction of splenic and SMV |
|
|
Term
| splenic vein and superior mesenteric vein |
|
Definition
| main contributors to portal vein flow |
|
|
Term
|
Definition
| right and left portal branches correspond with what? |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
| increased flow in portal vein after what? |
|
|
Term
|
Definition
| variation in flow rate with what? |
|
|
Term
| Triphasic in hepatic and pulsatile in PV |
|
Definition
| right sided heart failure causes what type of waveform in the hepatic and portal veins? |
|
|
Term
|
Definition
| 13mm diameter, quiet with respiration; increases in diameter during sustained deep inspiration |
|
|
Term
|
Definition
| 75% of blood flow comes from where? |
|
|
Term
|
Definition
| 25% of blood flow comes from where? |
|
|
Term
|
Definition
| what are the 3 hepatic veins? |
|
|
Term
| on the ivc at the diaphragm |
|
Definition
| where do the hepatic veins converge? |
|
|
Term
|
Definition
are intrasegmental
(within the liver) |
|
|
Term
|
Definition
are intersegmental
(between) |
|
|
Term
|
Definition
| which hepatic vein runs in a coronal plane; between the anterior and posterior segments of the right hepatic lobe? |
|
|
Term
|
Definition
| which hepatic vein runs between the right and left hepatic lobes; seen sagittal or parasagittal? |
|
|
Term
|
Definition
| which hepatic vein runs between middle and lateral segments of the left hepatic lobe? |
|
|
Term
|
Definition
| in 96% of individuals which two hepatic veins join to form a common trunk before entering the IVC |
|
|
Term
|
Definition
| the caudate lobe has its own venous drainage called? |
|
|
Term
|
Definition
| occasionally one of the three major hepatic veins are absent. usually which one? |
|
|
Term
|
Definition
| hepatic veins are what type of structure? |
|
|
Term
- HV- runs longitudinal
- PV - runs transverse
|
|
Definition
| Difference in hepatic and portal veins course? |
|
|
Term
- HV - converge on IVC at diaphragm
- PV - converge on porta hepatis
|
|
Definition
| Differnce in hepatic and portal veins convergence? |
|
|
Term
|
Definition
| which hepatic vein is commonly dupicaleted? |
|
|
Term
|
Definition
| portal vein is surrounded by echogenic fibrous tissue know as what? |
|
|
Term
|
Definition
| only vessel that goes above and below baseline (triphasic) |
|
|
Term
|
Definition
| anterior to spine and right of the aorta |
|
|
Term
|
Definition
| where does the IVC terminate? |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
| IVC flow pattern near heart, and more distally |
|
|
Term
|
Definition
| which renal artery is usually slightly superior to other? |
|
|
Term
|
Definition
| branches off the anteriolateral aspect of the aorta, passes posterior to the iVC |
|
|
Term
|
Definition
| branches from lateral or posterolateral aspect of the aorta and extends to the kidney |
|
|
Term
|
Definition
| renal arteries anterior division branches into ? |
|
|
Term
|
Definition
| renal arteries posterior division supplies what? |
|
|
Term
|
Definition
| interlobars terminate into what that curve around the corticomedullary junction? |
|
|
Term
| main renal--segmental--interlobar--arcuate--interlobular |
|
Definition
| order from largest to smallest of arteries in renals |
|
|
Term
|
Definition
renal veins exits - anteriorly
renal artery enters - inbetween
ureter - posteriorly |
|
|
Term
|
Definition
| renal artery flow pattern |
|
|
Term
| left suprarenal vein and left gonadal vein |
|
Definition
| left renal vein recieves what? |
|
|
Term
|
Definition
| passes anterior to aorta and posterior to the SMA, to enter IVC |
|
|
Term
|
Definition
| shorter than left extends directly to the IVC from the right renal hilum and usually receives no tributaries |
|
|
Term
| left side b/c gonadal vein is long and tortuous |
|
Definition
| more possibility of torsion of renal of which side and why? |
|
|
Term
|
Definition
| max infrarenal aortic diameter averages? |
|
|
Term
|
Definition
| max common iliac diameter is what in men and women? |
|
|
Term
|
Definition
| external iliac and common femoral artery measures what in men and women? |
|
|
Term
|
Definition
| aorta is aneurysmal at what meas.? |
|
|
Term
|
Definition
| Is there a genetic association with aorta aneurysms? |
|
|
Term
- true anuerysms
- pseudoaneurysns
- dissecting aneurysms
|
|
Definition
|
|
Term
|
Definition
small saccular commonly in cerebrum
(aneurysm) |
|
|
Term
|
Definition
|
|
Term
|
Definition
