Sectional Anatomy Quiz Study Ch. 9 & 10 (copy)

Angiotensin II -

A hormone released in the event of bleeding to initiate vasoconstriction and help maintain blood pressure. 

Aorta -

A retroperitoneal tubular structure coursing inferiorly from the heart, just to the left of the spine, through the chest and abdomen until it bifurcates into the common iliac arteries. Along its course, the aorta gives off multiple branches that supply body structures with oxygen-rich blood. 

Celiac Artery (CA) -

An anterior branch of the abdominal aorta. It is superior to and within centimeters of the superior mesenteric artery. It is also known as the celiac trunk and celiac axis. It branches into the left gastric artery, splenic artery, and common hepatic artery. 

Common Hepatic Artery (CHA) -

A branch of the celiac artery. It courses horizontally to the right and branches into the gastroduodenal artery and proper hepatic artery. 

Common Iliac Arteries -

A division of the abdominal aorta. It divides into the right and left common iliac arteries. Supplies the pelvis and lower extremities. 

Gastroduodenal Artery (GDA) -

A branch of the common hepatic artery that courses inferiorly. It supplies the right side of the greater curvature of the stomach via the right gastroepiploic artery and the pancreatic duodenal area via the superoanterior and superoposterior pancreatic duodenal arteries. 

Gonadal Arteries -

Branch anteriorly from the abdominal aorta and inferior to the renal arteries. Course inferiorly and supply the respective gonadal (reproductive) organs. 

Inferior Mesenteric Artery (IMA) -

An anterior branch of the abdominal aorta. Lies inferior to the superior mesenteric and renal arteries. Courses anteroinferiorly, dividing into several other smaller arteries supplying the transverse colon, descending colon, and rectum. 

Left Gastric Artery (LA) -

A branch of the celiac artery that courses superiorly and left laterally. It supplies the left side of the lesser curvature of the stomach and eventually anastomoses with the right gastric artery. 

Proper Hepatic Artery (PHA) -

A branch of the common hepatic artery, which courses right laterally and superiorly. It supplies the liver via the right, middle, and left hepatic arteries. 

Renal Arteries (RA, RRA, and LA) -

Bilateral branches of the abdominal aorta located a few centimeters inferior to the origin of the superior mesenteric artery. They course horizontally to the right and left kidneys. 

Renin-

An enzyme released from the kidneys in the event of bleeding. It acts on angiotensin II, which initiates vasoconstriction and maintains blood pressure. 

Splenic Artery (SPA) -

A branch of the celiac artery, which courses horizontally to the left with a slight inferior-to-superior angulation. It supplies the spleen, pancreas, and left side of the greater curvature of the stomach. 

Superior Mesenteric Artery (SMA) -

An anterior branch of the abdominal aorta that is inferior to and within centimeters of the celiac artery. It courses anteroinferiorly. It also divides into several arteries that supply the largest portion of the small intestine, the ascending colon, and part of the transverse colon. The inferoanterior pancreatic duodenal artery and the inferoposterior pancreatic duodenal artery originate from the superior mesenteric artery. They supply the pancreatic head and duodenal area. 

Suprarenal Arteries -

Bilateral branches of the abdominal aorta, also known as the adrenal arteries. They course horizontally to each adrenal gland at a level between the celiac artery and the superior mesenteric artery.

Common iliac Veins (Right and Left) -

Bilateral veins that empty the lower extremities end pelvis and converge at approximately the level of the umbilicus to form the inferior vena cava (IVC). 

Gonadal Veins (Right and Left) -

Bilateral veins that empty either the testes or ovaries. Superior to the lumbar veins, the right gonadal vein courses parallel to the IVC and empties into its anterolateral aspect; the left gonadal vein courses parallel and lateral to the IVC and empties into the left renal vein. 

Hepatic Veins (HVs) (Right, Middle, Left - RHV, MHV, LHV) -

Normally, three HVs meet at the superior aspect of the liver and empty into the anterior aspect of the IVC. In. general, the RHV empties the right lobe of the liver, the MHV empties the caudate lobe, and the LHV empties the left lobe of the liver. 

Inferior Phrenic Veins -

These veins bilaterally drain the diaphragm and empty into the lateral aspect of the IVC; they course in a superior-to-inferior direction. 

Inferior Vena Cava (IVC) -

A retroperitoneal, tubular structure coursing superiorly from the convergence of the common iliac veins in the lower abdomen, just to the right of the spine, through the abdomen and chest until it reaches the right atrium of the heart. Along its course, it receives multiple tributaries filled with deoxygenated blood from body structures. 

IVC Sections (Hepatic, Prerenal, Renal, Postrenal) -

The hepatic section is located directly posterior to the liver, where the HVs empty into the IVC. The prerenal section extends from just inferior to the HVs to slightly superior to the renal veins. The renal section includes the renal veins and multiple tributaries. This section terminates almost immediately after the branching of the renal veins. The postrenal section extends from just inferior to the renal veins to the convergence of the common iliac veins.

