1.
The IVC is formed at the confluence of what two veins?
Explanation
The IVC, or inferior vena cava, is a large vein that carries deoxygenated blood from the lower body back to the heart. It is formed by the confluence, or merging, of the right and left common iliac veins. The common iliac veins are major blood vessels that receive blood from the legs and pelvis. When they come together, they form the IVC, which then ascends through the abdomen and ultimately enters the right atrium of the heart.
2.
The IVC is formed at the level of the ____________.
Explanation
The IVC (Inferior Vena Cava) is formed at the level of the umbilicus. This means that the inferior vena cava, which is a large vein that carries deoxygenated blood from the lower body back to the heart, is formed or begins at the same level as the umbilicus or belly button. This is an anatomical reference point that helps locate the position of the IVC in the body.
3.
The IVC lies slightly to the ___________ (right or left?) of midline.
Explanation
The IVC lies slightly to the right of midline.
4.
The IVC courses ____________ (superiorly or inferiorly?) and ends when it enters the __________ ___________ of the heart.
Explanation
The IVC courses superiorly and ends when it enters the right atrium of the heart. This means that the inferior vena cava, one of the major veins in the body, travels in an upward direction and terminates in the right atrium, which is one of the four chambers of the heart.
5.
Renal Veins:The __________ (RRV or LRV) is shorter than the other renal vein because of its close proximity to the _________.
Explanation
The right renal vein (RRV) is shorter than the other renal vein because it is located in close proximity to the inferior vena cava (IVC).
6.
Renal Veins:The LRV runs anterior to the __________ and posterior to the __________.
Explanation
The LRV (left renal vein) runs anterior to the aorta and posterior to the SMA (superior mesenteric artery).
7.
Hepatic Veins:Normally, there are _____(#) hepatic veins.
Explanation
The correct answer is 3 or three because the hepatic veins are blood vessels that drain deoxygenated blood from the liver and return it to the heart. Typically, there are three main hepatic veins, known as the right, middle, and left hepatic veins, which drain blood from different regions of the liver.
8.
Hepatic Veins:The hepatic veins are named...?
Explanation
The hepatic veins are named right, middle, and left. This is because they are responsible for draining blood from different regions of the liver. The right hepatic vein drains the right lobe of the liver, the middle hepatic vein drains the middle portion of the liver, and the left hepatic vein drains the left lobe of the liver. Therefore, the correct answer is right, middle, and left.
9.
Hepatic Veins:The hepatic veins drain directly into the ___________.
Explanation
The hepatic veins drain directly into the IVC. The IVC, or inferior vena cava, is the largest vein in the body that carries deoxygenated blood from the lower body and organs back to the heart. In the case of the hepatic veins, they specifically drain deoxygenated blood from the liver and bring it back to the heart via the IVC. This is an important pathway for blood circulation and ensures proper functioning of the liver and overall cardiovascular system.
10.
Gonadal Veins:The gonadal veins are easily visible on sono.
Correct Answer
B. False
Explanation
The statement "The gonadal veins are easily visible on sono" is incorrect. The correct answer is False. The gonadal veins are not easily visible on sono, which refers to sonography or ultrasound imaging. This means that they cannot be easily detected or observed using ultrasound technology.
11.
What is the name of the vein that drains the ovaries or the testicles?
Correct Answer
gonadal
Explanation
The term "gonadal" refers to the organs involved in reproduction, such as the ovaries in females and the testicles in males. The question asks for the name of the vein that drains these organs, and the correct answer is "gonadal." This vein is responsible for carrying deoxygenated blood away from the ovaries or testicles and back to the heart.
12.
The RGV (right gonadal vein) drains directly into the lateral aspect of the _________ below the _________.
Correct Answer
IVC, RRV
Explanation
The right gonadal vein (RGV) drains directly into the lateral aspect of the inferior vena cava (IVC) below the right renal vein (RRV). This means that the RGV carries deoxygenated blood from the right gonad (ovary or testis) and empties it into the IVC, which is a large vein that carries deoxygenated blood from the lower body back to the heart. The RRV is located above the RGV in this drainage pathway.
13.
The LGV (left gonadal vein) inserts into the _________ that then drains into the IVC.
Correct Answer
LRV
left renal vein
Explanation
The LGV (left gonadal vein) inserts into the left renal vein that then drains into the IVC.
14.
A normal variant of the LRV is called ___________ LRV.
Correct Answer
retroaortic
Explanation
The correct answer is "retroaortic." In medical terminology, the term "retroaortic" refers to a normal variant of the left renal vein (LRV) that passes behind the abdominal aorta. This variant occurs when the LRV takes an abnormal course, but it is still considered a normal anatomical variation.
