487753
Beschreibung
Karteikarten von ecmarchese, aktualisiert more than 1 year ago
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Erstellt von ecmarchese
vor mehr als 10 Jahre
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| Frage | Antworten |
| What is the patient prep for a normal abdominal exam? | NPO after midnight, no smoking, no chewing gum |
| What medical things in a patients history will bring them in for a abdominal imaging? | Hepatocellular disease, abdominal pain, known hd, renal failure, hx of surgical intervention/ shunts |
| How should the patient be positioned? | Supine and or left lateral decubitus position |
| What windows are utilized in an abdominal exam? | Sub costal and intercostal windows |
| How do you optimize the image on the screen during an abdominal exam? | Breathing techniques |
| The standard abdominal Doppler examination Should consist of? | 2d gray scale, color Doppler, spectral doppler |
| The angle of isolation must be _______ to the vessel and to flow to ensure accurate Doppler interrogation. | Parallel |
| The Doppler angle should be ______ to obtain the maximum peak systolic velocity. | Less than 60 |
| Where should the sample volume be placed during Doppler? | Mid portion of the lumen |
| If your angle is too big during Doppler what will happen? | Falsely elevate velocities |
| If your Doppler angle is too small what how will it effect your velocities? | Falsely decrease velocities |
| What is the purpose of abdominal Doppler? | Provide valuable hemodynamics information |
| A sonographer must be familiar with what 3 things? | Vessel location, normal sonographic appearance, Doppler characteristics |
| What are some examples of Doppler characteristics? | Phasicity, resistance, direction of flow, velocity, normal flow dynamics |
| What causes Phasicity of blood flow? | Breathing and muscle contractions |
| Process of recurring cycles | Cyclical |
| What are the causes of cyclical pressure fluctuations? | Cardiac cycle (arterial) breathing (venous) |
| Demonstrates velocity and acceleration fluctuations. Generally cyclical in appearance. | Phasic blood flow |
| Pulsation, phasic flow pattern secondary to proximity to the right atrium. | Hepatic vein |
| What does flow in the hepatic veins reflect? | Atrial function |
| Hepatic vein pulsatility is partially transmitted to the ______ through the ______ | Portal vein, hepatic sinusoids |
| What happens as the hepatic veins empty into the IVC/ RA | Blood flow to the liver increases |
| An indicator of resistance to perfusion | Resistive index |
| What does Doppler spectral analysis reveal? | Systolic and diastolic flow |
| Systolic- diastolic/ systolic | Resistive index |
| Flow during systole, flow only when the heart is pumping | Higher resistive index |
| Flow during systole and diastole, flow when the heart is pumping and when at rest. | Lower resistive index |
| Visceral vessels that feed our organs | Splanchnic |
| What is a normal aortic Doppler? | Anechoic, pulsatilla waveform, mixed resistance (feeds high and low resistant vessels) |
| What are the aortic branches? | Celiac axis, hepatic/ splenic, SMA, rentals, gonadals, IMA |
| What does the celiac axis looks like in 2D? | T or seagull sign |
| What does the waveform for the celiac axis look like? | Continuous flow thought diastole, low resistant |
| Arises from the celiac axis, and courses to the right towards the liver. | Hepatic artery |
| What does the waveform look like in the hepatic artery? | Continuous flow throughout diastole, low resistance, hepatopetal |
| What two arteries arise from the celiac axis? | Hepatic, splenic |
| Arises from celiac axis, courses to the left toward the spleen | Splenic artery |
| Is the splenic artery very tortuous? | Yes |
| What does the waveform for a splenic artery look like? | Continuous flow throughout diastole, low resistant |
| Courses parallel and anterior to the aorta, and surrounded by an echogenic ring. | Superior Mesenteric Artery |
| The SMA has 2 different wave forms what are they? | Fasting, postprandial |
| The bowel is not actively needed, so blood flow is not on high demand, high resistant with minimal diastolic flow | Fasting |
| The bowel is active during digestion, so blood is needed, resulting in a low resistant waveform | Postprandial |
| Branch from the lateral aspect of the aorta | Renal arteries |
| What should the waveform look like for the renal arteries? | Low resistant with continuous diastolic flow |
| Branch from the aorta, low resistant | Gonadal arteries |
| Anechoic, courses through liver posterior to the left lobe, diameter fluctuations | IVC |
| What are the normal Doppler characteristics for the IVC? | Low resistance, phasic with respiration, pulsatile the closer to the right atrium |
| What does hepatopetal flow do? | Delivers nutrient rich blood to liver, and delivers oxygen rich blood |
| What veins deliver nutrient rich blood to the liver? | Splenic vein, SMV/ Portal confluence, portal vein |
| What delivers oxygen rich blood to he liver? | Hepatic artery |
| What does hepatofugal flow do? | Removes deoxygenated blood |
| Which veins remove deoxygenated blood? | Hepatic veins (left, right, middle) |
| What are the normal Doppler characteristics for the splenic vein, SMV, and portal confluence | Phasic, low velocity, hepatopetal |
| Portal and splenic flow will ___with inspiration and ___with expiration | Down, up |
| Will the portal and SMV increase flow or decrease after eating? | Increase flow |
| What is the normal Doppler characteristics of the portal vein? | Wall to wall color filling, low resistance, phasic, hepatopetal (above the baseline) |
| What is the normal portal vein velocity? | 16-30 cm/s |
| What are the 3 main hepatic vein branches? | Right, left,middle |
| What is the best way to view the hepatic veins? | Transverse subcostally |
| Play boy bunny appearance in 2D | Hepatic vein |
| What is the hepatic veins normal waveform? | Hepatofugal, pulsatile, phasic, low velocity, velocity changes with respiration, blue color filling |
| Reflection all or periodicity means? | Phasic or cyclical |
| The a wave on an ECG represents? | Atrial contraction |
| The S wave on an ECG represents? | Ventricular systole |
| The v wave on an ECG represents? | RA getting full, not much blood enters the liver |
| The d wave on and ECG represents? | As TV opens, more blood enters RA from liver (at the end of d wave the RA is empty again) |
| Will hepatic flow change if a patient holds his breath? | Yes |
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