CHAPTER 10: IVC

What is the function of the IVC?

returns deoxygenated blood to the heart

Normal measurement of the IVC

2.5 cm AP diameter

Normal measurements of the common iliac veins

1.68 to 1.8 cm AP diameter

Normal measurement of the right common iliac vein

5.5 cm long

Normal measurement of the left common iliac vein

7.5 cm length

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, aorta has thicker tunica media, veins take blood towards heart and aorta takes blood away from the heart

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

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? (4)

Hepatic, prerenal, renal, postrenal

Hepatic part of IVC empties from?

liver

Where is the prerenal segment of the IVC located?

inferior to hepatic veins, superior to 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/midline and to the right of 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?

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

Tributaries of the IVC (6)

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

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 abd wall

Where does the right gonadal vein drain into?

anterior IVC

Where does the left gonadal vein drain into?

left renal vein

What organ 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?

the 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?

3

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?

anterior to aorta posterior to sma

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

LRV passes in front of and slightly below the LRA

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

they widen

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

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?

the renal veins

Decreasing hematocrit in the ivc indicates

internal hemorrhage