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Adv. Vas. Son.
Test 3 Abdominal Doppler IVC
| Question | Answer |
|---|---|
| Where does the IVC begin? | Begins at the level of the 5th lumbar vertebra |
| Where is the IVC? | Retroperitoneal and lies to the right of the abdominal aorta |
| Where does the IVC course? | Courses posterior to the liver |
| What does the IVC terminate into? | The RA |
| Where does the IVC receive blood? | Receives blood from organs and tissues below the diaphragm |
| What does the IVC do? | Returns deoxygenated blood back to the heart |
| What is the IVC diameter in a well hydrated PT? | ~17-20 mm |
| When would Megacava occur? | In CHF PTs |
| Small diameter IVC can occur in who? | Dehydrated PTs |
| Major tributaries of the IVC: | Renal Vs (R&L), Hepatic Vs (R,M,&L), Lumbar Vs, Ovarian/Testicular Vs |
| Where does the left ovarian or testicular vein typically drains into? | Left renal vein |
| What are the left Ovarian/Testicular is also known as what? | Gonadal/Gonal |
| What TD to use? | Low freq 2-5 MHz TD |
| If you press too hard what will happen? | You'll compress the IVC |
| NORMAL IVC and iliac veins have what? | Echogenic, muscular walls, Lumen should be anechoic, and Diameter may change with respiration |
| What should Gray scale images be evaluated for? | Thrombosis, Intraluminal tumors, Extrinsic compression |
| Thrombosis may result from? | Propagation of lower extremity thrombosis |
| Thrombosis findings may include: | Distended vein with echogenic material in lumen (echogenicity of thrombus increases as it ages), Free-floating material w/in vessel |
| Neoplastic Obstruction means what? | A tumor has grown into the IVC |
| Intraluminal tumor: | Usually arise from hepatic or renal veins, Moderatley echogenoic mass, vascularity is usually demonstrated |
| Extrinsic Mass: | May completely or partially obstruct IVC or iliac veins, Dilated collateral veins may be present, Distention of IVC and iliac veins |
| IVC diameter varies with: | Respiration and the cardiac cycle- Ranges form 15-25 mm, Dependent on PT size, Right atrial pressure and fluid overload or heart failure |
| What does the Valsalva Maneuver do? | Blocks venous return and flow is temporarily reversed in IVC, Also caused dilation of IVC |
| What happens to the IVC with obstruction? | IVC dilates below level of obstruction, Respiratory changes are decreased or absent |
| Abnormal findings with the IVC include: | Visible tissue bruit (may be associated w/ fistula), Pulsatile flow, Direct connection between IVC and other vessels (difficult to visualize), & Lack of color filling |
| What is Power Doppler useful for? | Detecting slow flow states that are common in the venous system |
| NORMAL flow in the IVC should be what? | Respiratory phasic and may show slight pulsatility from the cardiac cycle. ↑ed pulsatility closer to the heart, Flow pattern becomes more respiratory phasic in the lower abdomen, severe fluid overload may cause ↑ in cardiac pulsatility |
| Lack of respiratory phasicity &/or cardiac pulsatility is an indication of? | IVC &/or iliac obstruction |
| What is the Peak velocity range? | 44-118 cm/s |
| What is iliac vein compression syndrome? | Occurs when left common iliac vein is compressed by right common iliac artery |
| What is iliac vein compression syndrome also known as? | May-thurner syndrome |
| What does iliac vein compression syndrome present itself as? | Left iliofemoral DVT, May also cause chronic left lower extremity pain and edema |
| Iliac vein compression can be seen on grey scale and with color and spectral doppler, how? | Lack of respiratory phasicity distal to compression and ↑ed flow velocity at point of compression |
| What is an IVC interruption device? | A device used to protect PTs from pulmonary emboli (Trap thromboemboli from lower extremity DVT) |
| Where is an IVC interruption device typically placed? | Distal to the renal veins |
| What does an IVC interruption device consist of? | Thin metal struts joined at one end (cone-shaped) |
| If a strut perforates the IVC wall what may it cause? | May cause hematoma, The hematoma may be seen but not the penetrating strut |
| In TRV how does the device appear? | As central echogenic dot in IVC lumen |
| In SAG how does the device appear? | Linear, echogenic structures are seen in the IVC lumen |
| IVC filer placement is traditionally performed under what? | Contrast venography guidance, must be done in an Operating Room or interventional radiology suit |
| The use of duplex ultrasound can do what? | Move the procedure bedside, does not require exposure to radiation or intravenous contrast |
| Where should filters be placed? | Distal to renal veins, Can use right renal artery as landmark when veins can't be visualized |
| Where is the right renal artery? | Identified posterior to the IVC in a sagittal plane |
Created by:
EmilyGriffin
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