Ch. 8 Vascular system

The arterial lumen is part of the __ __ layer of vascular structures.

tunica intima

The __ __ makes up the tiny arteries and veins that supply the walls of blood vessels.

vasa vasorum

The inferior epigastric and deep circumflex iliac

branches branch off before they pass under the

inguinal ligament to become the __ artery.

femoral

The portion of the femoral artery posterior to the knee is the __ artery.

popliteal

The popliteal artery further divides into the anterior

and posterior __ arteries.

tibial

The left gastric artery supplies the lower third of the esophagus and the upper right of the __.

stomach

The splenic artery is the tortuous vessel that forms the superior border of the ___.

pancreas

Which layer of vessels is composed of smooth muscle fibers with elastic and collagenous tissue?

tunica media

The __ __ is made of the tiny arteries and veins that supply the walls of blood vessels.

vasa vasorum

Which vessel feeds the RT and LT loves of the liver, gallbladder, and part of the stomach and pancreas?

hepatic artery

What occurs when the arterial system becomes thick and stiff, leading to the restriction of blood flow to the organs and tissues?

arteriosclerosis

A specific form of arteriosclerosis where there is build up of fats/cholesterol (plaque) that can restrict blood flow.

atherosclerosis

__ __ is common with a larger aneurysm.

mural thrombus

Aortic pseudoaneurysm is the result of trauma, while a true aneurysm affects all 3 layers of __

lumen

Mycotic aneurysm is the result of __.

infection

__ implies the diffuse dilation of a vessel, whereas an ___ is a region of focal enlargement.

Ecstasia; abdominal aortic aneurysm

The majority of AAA occur at the ___ level with the remainder occuring at the level of or above the kidneys.

infrarenal (below the kidneys)

AAA treatment option for aneurysms < 4cm

followed every 6 months w/intervention if pt becomes symptomatic

AAA treatment option for aneurysms 4 to 5 cm in diameter

surgical intervention may be suggested if pt is in good health

AAA treatment option for aneurysms >5-6 cm

may benefit from surgical repair, especially if patient has other factors for rupture (HTN, smoking, COPD)

AAA treatment option for aneurysms >6-7cm

highest risk patients

risk also increases with age/other medical conditions

Abnormality of IVC: blood flow into the superior vena cava instead of the IVC is seen with the presence of an __ vein.

azygos

The most common origin of pulmonary emboli is venous thrombosis from the __ __.

lower extremities

A __ filter is the most common surgical implant to prevent emboli to the lungs, especially in patients who cannot tolerate anticoagulants.

Greenfield

The hepatic veins drain their respective lobes of the liver and empty the deoxygenated blood into the __ at the level of the diaphragm.

IVC

variant of right renal artery where it courses anterior to IVC instead of posterior

precaval renal artery

The portal vein is formed __ to the pancreas by the union of the SMV and __ __.

posterior; splenic veins

The _ _ carries blood from the intestinal tract to the liver.

portal vein

The __ __ runs along the posteriomedial border of the pancreas.

splenic vein

Low resistant vessels have a __ diastolic component to supply organs that need constant perfusion.

high

Proximal AO has a __ systolic flow and a __ diastolic flow. At distal AO, the waveform represents a __ flow.

high systolic

low diastolic

distal: triphasic

The SMA is __ resistant in a fasting patient, and __ resistant in a non-fasting patient.

high; low

IVC and hepatic veins have variable Doppler flows due to respiration. It also shows flow above and below the baseline due to __

reflux from the right atrium

Portal veins have __ flow.

hepatopetal

What is the most common tumor invasion into the IVC?

Willm’s tumor (nephroblastoma), typically from the right kidney

What is portal HTN most frequently caused by?

Liver damage from cirrhosis, thrombus, sinusoidal (small vein) obstruction.

What finding is a definitive diagnosis of portal HTN?

patent paraumbilical vein

Where does the aortic root arise from?

left atrium of the heart