15.
Indications for an ultrasound study of the IVC and tributary veins. Check all that apply.
Correct Answer(s)
A. Swelling of trunk, lower extremities
B. IVC filter
E. Known pathology
F. Follow up study
G. History of renal cell carcinoma
Explanation
An ultrasound study of the IVC and tributary veins may be indicated in the following situations: swelling of the trunk and lower extremities, presence of an IVC filter, known pathology, a follow-up study, and a history of renal cell carcinoma. Swelling of the trunk and lower extremities may suggest venous insufficiency or deep vein thrombosis. The presence of an IVC filter indicates the need to assess its position and potential complications. Known pathology and a history of renal cell carcinoma may require monitoring for possible metastasis. A follow-up study may be needed to evaluate the effectiveness of previous interventions or to monitor disease progression.
16.
On sono, the tubular structure of the IVC appears ___________.
Correct Answer(s)
anechoic
Explanation
The correct answer is "anechoic." In ultrasound imaging, anechoic refers to a region or structure that appears black or without echoes. This means that sound waves are passing through the structure without being reflected back, indicating that the structure is filled with fluid. The tubular structure of the IVC (inferior vena cava) is expected to appear anechoic because it is a large vein that carries deoxygenated blood from the lower body back to the heart.
17.
On sono, the shape of the IVC tends to be more __________.
Correct Answer(s)
oval
Explanation
On sono, the shape of the IVC tends to be more oval. This means that when visualized using ultrasound, the inferior vena cava (IVC) appears to have a rounded or elliptical shape. This is a normal finding and can be attributed to the anatomical structure and positioning of the IVC within the body.
18.
The IVC responds to ___________ variations by either collapsing or dilating.
Correct Answer(s)
respiratory
Explanation
The IVC, or inferior vena cava, is a large vein that carries deoxygenated blood from the lower body to the heart. It responds to respiratory variations by either collapsing or dilating. During inhalation, the diaphragm contracts and descends, causing an increase in intra-abdominal pressure and a decrease in thoracic pressure. This leads to a collapse of the IVC, reducing blood flow to the heart. Conversely, during exhalation, the diaphragm relaxes and ascends, resulting in a decrease in intra-abdominal pressure and an increase in thoracic pressure. This causes the IVC to dilate, allowing for increased blood flow to the heart.
19.
If the IVC collapses due to increased pressure in the abdominal cavity, the patient is probably ____________ (inhaling or exhaling?).
Correct Answer(s)
inhaling
Explanation
When the IVC (inferior vena cava) collapses due to increased pressure in the abdominal cavity, it indicates that the diaphragm is contracting and moving downwards. This downward movement of the diaphragm creates negative pressure in the thoracic cavity, allowing air to be drawn into the lungs during inhalation. Therefore, the correct answer is inhaling.
20.
If the IVC dilates due to decreased pressure in the abdominal cavity, the patient is probably ____________ (inhaling or exhaling?).
Correct Answer(s)
exhaling
Explanation
When the IVC (inferior vena cava) dilates due to decreased pressure in the abdominal cavity, it indicates that the patient is exhaling. During exhalation, the diaphragm moves upward, causing a decrease in intra-abdominal pressure. This decrease in pressure allows the IVC to dilate, facilitating the return of blood to the heart.
21.
What two respiratory variations would cause the IVC to collapse?
Correct Answer(s)
inspiration, Valsalva
inspiration and Valsalva
inspiration & Valsalva
22.
What two respiratory variations would cause the IVC to dilate?
Correct Answer(s)
expiration, suspended inspiration
expiration and suspended inspiration
expiration & suspended inspiration
Explanation
During expiration, the diaphragm relaxes and moves upward, causing a decrease in thoracic pressure. This increase in abdominal pressure pushes on the inferior vena cava (IVC), causing it to dilate. Suspended inspiration refers to the moment when inhalation is paused, and the diaphragm is in a contracted position. This also leads to an increase in thoracic pressure, resulting in dilation of the IVC. Therefore, both expiration and suspended inspiration can cause the IVC to dilate.
23.
The hepatic veins are best visualized with the transducer positioned __________.
Correct Answer
B. Obliquely
Explanation
The hepatic veins are best visualized with the transducer positioned obliquely. This means that the transducer is angled or tilted in a way that is not directly parallel or perpendicular to the body. By positioning the transducer obliquely, it allows for a better view and imaging of the hepatic veins, which are the veins that drain blood from the liver. This positioning helps to optimize the visualization and assessment of the hepatic veins during imaging procedures.