Lumbar Veins -

These veins bilaterally empty the posterior abdominal wall into the lateral aspect of the IVC, just superior to the convergence of the common iliac veins. There can be multiple pairs up to the level of the renal veins. 

Renal Veins (Right and Left-RRV, LRV) -

These veins bilaterally empty the kidneys into the lateral aspect of the IVC. The RRV generally empties only the right kidney but sometimes assists the right adrenal gland via the right suprarenal vein. The LRV empties the left kidney and is subject to more tributaries than the RRV, such as the left gonadal vein, left suprarenal vein, and many smaller tributaries. 

Suprarenal Veins (Right and Left) -

These veins bilaterally empty the adrenal glands. The left suprarenal vein follows a course similar to that of the left renal vein, into which it eventually empties. When the right suprarenal vein does not empty into the RRV, it empties directly into the IVC at a level slightly superior to the RRV.

Why is the aorta vital?

Because the blood flowing to the abdominal organs & lower extremities must pass through at least some part of this vessel to reach its destination.

What are the two great vessels of the abdomen?

Aorta & IVC

Where does the aorta originate from?

The heart and then leads down into the thoracic cavity.

What is not visualized when a abdominal sonogram is performed?

Thoracic aorta

What happens after the aorta passes through the aortic hiatus(located on the posterior portion of the diaphragm) it is termed…

Abdominal aorta

Where is the aortic hiatus located?

Posterior portion of the diaphragm

AO stands for?

Abdominal Aorta

The AO bifurcates into?

Common illiac arteries

How does the aorta help to supply the underside of the diaphragm?

Directly after the aorta passes through the diaphragm, the inferior phrenic arteries branch off the anterolateral aspect of the aorta and course superiorly to supply the underside of the diaphragm.

What is another name for the celiac trunk?

Celiac artery (CA) or Celiac axis

How does the CA branch off from the aorta?

Anteriorly

How long does the CA measure in diameter?

1 cm

Why is the CA and its branches so important?

It helps to supply majority of the abdominal organs. (Stomach & duodenum)

What is another term for suprarenal arteries?

Adrenal arteries

The SMA divides into several arteries that supply the largest portion of?

The small intestine, ascending colon, and transverse colon.

Where is the SMA located according to the CA?

A few centimeters

What originates from the SMA and feeds the pancreatic head & duodenal area?

Inferoanterior pancreatic duodenal artery & inferoposterior pancreatic duodenal artery.

Both renal arteries do what?

Course horizontally supply the kidneys.

Which renal artery has a longer course & travels a greater distance to reach the right kidney?

Right renal artery (RRA)

The aorta sits on what side of the spine?

Left

How does the RRA course according to the IVC?

Posterior to the IVC & anterior to the spine on its way toward the right kidney.

How does the left artery originate according to the right artery?

Left artery is slightly superior to right artery.

What are the male & female gonadal arteries called?

Male- testicular arteries

Female- Ovarian arteries

What artery supplies the sacrum & is the most inferior branch of the aorta?

Medial sacral artery

How do the four lumbar arteries originate?

Bilaterally from the posterolateral aspect of the aorta throughout the entire lumbar vertebrae region of the aorta.

The size of the AO depends on?

Body habitus

AO- The average anteroposterior diameter at the most superior portion of the adult abdomen is?

2 cm

When the AO courses inferiorly it…

decreases in size with an average measurement of 1.5 cm at its bifurcation into the common iliac arteries.

The abdominal portion of the aorta is approx. how many cm long?

14 cm beginning at the aortic hiatus to the 4th lumbar vertebra.

The aorta bifurcates into common iliac arteries which vary in diameters between…

0.8 & 1.0 cm

The AO should NOT exceed…

3 cm at any level

What is the best way to decrease observer variation when measuring the aorta?

Take the anteroposterior measurement in a longitudinal section as opposed to an axial section.

What are the three layers of the aorta?

Tunica intima, tunica media, & tunica adventitia

Why do arteries often have a thicker tunica media?

To allow for greater elasticity

What is the primary function of the aorta & its branches?

To channel blood to organs & tissues to ensure oxygenation & metabolism.

What are the primary responsibilities of the arteriole-capillary system that the aorta can help with as well?

Blood pressure maintenance & control of bleeding.

What is the venous system capable of?

Maintaining blood pressure through its valves. However; valves are NOT present in the arterial system.

As ventricles contract during systole, blood is quickly sent to the aorta which causes…

Expansion of the vessel wall, which results in potential energy being stored in the vessel wall.

When the aortic valve in the heart closes & diastole ensues, the arterial wall recoils to release the stored potential energy. The wall recoil forces…

blood to continue its forward movement & blood pressure is maintained.

