Transverse Plane of Aorta (Module 1.1)

At what level is the SMA seen?

At the level of the renals

How can you tell the difference between the left renal vein and renal arteries?

- Arteries are posterior to corresponding veins

- LRV travels anterior to the aorta to get to the IVC, while the renal arteries come off the abdominal aorta as a branch

Where are most pathologies seen in the abdominal aorta?

Distal aorta

Where does bifurcation of the abdominal aorta occur? What vessels does it split into?

Bifurcation occurs in the umbilical region and birfucates into the left and right common iliac arteries

How can you tell the difference between an artery or vein sonographically?

- Pulsatility (aorta pulses, IVC flutters)

- Compressiblity (only veins compress)

- Response to respiration

- Doppler characteristics

Why are the artery vessel walls strong reflectors?

They are perpendicular to the sound beam, making them specular reflectors that produce hyperechoic walls

What may prompt someone to receive an aortic sonogram?

- Pulsatile abdominal mass

- Hemodynamic compromise of lower limb arterial system (may cause pain in lower limbs)

- Abdominal pain

- Abdominal bruit (sound)

What does a routine scan of the aorta look like?

Sweeping from the diaphragm to bifrucation into proximal common iliac arteries in longitudinal and transverse planes

Assess for:

- Smooth, homogenous walls

- Anechoic lumen

- Pulsatility

- Size that is less than 3cm (avg. 2cm in proximal, 1.5cm in distal)

- Measuring walls outer to outer

What is the size of the celiac trunk, SMA, renals, and IMA?

- Celiac trunk = 0.7cm

- SMA = 0.6cm

- Renals = 0.4-0.5cm

- IMA = 0.3cm

What does the celiac trunk look like sonographically?

"Seagull" shaped w/ the right "wing" representing the common hepatic artery and the left "wing" being the splenic artery

TRUE or FALSE: The SMA is posterior to the aorta.

FALSE: The SMA is ANTERIOR to the aorta.

TRUE or FALSE: The right crus appears hyperechoic in an U/S image.

FALSE: The right crus is a HYPOechoic "line" in the diaphragm

What does the GEJ look like in an U/S image?

Hypoechoic "oval" w/ bright gas in the middle b/w the liver and the aorta