Blood Vessels

Abdominal

vasa vasorum

The vascular network that feeds the arteries.

tunica intima

The innermost layer of a blood vessel.

tunica media

Middle layer of an artery made up of smooth muscle fibers and a thick layer of elastic connective tissue, thicker in arteries.

tunica adventitia

The outer layer of tissue of a blood vessel wall, composed of elastic and fibrous connective tissue, containing vasa vasorum.

ascending aorta

Branches off the left ventricle; carries oxygen-rich blood to parts of the body above the heart.

descending aorta

The descending part of the aorta that branches into the thoracic and abdominal aortae.

abdominal aorta

Continuation of the thoracic aorta that runs through the abdominal cavity, starting when it exits the diaphragm.

root of aorta

Arises from the left ventricular outflow tract in the heart.

brachiocephalic artery

The first major branch off of the aorta and the major artery to the forelimbs and head.

common carotid artery

Artery that supplies blood to the face, head, and neck.

subclavian artery

Blood vessels that supply blood to the shoulders and upper limbs; both left and right.

aortic valve

The semilunar valve separating the aorta from the left ventricle, preventing blood from flowing back into the left ventricle.

coronary arteries

Blood vessels that branch from the aorta and carry oxygen-rich blood to the heart muscle.

celiac axis

Located 2cm below diaphragm, it includes the left gastric artery, splenic artery, and common hepatic artery.

common hepatic artery

Arises from the celiac trunk to supply the liver, splitting into proper hepatic and gastroduodenal artery.

mesenteric/splanchnic arteries

Numerous arteries that supply the small and large intestines; come off the dorsal aorta.

Celiac trunk, SMA, IMA , and branches.

mesenteric ischemia

An interruption of the blood supply to the mesentery, with symptoms including postprandial pain and weight loss.

lymphadenopathy

disease of the lymph nodes
enlarged lymph nodes
appear as hypoechoic spots between the SMA and AO (in the longitudinal view)

renal arteries

Two branches of the abdominal aorta that supply the kidneys, arising from the lateral sides of the aorta.

RRA (right renal artery)

Arises from the lateral wall of the aorta, travels posterior to the IVC to supply the kidney, longer than the LRA.

renal artery stenosis

Narrowing of the renal artery due to atherosclerosis or other processes, potentially causing secondary hypertension.

secondary hypertension

High blood pressure caused by kidney disease.

arterial stents

Devices placed in arteries, typically iliac, aorta, renal, or coronary, to open occluded vessels.

renal angiography

X-ray examination (with contrast) of the blood vessels of the kidney.

aortic sonogram assessment

Evaluate diameter, calcification, thrombus, or dissection of the aorta.

atheroma

Fatty deposit within the wall of an artery.

aneurysm

Ballooning of a weakened portion of an arterial wall, defined as a permanent localized dilation.

aortic aneurysm

A weakness in the aorta wall that can lead to rupture, typically 3cm or more in diameter.

abdominal bruit

A whooshing sound heard with a stethoscope over the abdominal aorta.

symptoms of arterial pathology

Includes pulsatile abdominal mass, abdominal pain radiating to back, abdominal bruit, and hemodynamic compromise in lower legs.

Abdominal Aortic Aneurysm (AAA)

Condition where the walls of the aorta weaken in the abdomen, leading to bulging and potential rupture.

aortic dissection

Diagnosis in which the arterial wall splits apart, causing potential danger and pain.

arteriovenous (AV) fistula

An abnormal connection between an artery and a vein, sometimes surgically created for hemodialysis access.

arteriosclerosis

Hardening of the artery walls.

Atherosclerosis

Condition where fatty deposits called plaque build up on the inner walls of the arteries.

risk factors for aneurysm

Include atherosclerosis, arteriosclerosis, trauma, congenital defects, syphilis, mycosis, cystic medial necrosis, inflammation, and hypertension.

fusiform aneurysm

Circumferential enlargement of a vessel with tapering at both ends.

saccular aneurysm

A sac-like bulge on one side of an artery.

aneurysms <4cm

Followed every 6 months; intervention if the patient becomes symptomatic.

aneurysms 4-5cm

Surgical intervention if the patient is in good health.

aneurysms >5-6cm

May benefit from surgical repair, especially if there are other risk factors.

aneurysms >6-7cm

Pose the greatest risk of rupture; risk increases with age and other medical conditions.

aortic dissection

Condition where high-pressure blood splits aortic layers apart, can be due to hypertension or trauma.

aortic dissection stage 1

Rupture of intima.

aortic dissection stage 2

Dissection of media.

aortic dissection stage 3

Rupture of vessel.

aortic dissection type 1

Begins at aortic root and may extend through the entire length of the aortic arch, considered most dangerous.

aortic dissection type II (Marfan's)

A complication of Marfan's syndrome where connective tissue in the aorta is damaged.

aortic dissection type III

Aortic dissection starting in the descending aorta.

false lumen

A blood-filled channel that forms in the wall of an artery during an aortic dissection.

true lumen

The true or original channel within a vessel.

aortic graft

A surgical repair of an aneurysm, typically using flexible materials like Teflon or Dacron.