How is blood pressure & flow maintained with the help of the aorta & large arteries.

As ventricles contract during systole, blood is quickly sent to the aorta which causes expansion of the vessel wall, which results in potential energy being stored in the vessel wall. When the aortic valve in the heart closes & diastole ensues, the arterial wall recoils to release the stored potential energy. The wall recoil forces blood to continue its forward movement & blood pressure is maintained.

What can cause vasoconstriction or vasodilation?

Many local systemic chemical & neurologic events

Renin acts on angiotensin II which initiates…

vasoconstriction, & thus blood pressure is maintained.

Vasoconstriction of certain arterial segments can result in..

Increases organ perfusion or heat dissipation

The aorta & its branches play a critical role in..

homeostasis

Arterial vasculature should normally display…

Anechoic lumen w/ bright, echogenic walls

In sag & coronal scanning plane the aorta is seen as..

tubular longitudinal pulsatile structures.

The aorta continues to run anteriorly until it..

Bifurcates

The aorta is often tortuous so it can be difficult to identify a significant longitudinal portion.

The aorta is often tortuous so it can be difficult to identify a significant longitudinal portion.

The tunica intima often appears as a bright and echogenic line.

The tunica media appears echo-free located between the tunica intima and tunica adventitia.

The Tunica adventitia is the fibrous outermost section, it appears as a bright line.

The tunica intima often appears as a bright and echogenic line.

The tunica media appears echo-free located between the tunica intima and tunica adventitia.

The Tunica adventitia is the fibrous outermost section, it appears as a bright line.

What are the branches of the aorta that are demonstrated w/ reasonable consistency on ultrasound?

CA, SMA, renal arteries, & common iliac arteries

The renal arteries are usually better seen in what scanning plane?

Transverse

The bifurcation of the aorta is most easily demonstrated in what scanning plane?

Transverse

Doppler assessment of the AO and its branches is extremely useful in understanding..

Systolic & diastolic flow.

The aorta & its branches are primarily evaluated to detect?

Aneurysms & stenosis.

Stenosis of the CA, SMA, renal artery, & common iliac arteries can be identified w/ the aid of?

Doppler sonography

Stenosis is often the factor in other disease states.

Stenosis is often the factor in other disease states.

Grafts can be evaluated for patency & complications using?

Doppler sonography.

The abdominal organs all have that empty deoxygenated blood into?

The IVC

A sonographer must have a full understanding of this vasculature to adequately evaluate the abdomen during a sonographic examination and ensure that each patient receives the best possible care.

A sonographer must have a full understanding of this vasculature to adequately evaluate the abdomen during a sonographic examination and ensure that each patient receives the best possible care.

The IVC is formed by the convergence of the common iliac veins, which empty into the..

Lower extremities and pelvis.

The following variations are attributable to the complex embryologic development of the IVC.

The IVC can have congenital variations, including double IVC, IVC located on the left, absence of certain portions of the IVC, or a combination of these.

What tributaries empty into the IVC as it continues its superior course and pierces the diaphragm to enter the right atrium of the heart?

Lumbar veins, right gonadal vein, renal veins, & hepatic veins

Where is the IVC located according to the intestines & liver?

Posterior

Where is the IVC located according to the right kidney?

Medial

What are the 4 sections of the IVC?

Hepatic section- Hepatic veins empty into the IVC

Prerenal section

Renal section- Renal veins & multiple tributaries are located within this section.

Postrenal section- due to overlaying bowel gas, the postrenal section may be very difficult to see sonographically.

What tributaries empty the lower extremities & pelvis at the same level as the umbilicus?

Right & left common iliac veins

The right gonadal vein-

Courses parallel to the IVC & empties into the anterior lateral aspect of the IVC.

Right renal vein-

generally empties only the right kidney, sometimes assists the right adrenal gland via the right suprarenal vein.

Left renal vein-

Normally longer than the right renal vein bc it runs from the left kidney to the IVC.

Which vein empties into the left renal vein?

Left gonadal vein

What happens when the right suprarenal vein does not empty into the right renal vein?

It empties directly into the IVC at a level slightly superior to the right renal vein.

Three hepatic veins course from the inferior aspect, deep within the liver to the superior aspect of the liver.

Right hepatic vein-Empties right lobe of the liver

Middle hepatic vein- Empties the caudate lobe

Left hepatic vein- Empties left lobe of the liver

What is the most superior tributaries of the IVC?

Inferior phrenic veins- course superior to inferior direction.

The left & right hepatic veins measure…

1.6 to 1.8 cm in diameter.

Why is the left common iliac vein slightly longer than the right common iliac vein?

The common iliac veins join to the right of the spine.

What is the approx. length of the left common iliac vein?

7.5 to 5.5 cm