24.
When trying to visualize the hepatic veins, the transducer should be placed just inferior to the __________ __________ and angled toward the patient's ___________ ___________.
Correct Answer
xiphoid process, right shoulder
Explanation
To visualize the hepatic veins, the transducer should be placed just inferior to the xiphoid process, which is the small cartilaginous extension at the bottom of the sternum. The transducer should then be angled toward the patient's right shoulder. This positioning allows for optimal visualization of the hepatic veins and ensures accurate imaging of the liver.
25.
Partial imaging of the right hepatic vein and simultaneous imaging of the middle and left hepatic veins resembles the __________ __________ sign
Correct Answer
playboy bunny
26.
The renal veins are best visualized holding the transducer in a ___________ plane.
Correct Answer
C. Transverse
Explanation
The renal veins are best visualized holding the transducer in a transverse plane because this plane allows for a cross-sectional view of the kidneys and their surrounding structures. By positioning the transducer perpendicular to the body's long axis, the renal veins can be seen clearly and accurately assessed. The oblique and sagittal planes would not provide the same level of visibility and may result in incomplete or distorted images of the renal veins.
27.
The renal veins would be visualized just __________ (superior or inferior?) to the SMA.
Correct Answer
inferior
Explanation
The renal veins would be visualized inferior to the SMA. This means that the renal veins are located below the superior mesenteric artery in the body.
28.
A __________ Doppler pattern would be seen in the IVC near the diaphragm.
Correct Answer
pulsatile
Explanation
A pulsatile Doppler pattern would be seen in the IVC near the diaphragm because the IVC is a large vein that carries deoxygenated blood from the lower body back to the heart. As the heart beats, it creates a pulsatile flow of blood through the IVC, which can be detected using a Doppler ultrasound. This pulsatile pattern is normal and indicates that the blood flow in the IVC is being properly regulated by the heart's contractions.
29.
A __________ Doppler pattern would be seen in the IVC in the distal abdomen.
Correct Answer
phasic
Explanation
A phasic Doppler pattern would be seen in the IVC in the distal abdomen because the IVC is a large vein that carries deoxygenated blood from the lower body back to the heart. In the distal abdomen, the IVC experiences changes in blood flow due to respiratory and cardiac activity. During inspiration, the negative intrathoracic pressure causes an increase in venous return, resulting in increased blood flow velocity in the IVC. This leads to a phasic Doppler pattern characterized by a respiratory variation in flow velocity, with increased flow during inspiration and decreased flow during expiration.
30.
The hepatic veins display a __________ flow pattern dependent on __________ cycle and pressure variation in renal arteries.
Correct Answer
pulsatile, cardiac
Explanation
The hepatic veins display a pulsatile flow pattern dependent on the cardiac cycle and pressure variation in renal arteries. This means that the flow of blood in the hepatic veins is not constant but instead fluctuates with the beating of the heart. The pressure changes in the renal arteries also contribute to this pulsatile flow pattern.
31.
The hepatic veins will have the same waveform as the portion of the IVC closest to them.
Correct Answer
A. True
Explanation
The hepatic veins drain blood from the liver and empty into the inferior vena cava (IVC). The waveform of a blood vessel refers to the pattern of blood flow observed on a Doppler ultrasound. Since the hepatic veins are directly connected to the IVC, they will have a similar waveform as the portion of the IVC closest to them. This is because the blood flow characteristics in the IVC will be transmitted to the hepatic veins. Therefore, the statement is true.
32.
The renal veins are examined sonographically usually to rule out ____________.
Correct Answer
thrombosis
Explanation
Renal veins are examined sonographically to rule out thrombosis. Thrombosis refers to the formation of blood clots within the veins, which can obstruct blood flow and cause serious complications. By examining the renal veins, healthcare professionals can determine if there are any blood clots present, allowing them to diagnose and treat thrombosis if necessary. This examination is important as untreated thrombosis can lead to conditions such as deep vein thrombosis or pulmonary embolism.
33.
The renal veins have a _________ (high or low?) velocity, __________ signal.
Correct Answer
low, continuous
Explanation
The renal veins have a low velocity, continuous signal. This is because the renal veins carry deoxygenated blood from the kidneys back to the heart. The low velocity indicates that the blood flow in the renal veins is slower compared to other veins in the body. The continuous signal suggests that there is a constant flow of blood in the renal veins without any interruptions or pulsations.
34.
The __________ ___________ system is comprised of the veins that drain blood from the bowel and spleen and are separate from the IVC.
