Sectional Anatomy-The Great Vessels; Test 1
Terms
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- Retroperitoneum- Includes What organs? (7)
- Pancreas, Kidneys, adrenals, ascending and descending colon, duodenum, lymphatic, and great vessels
- 3 parts of Retroperitoneum:
-
1. perineal space- kidney, adrenals
2. anterior perineal space- IVC, pacreas,duodenum, splenic v.
3. posterior perineal space- quadratus laborum, psoas muscle
4. pelvic retroperitineum- ureters, colon, lymph nodes fat, vessels of pelvis - Characteristics of Arteries:
- echogenic walls; hard to compress, comprised of 3 layers, carries bld. away; no valves, blood moves faster, elasticity, higher pressure, comes from ventricles
- 3 layers of artery
-
tunica intima
tunica media
tunica adventitia - Characteristics of veins
- less echogenic; comprised of 3 layers; compressible; carries bld. back to heart; larger; phasic (moves when you breathe)
- normal measurement of aorta
- 2-3 cm
- branches of aorta
-
celiac axis
SMA
renal arteries
IMA
Bifurcates into Common iliac A. - Celiac Axis branches into: (3)
-
common hepatic
gastric
splenic(largest) - Left Gastric Artery supplies blood to
-
the upper 2/3 of the stomach
(can also originate directly off of aorta) - Common hepatic artery branches into:
- GDA and Proper Hepatic A.
- Renal Arteries branches directly off the
- aorta
- Renal Arteries courses ___towards the kidneys
- laterally
- Which renal artery is longer?
- Right
- Number one pathology for aorta is _____
- aneurysm
- permanent dilatation of an artery
- aneurysm
- An aneurysm must be greater than ___cm. _____% will get them. Usually appear as a pulsatile mass to the left of the midline
- 3 ; 5 to 7
- types of aneurysms (3)
-
true
false
dissecting - composite layers of vessel walls are in tact, but they are STRETCHED
- true aneurysm
- THe majority of AAAA is of What type of aneurysm?
- true
- WHere are true aneurysms usually located?
- below the level of the renal arteries
- 3 clinical findings with a true aneurysms:
-
plaque
syphillis
cystic medial necrosis
**smokers and already known vascular disease - Types of True aneurysms:
-
ectatic
saccular
fusiform - ectatic true aneurysm:
- diffusely dilated aorta
- saccular aneurysm:
- one wall is distended
- fusiform true aneurysm
- both walls are distended
- symptoms of a true aneurysms:
-
palpable pulsatile mass
shortness of breath
numbness of extremities - hole in arterial wall; allows blood to escape; hematoma; blood continues to circulate within hematoma; caused by procedures that involve arterial puncture or violent trauma
- false aneurysms
- result from the separation of the intima away from the aortic wall;
- arterial dissection
- Arterial dissection usually originates from ______
- ascending aorta
- A common pathology with arterial dissection is ____
- Marfans Syndrome
- What all can cause arterial dissection?
- Marfans syndrome, multiple caths, hypertension
- Dissection symptoms:
-
massive anterior chest pain
radiates upward to shoulder
travels down back
shock - Sonographic Apperance of Dissection:
-
double lumen
intimal flap
free fluid
can contain thrombus
- Symptoms of Rupture of aneurysm:
-
-Abdominal pain that increases in erect postion
-bluing discoloration
-hypotension
-shock
-decrease renal
-central back pain - Surgery criteria for aneurysms:
-
.5 cm a year is normal
6 = removal
4-5= tracking
- pain
-distal emboli
-renal obstruction
-GI bleeding - Complications of Aneurysms:
-
Atherosclerotic renal artery obstruction
-hydronephrosis(urine supply occluded)
- retroperitoneal fibrosis(connective tissue)
-rupture(death) - IVC lies to the ____of the aorta
- right
- The IVC contracts on ____ and expands on _____
- exhalation and inhalation
- The IVC carries blood _____.
- back to heart
- normal measurement of IVC
- 2.5
- THe IVC is formed by the confluence of the ____and ___v.
- Common iliac veins
- Evaluation to the IVC for:
- tumor invasion and thrombus or bloodclot
- IVC is ____to body of liver, _____to right kidney and to _____side of aorta
- posterior; medial ; right
- IVC variations:
- double IVC; IVC on Lt; absent portions
- Reason WHy an IVC might be displaced?
-
-caudate or right hepatic mass
-RRA aneurysm
-lymphadenopathy
-tortuous aorta
-right renal mass
-right adrenal mass
-retroperiotoneal tumors - The Right, Middle, and Left Hepatic veins drain into the ____
- IVC
- The Renal V. drains _____
- renals
- Lt. gonadal v. does not take off the IVC, it comes off the ____
- Lt Renal V.
- Phrenic= _____
- diaphragm
- Lt. Renal Vein is ____to aorta and ____to the right of IVC
- anterior and posterior
- WHat do valves do?
- direct bld. flow in one direction only
- Valsava Maneuver cause IVC to do what?
- get larger
- Expiration causes IVC to _____
- contract
- Portal Vein hypertension causes ______
- hepatofugal
- Which vein is located directly under the neck of the pancreas?
- portal vein
- The portal splenic confluence is formed by the ___and ____
- splenic and SMV
- Which vein is posterior to the head of the pancrease?
- portal vein
- normal measurement of portal vein
- less than 13mm
- WHat are the main portal branches?
-
Right (Anterior and Posterior)
Left (Medial and Lateral) - Portal Veins walls are ____
- highly echogenic
- WHat is the job of the portal vein?
- cleans, breaks down and metabolizes bld.; 70% via portal vein
- Portal Triad:
-
common hepatic duct
common hepatic artery
portal vein - the media is composed of
- muscular tissue
- the intima is composed of
- endothelial tissue
- the adventitia is composed of
- loose connective tissue