weakening of media
(aneurysm) |
|
|
Term
|
Definition
spindle-shaped affecting entire circumference
(aneurysm) |
|
|
Term
|
Definition
localized spherical out-pouching
(aneurysm) |
|
|
Term
|
Definition
| most common frequently occur because of this anuerysm |
|
|
Term
|
Definition
| most common shape of aneurysm |
|
|
Term
|
Definition
| aneurysm that all layers of vessel are intact, but stretched; majority |
|
|
Term
|
Definition
| aneurysm with hole in arterial wall permits escape of blood that forms a walled off hematoma, ehich blood continues to circulate; not confined by all layers of arterial wall |
|
|
Term
- surgical repair
- compression repair
- thrombin injection repair
|
|
Definition
| 3 correction procedures for anuerysms |
|
|
Term
|
Definition
| you will see the ying yang sign and to and fro with what? |
|
|
Term
|
Definition
| blood enters a hole in the intima, and some cases the media and strips the layer forming a new lumen, called the false lumen; associated with Marfan's syndrome |
|
|
Term
| just below the left subclavian artery |
|
Definition
| most common site of dissection is where? |
|
|
Term
|
Definition
| second most common site of dissection is where? |
|
|
Term
|
Definition
| what percent of aneurysms occur in men? |
|
|
Term
|
Definition
| what percent of aneurysms are asymptomatic? |
|
|
Term
| sudden onset of severe back or abdominal pain |
|
Definition
| what suggests leakage of an AAA? |
|
|
Term
|
Definition
| sugical repair is recommended for AAA's mesuring what? |
|
|
Term
|
Definition
| what intervals are AAA's followed at after discovery? |
|
|
Term
|
Definition
| how much to aneurysms usually grow a year? |
|
|
Term
|
Definition
| do AAA's decrease in size? |
|
|
Term
|
Definition
| After rupture what is needed immediately? |
|
|
Term
|
Definition
| After graft placement aneurysm should shrink down to size of graft by when? |
|
|
Term
|
Definition
| stenosis in endograft ratio of 2:1 |
|
|
Term
|
Definition
| stenosis in endograft 3:1 ratio |
|
|
Term
|
Definition
| <45 cm/sec suspects what? |
|
|
Term
| phasic, bidirectional/pulsatile signals |
|
Definition
|
|
Term
|
Definition
| deep inspiration does what to the iVC? |
|
|
Term
|
Definition
| most common tumor to involve the iVC is what? |
|
|
Term
|
Definition
| devices that are placed in the IVC below the level of the renal veins to prevent thrombus from extremities to enter the pulmonary system preventing pes |
|
|
Term
| widespread persistent venous dilation |
|
Definition
| what is consistent with systemic venous hypertension? |
|
|
Term
- postprandial pain
- weight loss
- "fear" of food/eating
- diarrhea
- nausea and vomiting
- Hx of arterial disease
|
|
Definition
| indications to scan mesenteric vessels |
|
|
Term
| mesenteric ischemia, caused by stenosis or occludion of the SMA, celiac, or IMA |
|
Definition
| pts present with a hx of dull, achy pain after eating may suffer from what?caused by what? |
|
|
Term
|
Definition
|
|
Term
50-160 cm/sec
PSV - <200 cm/sec |
|
Definition
|
|
Term
PSV - >200 cm/sec indicates
70-99% stenosis |
|
Definition
|
|
Term
celiac compression syndrome
(arcuate ligament compression) |
|
Definition
in expiration - compression of celiac by median arcuate ligament producing "s" shape and significant stenosis
In inspiration - axis straightens causing stenosis to disappear |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
| originates 3-4cm above aortic bifurcation;small; if easy to locate it may suggest occlusion of the SMA |
|
|
Term
|
Definition
| signal of aorta above renals is different than below the renals |
|
|
Term
|
Definition
| what is the waveform of the aorta suprarenal? |
|
|
Term
|
Definition
| waveform of aorta infrarenal? |
|
|
Term
|
Definition
|
|
Term
|
Definition
| SMA waveform in fasting pt |
|
|
Term
greater than or equal to 275 cm/sec for 70-99% diameter reduction
>45 cm/sec EDV for severe stenosis
absence of triphasic waveform and a PSV of >300 cm.sec suggest severe stenosis |
|
Definition
| abnormal waveform in fasting pt |
|
|
Term
|
Definition
| normal preprandial SMA should be? |
|
|
Term
| high resistant; instestines need continuous flow during digest |
|
Definition
| normal postprandial waveform should be?why? |
|
|
Term
|
Definition
| elevated pressure in the portal system due to flow obstruction |
|
|
Term
|
Definition
| what is usually associated portal hypertension? |
|
|
Term
|
Definition
ultrasound appearance of what?