Pseudoaneurysm

Occurs when blood escapes through a hole in the intima but is contained by deeper layers of the artery or adjacent tissue.

causes of pseudoaneurysm

Typically due to surgery or trauma.

correction of pseudoaneurysm

Compression is the primary method of correction.

vein vs artery tunica media

Veins have a diminished tunica media with little elastic or muscle fiber compared to arteries.

IVC deoxygenated blood delivery

Right atrium of the heart receives deoxygenated blood from the IVC.

valsalva maneuver

Process of expiring against a closed windpipe to create additional intra-abdominal pressure and spinal stability.

congestive heart failure

Disease causing backward flow in the IVC due to right side heart dysfunction.

IVC formation

Formed by the convergence of two common iliac veins.

location of the IVC

Posterior to the liver and to the right of the spine.

three hepatic veins

Right, middle, left hepatic veins draining the liver.

four sections of the IVC

Hepatic, prerenal, renal, postrenal.

right renal artery relationship to IVC

Right renal artery runs behind the IVC.

congenital anomalies in IVC

Can include duplicated IVC or missing sections, with azygos veins compensating.

azygos vein

Vessel draining blood from the chest wall, emptying into the superior vena cava.

causes of dilated IVC

Includes right ventricular failure, congestive heart failure, pregnancy, and tumors compressing the IVC.

thrombosis definition

A blood clot.

IVC filters

Tubular wire mesh implanted to trap emboli that may cause heart or lung problems.

LE DVT

Lower Extremity Deep Vein Thrombosis.

Budd-Chiari syndrome

An occlusion in the IVC or hepatic vein, usually caused by a clot.

left renal vein size comparison

Left renal vein is larger because the left gonadal vein drains into it.

right hepatic vein

Vein draining the right lobe of the liver via the IVC.

middle hepatic vein

Vein draining the caudate lobe of the liver via the IVC.

left hepatic vein

Vein draining the left lobe of the liver via the IVC.

hepatopetal flow

Flow of blood toward the liver.

hepatofugal flow

Flow of blood away from the liver.

identifying hepatic veins

Characterized by thin walls, drainage toward the diaphragm, increase in size approaching the diaphragm, and hepatofugal flow.

triphasic flow

Vascular flow yielding three phases, typically observed in hepatic veins.

hepatomegaly

Enlargement of the liver.

causes of dilated hepatic veins

Including liver masses, hepatomegaly, and IVC obstruction.

splenic vein

Drains spleen, stomach, and pancreas, located posterior and superior to pancreas, receiving inferior mesenteric vein.

inferior mesenteric vein

Vein that drains most of the colon and drains into the splenic vein.

superior mesenteric vein

Drains small bowel and parts of the colon, arising from the small bowel and joining the splenic vein behind the pancreas head.

main portal vein length

5-7cm long.

anastomoses with main portal vein

Includes esophageal, rectal, and superficial abdominal veins.

main portal vein liver entry

Enters the liver at the porta hepatis through the lesser omentum.

portal triad

A portal vein, hepatic artery, and bile duct in connective tissue sheath.

left portal vein supply

Supplies blood to the left lobe and caudate lobe.

coronary gastroesophageal shunting

Lower esophageal varices occur with connections between left gastric and azygos veins.

paraumbilical vein

Continuation of the left portal vein extending down the anterior abdominal wall to umbilicus.

hemorrhoidal anastomoses

Connections between superior and middle hemorrhoidal veins.

retroperitoneal anastomoses

Vascular structures within lesser omentum creating thickening of omentum, useful in distinguishing with Doppler.

caput medusa

Blood flowing away from the portal vein to the superficial abdominal veins, creating a 'stone' appearance.

cavernous transformation of portal vein

Develops collateral channels when the native portal vein is thrombosed.

TIPS usage

Used in advanced liver disease, often while waiting for a transplant, to decompress the portal system.

Transjugular Intrahepatic Portosystemic Shunt (TIPS)

A procedure creating a portocaval shunt between a portal vein and a vein connecting to the IVC.

Doppler in abdomen use

To detect blood flow, verify directional flow, and examine blood profile.

color Doppler in abdomen use

Aids in locating vessels, assessing blood flow, and positioning spectral Doppler sample volume.

spectral Doppler in abdomen use

Provides precise measurements of blood flow velocity, profile, and characteristics.