Correct Answer
portal venous
Explanation
The portal venous system refers to the veins that collect blood from the gastrointestinal tract and spleen and transport it to the liver. This system is separate from the inferior vena cava (IVC), which collects blood from the lower body and returns it to the heart. The portal venous system plays a crucial role in delivering nutrients and toxins from the digestive organs to the liver for processing and detoxification.
35.
The main portal vein is formed at the junction of the __________ vein and __________ vein.
Correct Answer
splenic, superior mesenteric
splenic, SMV
Explanation
The main portal vein is formed at the junction of the splenic vein and superior mesenteric vein. Additionally, it can also be formed at the junction of the splenic vein and SMV (superior mesenteric vein).
36.
To image the portal venous system, it is easiest to begin by placing the transducer in the midline of the abdomen, just inferior to the __________ __________, in the __________ plane.
Correct Answer
xiphoid process, transverse
Explanation
To image the portal venous system, the transducer should be placed in the midline of the abdomen, just inferior to the xiphoid process, in the transverse plane. The xiphoid process is a bony structure at the lower end of the sternum, and the transverse plane refers to a horizontal plane that divides the body into upper and lower sections. By positioning the transducer in this way, a clear view of the portal venous system can be obtained.
37.
When trying to image the portal venous system, which vein can be used as a reference point since it is easily seen in the transverse plane?
Correct Answer
splenic vein
SV
Explanation
The splenic vein can be used as a reference point when imaging the portal venous system because it is easily seen in the transverse plane.
38.
The splenic vein emerges from the __________ __________ and courses the abdomen running __________ (direction?).
Correct Answer
splenic hilum, medially
Explanation
The splenic vein emerges from the splenic hilum, which is the area where the splenic artery and vein enter and exit the spleen. It then courses through the abdomen, running medially.
39.
What vein borders the posterior surface of the pancreatic body and tail AND is anterior to the SMA?
Correct Answer
splenic vein
SV
Explanation
The splenic vein is the vein that borders the posterior surface of the pancreatic body and tail. It is also located anterior to the SMA (superior mesenteric artery). Therefore, the splenic vein is the correct answer to the question.
40.
At its termination, the splenic vein can be seen ___________ in caliber.
Correct Answer
A. Increasing
Explanation
The correct answer is "increasing". At its termination, the splenic vein can be seen increasing in caliber. This means that as the vein reaches its end, it becomes wider or larger in size.
41.
What is the name of the structure that is the junction of the splenic vein and the SMV and can be visualized just posterior to the neck of the pancreas?
Correct Answer
portal splenic confluence
Explanation
The structure that is being referred to in the question is called the portal splenic confluence. It is the junction where the splenic vein and the superior mesenteric vein (SMV) come together. This junction can be seen just behind the neck of the pancreas.
42.
While visualizing the portal splenic confluence, the SMV can be seen by...
Correct Answer
rotating the transducer longitudinally
turning the transducer longitudinally
43.
What vein runs parallel and to the right of the SMA?
Correct Answer
SMV
superior mesenteric vein
Explanation
The superior mesenteric vein (SMV) is the vein that runs parallel and to the right of the superior mesenteric artery (SMA). It is responsible for draining blood from the small intestine and parts of the large intestine. The SMV is an important anatomical structure in the abdominal region and plays a crucial role in the circulatory system.
44.
The main portal vein runs somewhat __________ to enter the liver at the ___________.
Correct Answer
obliquely, hilum
Explanation
The main portal vein runs somewhat obliquely to enter the liver at the hilum. This means that the vein enters the liver at an angle rather than directly. The hilum refers to the area on the liver where the blood vessels, ducts, and nerves enter and exit. So, the main portal vein enters the liver at an angle at the hilum.
45.
To view the portal vein in its long axis, rotate the transducer ___________ (clockwise or counter-clockwise?) while imaging the portal splenic confluence.
Correct Answer
clockwise
Explanation
To view the portal vein in its long axis, rotating the transducer clockwise while imaging the portal splenic confluence allows for a better visualization of the vein. This rotation helps align the transducer with the vein and improves the clarity of the image.
46.
When the portal vein reaches the liver, it soon divides into ________ and ________ portal veins.
Correct Answer
left, right
right, left
Explanation
The portal vein divides into left and right portal veins when it reaches the liver. This is because the portal vein carries blood from the digestive organs to the liver for processing, and it needs to distribute the blood to the different lobes of the liver. The left portal vein supplies blood to the left lobe of the liver, while the right portal vein supplies blood to the right lobe of the liver. Therefore, the correct answer is left, right. The answer right, left is incorrect as it does not accurately describe the division of the portal vein in the liver.