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65 Cards in this Set
- Front
- Back
anastomosis
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a communication between two blood vessels without any intervening capillary network
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aneurysm
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permanent localized dilation of an artery, with an increase in diameter of 1.5 times its normal diameter
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arteriosclerosis
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a disease of the arterial vessels marked by thickening, hardening, and loss of elasticity in the arterial walls
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arteriovenous fistula
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communication between an artery and a vein
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atherosclerosis
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condition in which the aortic wall becomes irregular from plaque formation
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Budd-Chiari syndrome
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thrombosis of the hepatic veins
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cavernous transformation of the portal vein
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periportal collateral channels in patients with chronic portal vein obstruction
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cystic medial necrosis
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weakening of the arterial wall
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dissecting aneurysm
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tear in the intima and/or media of the abdominal aorta
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Doppler sample volume
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the sonographer selects the exact site to record Doppler signals and sets the sample volume (gate) at this site
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fusiform aneurysm
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circumferential enlargement of a vessel with tapering at both ends
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inferior mesenteric artery (IMA)
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arises from the anterior aortic wall at the level of the third or fourth lumbar vertebra to supply the left transverse colon, descending colon, sigmoid colon, and rectum
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inferior mesenteric vein (IMV)
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drains the left third of the colon and upper colon and joins the splenic vein
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left gastric artery (LGA)
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arises from the celiac axis to supply the stomach and lower third of the esophagus
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left hepatic artery (LHA)
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small branch supplying the caudate and left lobes of the liver
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left renal artery (LRA)
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arises from the posterolateral wall of the aorta directly into the hilus of the kidney
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left renal vein
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leaves the renal hilum and travels anterior to the aorta and posterior to the superior mesenteric artery to enter the lateral wall of the inferior vena cava
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Marfan’s syndrome
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hereditary disorder of connective tissue, bones, muscles, ligaments, and skeletal structures
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nonresistive
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vessels that have a high diastolic component and supply organs that need constant perfusion (i.e., internal carotid artery, hepatic artery, and renal artery)
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portal vein (PV)
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formed by the union of the superior mesenteric vein and the splenic vein near the porta hepatis of the liver
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portal venous hypertension
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caused by increased resistance to venous flow through the liver; sonographic findings include dilation of the portal and splenic and mesenteric veins, reversal of portal venous blood flow, and the development of collateral vessels
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pseudoaneurysm
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pulsatile hematoma that results from leakage of blood into soft tissues abutting the punctured artery with fibrous encapsulation and failure of the vessel wall to heal
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resistive
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vessels that have little or reversed flow in diastole and that supply organs that do not need a constant blood supply (e.g., external carotid artery, brachial arteries)
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resistive index
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peak systole minus peak diastole divided by peak systole (S − D/S = RI)
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What resistive index means good perfusion? Bad perfusion?
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An RI of 0.7 or less indicates good perfusion; an RI of 0.7 or higher indicates decreased perfusion
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right gastric artery (RGA)
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supplies the stomach
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right hepatic artery (RHA)
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supplies the gallbladder via the cystic artery
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right renal artery (RRA)
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arises from the posterolateral wall of the aorta and travels posterior to the inferior vena cava to supply the kidney
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right renal vein (RRV)
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leaves the renal hilum to enter the lateral wall of the inferior vena cava
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saccular aneurysm
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localized dilation of the vessel
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spectral broadening
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change in spectral width that increases with flow disturbance
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splenic artery (SA)
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one of the three vessels that arise from the celiac axis to supply the spleen, pancreas, stomach, and greater omentum
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splenic vein (SV)
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drains the spleen; travels horizontally across the abdomen (posterior to the pancreas) to join the superior mesenteric vein to form the portal vein
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superior mesenteric artery (SMA)
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arises inferior to the celiac axis to supply the proximal half of the colon and the small intestine
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superior mesenteric vein (SMV)
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drains the proximal half of the colon and small intestine; travels vertically (anterior to the inferior vena cava) to join the splenic vein to form the portal veins
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TIPS
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transjugular intrahepatic portosystemic shunt
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true aneurysm
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permanent dilation of an artery that forms when tensile strength of the arterial wall decreases
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tunica adventitia
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outer layer of the vascular system; contains the vasa vasorum
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tunica intima
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inner layer of the vascular system
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tunica media
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middle layer of the vascular system; veins have thinner tunica media than arteries
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vasa vasorum
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tiny arteries and veins that supply the walls of blood vessels
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What are the Doppler Flow patterns for the Renal Vein?
