CHAPTER 10: IVC

What is the function of the IVC?

returns deoxygenated blood to the heart

Normal measurement of the IVC

less than or equal to 3.7 cm

Normal measurements of the common iliac veins

1.68 to 1.8 cm AP diamteter

Normal measurement of the right common iliac vein

5.5 cm long

Normal measurement of the left common iliac vein

7.5 cm length

Normal measurement of the IVC

2.5 cm AP diameter

When does the diameter increase of the veins?

valsalva or inspiration

Diameter will decrease in the IVC when?

with expiration and with a sniff

3 differences between Aorta and veins

veins have valves, arteries have thicker walls, veins take blood towards heart and arteries take blood way

Wall layers of the IVC

Tunica intima, tunica media, tunica adventitia

The tunica media is thicker or thinner than arteries?

thinner

In regards to pressure the tunica media is a

low pressure network

The IVC is formed by the convergence of

the common iliac veins

What does the IVC empty into

right atrium

Congenital variants of IVC?

double ivc, ivc located on the left, absence of portions of IVC

Segments of the IVC?

Hepatic, prerenal, renal, postrenal

Hepatic part of IVC empties from?

liver

Where is the prerenal segment of the IVC located?

It extends inferior to the hepatic veins and ends superior to the renal veins

How do venous valves work?

Blood momentum during systole pushes valves open, valves close when momentum stops to prevent retrograde (backward) flow.

The IVC is peritoneal or retroperitoneal?

Retroperitoneal

The IVC is located

slightly to the right of the spine or midline and to the right of the aorta

The IVC travels

inferior to superior

What is located in the renal segment of the IVC?

renal veins and other tributaries

Where is the postrenal segment of the IVC located?

It extends inferiorly from the renal veins to the convergence of the common iliac veins

Tributaries of the IVC

common iliac veins, gonadal veins, hepatic, lumbar veins, renal veins, suprarenal veins

Where do the common iliac veins empty into?

lower extremities and pelvis

Where do the common iliac veins converge?

At the level of the umbilicus

Where do the lumbar veins empty into?

Lateral aspect of IVC

What do the lumbar veins drain?

posterior abdominal wall

Where does the right gonadal vein drain into?

anterior IVC

Where does the left gonadal vein drain into?

left renal vein

Overall what do the gonadal veins drain?

ovaries or testes

Where do the renal veins empty into?

lateral aspect of IVC

What do the renal veins drain?

Kidneys

The left renal vein is longer because?

it drains into IVC

Where does the left renal vein travel in between?

SMA and AORTA

Nutcracker Syndrome

engorgement of LRV due to compression by SMA and AO

Suprarenal veins empty into?

adrenal glands

Right suprarenal vein may drain into

right renal vein and IVC

The left suprarenal vein drains into

left renal vein

How many hepatic veins are there?

three

The right hepatic vein drains into?

right lobe of liver

The middle hepatic vein drains into?

caudate lobe, right and left lobes

The middle hepatic vein often joins the ____ _____ ____ prior to draining into liver

left hepatic vein

The left hepatic vein drains

left lobe of liver

The inferior phrenic veins are

most superior

The inferior phrenic veins drain

the diaphragm

The lumen of the IVC is

anechoic

The walls of the IVC are

thin and hyperechoic

What is the course of the left renal vein?

It runs anterior to the aorta and posterior to the superior mesenteric artery (SMA),

Where is the left renal vein located in relation to the left renal artery?

The left renal vein passes in front of and slightly below the left renal artery.

How does the diameter of the hepatic veins change as they approach the IVC?

How does the diameter of the hepatic veins change as they approach the IVC?

How are the walls of hepatic veins usually seen on imaging?

The walls are very thin and not usually visible.

What are the common imaging signs for hepatic veins?

Bunny ear, Reindeer, or Moose sign, describing the branching pattern as they enter the IVC.

What should hepatic veins be evaluated for?

Thrombosis and tumor invasion

Where do most tumor invasions of the hepatic veins originate?

Most commonly from the renal veins.

Decreasing hematocrit in the ivc indicates

internal hemorrhage