Inferior Vena Cava Anatomy and Ultrasound Exam

Where does the IVC pierce the diaphragm?

T8

Gonadal Veins consist of?

Testicular and ovarian veins

IVC

Inferior Vena Cava;
Venous blood drains all the organs and structures from the upper and lower abdomen and lower extremities

SVC drains?

head, neck, thoracic cavity, upper extremities

The IVC is formed by the union of what vessels?

iliac veins

The IVC lies posterior and to the right of the _________.

aorta

Where is the IVC formed?

L5

Where does the IVC enter the heart?

right atrium

3 lateral IVC Tributaries?

Rt suprarenal (adrenal) vein, Rt and Lt renal veins, Rt testicular vein

How many branches unite to form the main renal veins?

5 - 6 branches

Right Renal Vein (RRV) best visualized in LNG or TRV?

TRV

Right Renal Vein (RRV) flows directly from the kidney to the _______.

IVC

Where/in what orientation does the RRV enter the IVC?

posterolaterally

Which 2 veins enter the IVC directly?

Rt adrenal (suprarenal) and rt gonadal

Left Renal Vein (LRV) lies ________ to the SMA and ________ to the aorta.

posterior, anterior

Is the RRV or LRV larger? Why?

LRV, accepts branches from the L adrenal, L gonadal, and lumbar veins.

In longitudinal the LRV is seen as a _______ structure between the _______ and _______.

circular, SMA, AO

In transverse, the LRV is an _______ _______ structure between the _______ and _______.

anechoic tubular, SMA, AO

Gonadal veins course _______ to the internal and external iliac veins.

anterior

Gonadal veins continue within the _______ abdomen and continue cranially within the _______ muscle.

retroperitoneal, psoas

Lft gonadal vein enters the_______ which then enters the _______.

LRV, IVC

Rt gonadal vein enters the _______ directly on the _______ border above the _______ veins.

IVC, anterolateral, lumbar

Suprarenal Veins are also known as what?

Adrenal Veins

The rt and lt suprarenal veins arise from the?

suprarenal gland

The rt adrenal vein drains directly into the which vessel?

IVC

L adrenal vein drains into the?

LRV

What are the anterior tributaries to the IVC which are also the largest visceral tributaries of the IVC?

hepatic veins

Where do the hepatic veins originate?

liver

What do the hepatic veins drain into?

IVC (at diaphragm level)

Hepatic veins return deoxygenated blood from the _______.

liver

What does the RHV (rt hepatic vein) drain?

rt lobe of the liver

_______ drains the portions of right and left lobe of the liver.

MHV

_______ drains the left lobe of the liver.

LHV

Which lobe of the liver has its own direct drainage into the IVC?

caudate lobe

RHV, MHV and LHV increase in caliper as they approach the _______.

IVC

The portal venous system is responsible for directing blood from parts of the _______ _______ to the _______.

gastrointestinal tract, liver

Substances absorbed in the small intestine travel first to the _______ for processing before continuing to the _______.

liver, heart

Not all of the gastrointestinal tract is part of this system

portal venous system

Portal venous system has which 2 tributaries?

IMV, gastric veins

The portal venous system extends from about the lower portion of the _______ to the upper part of the_______ _______ .

esophagus, anal canal

Venous drainage from the _______ and _______ are included in the portal venous system.

spleen, pancreas

Formed by the union of the superior mesenteric vein (SMV) and the splenic vein at level of L2 (in the epigastric region)

portal vein

How long is the portal vein?

5 - 7 cm

Portal vein enters the _______ _______ of the liver.

porta hepatis

Portal vein bifurcates into what?

rt and lt portal veins

Portal vein courses _______ through the liver.

transversely

Portal vein lies _______ to the IVC.

anterior

Portal vein becomes _______ as branching occurs throughout the _______.

smaller, liver

Portal vein is surrounded by _______ _______ which is highly reflective - echogenic on ultrasound.

fibrous tissue

Where does the splenic vein begin?

splenic hilum

Splenic vein is tributary of?

portal circulation

Splenic vein is joined by the _______ _______ and _______ veins.

short gastric, gastroepiploic

Splenic vein courses along _______ _______ border of the _______.

posterior medial, pancreas

Joins SMV posterior to the neck of the pancreas and drains blood from the stomach, spleen and pancreas

Splenic vein

Superior Mesenteric Vein (SMV) begins at?

ileocolic junction

SMV passes _______ to the neck of the _______ to join the _______ _______.

posterior, pancreas, splenic vein

SMA is a tributary to which vein?

portal vein

SMA drains blood from which 3 veins?

middle colic vein (transverse colon), rt colic vein (ascending colon), and the pancreatic duodenal vein

Does the IVC drain "gut" blood?

no but it drains the organs

Why do we look at the IVC?

concerned about thrombus

IVC touches the liver. Does the aorta touch the liver?

no

Which Hepatic vein usually enters the lt Hepatic?

middle

IVC runs ________ to the liver.

posterior

Which renal vein is seen best in TRV?

right

Are renal veins anterior to renal arteries?

yes

Proper hepatic supplies what percent of OXYGENATED blood to the liver?

20-30%

70-80% of DEOXYGENATED blood supplied to the liver is provided by the?

portal vein

Hepatic veins are _____ and get _____ as they branch.

small, bigger

What is the threshold number for the portal vein?

1.3 cm

What is the area of the liver called where vessels are coming and going?

Porta Hepatis

When the splenic vein is circular, the SMA is:
circular or tubular?

tubular

Venious flow is a _______ waveform that sounds like wind.

continuous

Hepatic veins have this pattern because they sit close to the heart.

pulsatile/multiphasic waveform

What can help to distinguish Hepatic veins from other veins?

different wave pattern than other veins