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ARDMS Abdomen Review (Based off of URR Review Course)

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ARDMS Abdomen Review (Based off of URR Review Course) What does an increased RI mean Ans- increased resistance in vascular bed What does an increased pulsatility index mean Ans- increased resistance in vascular bed Normal PI for vessels supplying organs such as kidneys Ans- < 0.75 Hydrosta...

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  • March 1, 2023
  • 103
  • 2022/2023
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ARDMS Abdomen Review (Based off of
URR Review Course)
What does an increased RI mean Ans- increased resistance in vascular bed



What does an increased pulsatility index mean Ans- increased resistance in vascular bed



Normal PI for vessels supplying organs such as kidneys Ans- < 0.75



Hydrostatic pressure:

when supine

at ankle when standing

above heart when standing Ans- 0 mmHg

100 mmHg

-30 mmHg



What vessel is the most posterior abdominal vessel Ans- aorta



Paired branches of the aorta (5) Ans- suprarenal arteries (adrenal glands)

renal arteries (kidneys)

gonadal arteries (ovaries/testicles)

lumbar arteries

common iliac arteries



Unpaired branches of the aorta (4) Ans- celiac axis (common hepatic, splenic, left gastric arteries)

SMA

IMA

median sacral artery

,What level common iliac arteries bifurcate Ans- L3-4



Decreased hematocrit may indicate what Ans- bleed in body



What happens to the aorta as you follow it distally (2) Ans- gets smaller

becomes more anterior



Aortic Ectasia Ans- lack of tapering of aorta as you move distally (can be precursor to aneurysm)



AAA

What vessel walls are involved Ans- focal dilation of aorta >3cm or >50% diameter between two
adjacent segments

all three



Most common cause of AAA Ans- atherosclerotic disease



Risk factors for AAA (4) Ans- 1. male

2. family history

3. smoking

4. chronic hypertension



Saccular aneurysm Ans- localized round out pouching, may have small stalk



Fusiform aneurysm Ans- vessel wall stretched in circumferential manner (most common)



Mycotic aneurysm Ans- infected aneurysm, seen with syphilis



Most common location of fusiform aneurysms Ans- infrarenal

,At what diameter is surgical intervention done on an AAA Ans- >5.5cm



Complications of AAA (5) Ans- 1. rupture

2. decreased blood to lower extremities

3. thrombus accumulation and embolization (blue toe syndrome)

4. affects renal circulation and systemic blood pressure (if suprarenal)

5. compress IVC



Yin Yang Sign Ans- sonographic sign with AAA

swirling of blood in body of aneurysm on color doppler



Splanchnic artery aneurysm most commonly occurs in

What gender is this more common in Ans- splenic artery

women



Aneurysm in the hepatic artery most commonly occurs in what segment Ans- extra hepatic



With endovascular aortic repair, what happens to the native aortic sac over time

What plane should it be measured in Ans- decreased in size

transverse



If aortic sac expands more than _____ between exams, a leak should be suspected Ans- 0.6 cm



Type I dissection

Type II dissection

Type III dissection Ans- ascending and descending aorta

ascending aorta, associated with Marfan syndrome

descending aorta

, Marfan syndrome Ans- genetic disorder affecting connective tissue of heart, vessels, bones



Aortic rupture symptoms Ans- back pain

hypotension



Leriche syndrome (3) Ans- aortoiliac occlusive disease

occlusion of abdominal aorta just above CIA bif

causes bilateral lower extremity ischemia symptoms



Retroperitoneal fibrosis other name, most common location Ans- Ormond disease

most commonly at aortic bifurcation and inferiorly in pelvis



Retroperitoneal fibrosis sonographically (4) Ans- soft tissue mass surrounding great vessels

hypoechoic

smooth borders

possible hydronephrosis (due to ureteral obstruction)



Abnormal dilation of the abdominal segment of the IVC measures Ans- > 2.5 cm



Normal Doppler flow of the IVC is Ans- triphasic



Most common variation of IVC anatomy Ans- duplicated IVC

infrarenal segment duplicated with left IVC entering left renal vein (suprarenal IVC normal)



Transposed IVC Ans- IVC on left side of abdomen (instead of right)



Interrupted IVC (3) Ans- IVC doesn't go to right atrium

enters azygos/hemiazygos veins to reach SVC

no intrahepatic segment

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