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• Variable flow like IVC
• Evaluate with renal transplants |
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What are the Doppler Flow patterns for the IVC & Hepatic Vein?
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• Vary with respiration
• Flow above and below baseline • Affected by Rt. atrium contraction |
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What are the Doppler Flow patterns for the Budd-Chiari Syndrome?
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• Thrombosis of hepatic veins
• Hepatic veins are small and echogenic • Normal flow = No Budd-Chiari |
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What are the Doppler Flow patterns for the Portal Vein?
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• Hepatopetal flow
• Continuous flow pattern; Varies slightly with respirations |
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What are the Doppler Flow patterns for the Cavernous Transformation of the Portal Vein?
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• Complication of chronic portal vein obstruction
• No Extrahepatic portal vein visualized • Echogenic porta hepatis • Periportal collaterals |
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What are the Doppler Flow patterns for Portal Venous Hypertension?
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• Hepatopetal vs Hepatofugal
• Low velocity in Portal Vein • Patent Umbilical Vein (Definitive diagnosis) • No respiratory variation |
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What are the Doppler Flow patterns for Renal Artery Stenosis?
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• Stenoses difficult to visualize
• Collaterals may form |
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What are the Doppler Flow patterns for the Renal Hydronephrosis?
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Doppler needed to rule out prominent vessels.
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What are the Doppler Flow patterns for Renal Transplants?
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• Turbulence near anastomosis
• 12% of transplants = renal artery stenosis • Occlusion easier to diagnose in transplant than in native kidney |
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What are the Doppler Flow patterns for the Aorta?
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• Flow varies at different levels
• Proximal AO has high systolic and low diastolic • Distal has triphasic flow |
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What are the Doppler Flow patterns for the Celiac Axis?
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• Spectral broadening
• Unchanged after meals |
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What are the Doppler Flow patterns for the Hepatic Artery?
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• Spectral broadening
• Review after heart transplants |
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What are the Doppler Flow patterns for the Splenic Artery?
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• Very turbulent flow
• Very prone to aneurysm |
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What are the Doppler Flow patterns for the SMA?
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• Highly resistive for fasting
• Non resistive for eating |
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What are the Doppler Flow patterns for the Renal Artery?
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• Nonresistive
• Spectral broadening |
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True or False. Aneurysms smaller than 6 cm have high growth patterns. Those higher than 6 cm has low growth patterns.
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False. Aneurysms SMALLER than 6 cm have LOW growth patterns. Those HIGHER than 6 cm has HIGH growth patterns.
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What is your survival rate with an aneurysm of less than 6 cm?
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75% chance of 1 year survival.
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What is your survival rate with an aneurysm of larger than 6 cm?
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50% chance of 1 year survival.
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What is your survival rate with an aneurysm of larger than 7 cm?
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25% chance of 1 year survival.
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What is your risk of fatal rupture with an aneurysm larger than 7 cm?
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75%
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What percent of aneurisms are smaller than 5 cm?
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1%
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What is the mortality rate of surgery before aneurysm rupture? For surgery after rupture?
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5% ; 50%
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What are some MOST COMMON features of abdominal aortic aneurisms? List 5
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• Most are TRUE aneurysms
• 95% are INFRARENAL • MURAL thrombus common in large ones • Mycotic (infection) • Atherosclerosis TIMMA ! |
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When should surgery of aneurism be considered?
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> 5cm
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