- splenomegaly
- dilated PV >1.3cm
- slowed or reversed flow in the portal vein
- Cavernous transformation
- potential portal vein thrombosis
|
|
|
Term
|
Definition
| formation of venous varices/collaterals at porta hepatis |
|
|
Term
- gastroesophageal varices
- recanilized umbilical vein
- splenorenal varices
- intestinal varices
- rectal varices
|
|
Definition
| portal systemic collaterals |
|
|
Term
- dilated veins on anterior wall of abdomen
- caput medusa
- hemorrhoids
- ascites - fluid wave
|
|
Definition
| physical signs of collateral |
|
|
Term
|
Definition
| tortuous collaterals around umbilicus |
|
|
Term
|
Definition
| what is treatment for portal hypertension? |
|
|
Term
| portal systemic collateral is forming |
|
Definition
| rectal bleeding is a sign of what? |
|
|
Term
|
Definition
| treatment for portal vein thrombosis |
|
|
Term
Tranjugular Intrahepatic Portosystemic Shunt
(TIPS) |
|
Definition
|
|
Term
hepatopedal in prox
and
hepatofugal in dist |
|
Definition
| what should flow be in proximal and distal shunt? |
|
|
Term
TIPS
(Transjugular intrahepatic portosystemic shunt) |
|
Definition
| catheter is inserted into the IJ and advanced into the hepatic vein through the liver and into the portal system; a shunt is then placed between the hepatic vein usually the right hepatic vein and the portal system; blood bypasses the liver and goes from the digestive system straight into the IVC |
|
|
Term
- infection
- abscess
- shunt stenosis
- thrombosis
|
|
Definition
|
|
Term
|
Definition
| prox splenic vein connected to renal vein |
|
|
Term
|
Definition
| IJV/ Hep V connected to PV |
|
|
Term
distal splenorenal shunt
(warren shunt) |
|
Definition
| Distal splenic vein connected the renal vein |
|
|
Term
|
Definition
|
|
Term
|
Definition
| AFter TIPS right portal vein will always have what type of blood flow? |
|
|
Term
|
Definition
| after TIPS placement left portal vein can have what type of blood flow due to recanalization? |
|
|
Term
- shunt walls are very echogenic with linear echoes in longitudinal and echogenic foci seen in the wall on transverse
- normal flow is from the portal system to the hepatic system
|
|
Definition
| ultrasound appearance of TIPS: |
|
|
Term
|
Definition
| peak flow velocitys at any point along the shunt should not exceed what? |
|
|
Term
|
Definition
| caused by ulcerative colitis or necrotizing enterocolitis (common acute abdominal condition in neonatal period) |
|
|
Term
|
Definition
| seen as echogenic bands in the portal vein system; seen near the periphery of the liver |
|
|
Term
hereditary hemorrhagic telangiectasia
(OSLER-WEBER-RENDU disease) |
|
Definition
| genetic disorder; AV malformations, fibrosis, and cirrhosis; recurrent episofes of bleeding |
|
|
Term
Hereditary Hemmorhagic Telangiectasia
(OSLER-WEBER-RENDU disease) |
|
Definition
Ultrasound appearance of what?
- Dilated Hepatic artery (up to 10mm)
- Multiple dilated tubular structures w/ color flow demonstrated
- dilated hepatic veins
|
|
|
Term
- evaluate for rejection
- evaluate for PV, HV, IVC patency
- HA patency
- Evaluate for fistulas
- Evaluate for pseudoaneurysms
|
|
Definition
| What do you evaluate in a liver transplant? |
|
|
Term
- HA occlusion
- Pseudoaneurysm
- PV thrombosis
- IVC/hep V thrombosis - Budd chiarri
- fluid collections
|
|
Definition
| Surgical complications of liver transplants |
|
|
Term
|
Definition
| where do the renal arteries arise? |
|
|
Term
| Anterolateral, passes posterior to IVC |
|
Definition
| orientation of Rt renal artery |
|
|
Term
|
Definition
| which renal artery is longer? |
|
|
Term
|
Definition
| which renal vein is longer? |
|
|
Term
| posterolateral, posterior to Lt renal vein |
|
Definition
| orientation of the lt renal artery |
|
|
Term
|
Definition
| duplicated main renal arteries occur in what percent of individuals? |
|
|
Term
low resistant
spectral broadening |
|
Definition
| flow pattern of renal arteries |
|
|
Term
- atherosclerosis
- fibromuscular dysplasia
|
|
Definition
| causes of renal artery stenosis |
|
|
Term
|
Definition
| seen more in older pts with renal artery stenosis |
|
|
Term
|
Definition
| seen more in males with renal artery stenosis |
|
|
Term
|
Definition
| seen more in proximal segments with renal artery stenosis |
|
|
Term
|
Definition
| seen more in younger pts with renal artery stenosis |
|
|
Term
|
Definition
| seen mor in females with renal artery stenosis |
|
|
Term
|
Definition
| seen more in mid and distal segments with renal artery stenosis |
|
|
Term
| renovascular hypertension |
|
Definition
| renal artery stenosis leads to what? |
|
|
Term
| renovascular hypertension |
|
Definition
| kidneys recieve lower blood flow due to stenosis and perceives this as the body having overall low blood pressure; response is activation of renin-angiotension aldosterone system, raising pressure to try to increase blood flow to the kisneys leading to systemic hypertension |
|
|
Term
| no is unresponsive to meds |
|
Definition
| Can hypertension be treated with meds? |
|
|
Term
- smoker
- family history
- obesity
- HTN
- diabetes
- hyperlipidemia
- age
- gender
|
|
Definition
| risk factors to renovascular hypertension |
|
|
Term
| Renovascular hypertension |
|
Definition
Clinical findings of what?
- diastolic blood pressure greater than 120mm/hg w/o meds
- onset of HTN before age 30 or after age 50
- generalized atherosclerosis, older pts
- abdominal bruit
|
|
|
Term
| greater than 60% diameter reduction |
|
Definition
| hemodynamically significant renal artery stenosis is ? |
|
|
Term
| direct and indirect methods |
|
Definition
| a combination of what helps diagnose renal artery stenosis |
|
|
Term
(main renal artery)
(renal aortic ratio)
Evaluate:
- compare length of kidneys
- evaluate cortex
- evaluate echogenicity of kidney
|
|
Definition
| direct method of evaluation of renal artery stenosis |
|
|
Term
(evaluation of segmental/interlobar arteries)
(acceleration time)
(resistive index) |
|
Definition
| indirect evaluation of renal artery stenosis |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
| differences of what between kidneys is suggestive of renal artery occlusion on side of smaller kidney |
|
|
Term
|
Definition
| normal cortex should measure what? |
|
|
Term
|
Definition
| renal artery PSV/ aortic PSV |
|
|
Term
|
Definition
| normal resistive index is what? |
|
|
Term
|
Definition
| abnormal resistive index is what? |
|
|
Term
|
Definition
| measured from start of systolic upstroke to first peak or early systolic peak |
|
|
Term
|
Definition
|
|
Term
>0.7-0.10 seconds
(70-100msecs)= main renal artery stenosis exceeding 60% |
|
Definition
| abnormal acceleration time |
|
|
Term
PSV >180-200 cm/sec
renal aortic ratio >3.5 |
|
Definition
| direct criteria for detection of >60% renal artey stenosis |
|
|
Term
|
Definition
high grade stenosis of a feeding artery, delays systolic rise in arteries immediately distal to it
tardy delay |
|
|
Term
absent end systolic peak
Acceleration time >0.07-0.10 sec
Resistive index >0.70 |
|
Definition
| indirect criteria for detection of >60% renal artery stenosis |
|
|
Term
|
Definition
| treatment for renal artery stenosis |
|
|
Term
|
Definition
| most common vessels used for vessel anastmosis |
|
|
Term
(pelvis)
right iliac fossa |
|
Definition
| most common site for renal transplants |
|
|
Term
| kidney of left and pancreas on rt |
|
Definition
| where are organs placed on pancreas/renal transplants? |
|
|
Term
|
Definition
| a kidney disorder involving damage to the tubule cells of the kidneys, resulting in acute kidney failure. |
|
|
Term
|
Definition
symptoms of what?
- decreased consciousness coma
- delirium or confusion
- drowsy
- lethargic
|
|
|
Term
- acute tubular necrosis
- infection
- renal vein thrombosus
|
|
Definition
| Signs of renal transplant rejection: |
|
|
Term
parenchymal resistance ratio >2.0
arcuate resistive index 0.6-0.8 |
|
Definition
| normal diagnostic criteria for transplant |
|
|
Term
- increased parenchymal resistance <0.2
- resistive index >0.9
- thrombosis of artery or vein shows decreased or absent flow
- fluid collections
|
|
Definition
| diagnostic criteria for abnormal transplant |
|
|
