Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Son. theory > 108 > Flashcards

108 Flashcards

1
Q

Deep system consists of:

A
  1. IVC: connects CIV to rt atrium
  2. CIV: internal and external iliac veins
  3. IIV: drains blood from pelvis aka hypogastric vein
  4. EIV: extends to inguinal ligament
  5. CFV: inguinal ligament to bifurcation
  6. FV P,M,D, and PFV
  7. Pop V: runs behind knee, connects anterior tibial vein
  8. ATV: drains anterior calf and foot, paired veins
  9. PTVS: drains medial and posterior calf and foot
  10. PER VS: drain medial and posterior calf
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Superficial system consists of :

A

GSV and SSV

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

why would we see pulsatility in CFV or POP V?

A

increased resistance due to CHF causes pulsatility

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are the three systems in the leg for a pump?

A
  1. Foot pump: primes the calf pump
  2. Calf veno motor pump: major ejection
    3: thigh pump: ejects thigh blood volume
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is venous thromboembolism?

A

Generic term for saying there is a clot in the venous system (superficial, deep, or even PE in lungs)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Phlegmasia cerulean dolens

what is it? why does it happen? what do we see?

A
  1. has a high predictive positive value (PPV) for DVT
  2. Iliofemoral outflow obstruction presents as massive thigh/calf swelling. blood is trapped so calf swells up
  3. pt is in pain, and leg looks purple
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Superficial thrombophlebitis

A

Not life-threatening unless thrombus extends into deep system, but its more painful than DVT
Symptoms include:
erythema/ inflammation
tenderness
palpable cord or mass(might be able to feel blood clot)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Acute DVT

A
  • happened during a short period of time
  • weakly echogenic or partially anechoic thrombus (heterogeneous)
  • poorly attached thrombus, spongy texture and dilated vein
  • we can get acute DVT if we have a chronic DVT
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Chronic DVT

A
  • highly echogenic thrombus (hyperechoic)
  • well attached thrombus
  • rigid/fibrous texture
  • vein smaller than artery
  • recannalization and or venous webbing (blood is beating down on door of clot so little webs are created to get blood moving again
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

May Thurner Syndrome

what is it? why does it happen? what do we see?

A
  1. thrombosis of left iliac vein
  2. caused by compression of the overlying right iliac artery
  3. leg is swelling, color change, erythema and warmth
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What must you compare before ruling out iliac obstruction?

A

must compare bilateral CFV waveforms to rule out iliac obstruction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

A) You’re scanning bilateral CFV’s, Lt CFV is a flat line, while Rt CFV shows phasic flow. Where is the clot located?
B) If both waveforms are flat, where is the clot?

A

A) Clot is in the left CVF

B) Clot is either in both CFV and the IVC, or just IVC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

a) Having a flat line on venous flow means …

b) Having pulsatile flow in venous flow means…

A

a) we have a clot

b) we have cardiac influence, could be CHF

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Spontaneity is

A

flow within the vein occurs on its own

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Phasicity is

A

flow ceases with inspiration, resumes with expiration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Augmentation is when

A

flow increases towards heart when vein is compressed distal to the site

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Valsalva maneuver

A

pushing down on pt belly and flow stops

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Symptoms for UVE

A
  • pain and swelling in arm
  • local erythema, palpable cord
  • dilated superficial veins of arm/shoulder
  • chest pain, SOB (if PE)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Deep veins of upper extremity

A
  • SVC (drains blood from arms to rt atrium)
  • Innominate (joins to form SVC)
  • Subclavian (runs above clavicle from innominate to axillary)
  • Axillary (begins at lateral margin of first rib)
  • Brachial (usually paired axillary vein to elbow)
  • ulnar (brachial wrist to pinky side) and radial (brachial wrist to thumb side)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Superficial veins in UE

A
  • basilic (joins brachial v to from axillary {travels medial side)
  • Cephalic (from axillary v travels down lateral arm{outer side of arm)
  • Median cubital: connects cephalic and basilica at elbow
21
Q
  • What is the subclavian vein assessment?

- contralateral assessment?

A
  • Subclavian vein cannot be compressed due to clavicle but we can do sniff test (only if you have reason to) and we must use color and doppler
  • its important and required by ICAVL that a comparison be made with the contralateral subclavian vein in the same spot
22
Q

Pulsatility is

A

related to cardiac nature, arterial waveforms

23
Q

What do you do to look for thrombosis on the upper peripheral veins?
b) what do you do to look for thrombosis in the upper central veins such as clavicle?

A

a) use compression

b) use grayscale, color and doppler

24
Q

Paget-Schroetter

(what is it? how does it happen? what do we see?0

A
  1. Spontaneous thrombosis of subclavian or axillary vein
  2. repeated extrinsic compression of subclavian and axillary vein can lead to this (Sylvester Stallone)
  3. veins pop out, looks like Swiss cheese on US
25
Q

Superior vena cava syndrome (what is it? how does it happen? what do we see?)

A
  1. Occlusion or compression of SVC, increasing venous pressure
  2. Clot in SVC, blood won’t be able to get to heart so it creates buildup and increases venous pressure
  3. Edema of neck face and arms usually bilaterally
26
Q

LEA symptoms (6)

A
  • no limb swelling
  • intermittent pain when walking
  • foot/limb coolness and pallor
  • rest pain
  • gangrene, tissue necrosis
27
Q

What is reflux?

A

Abnormal reversed flow direction

28
Q

What is tumescence in venous ablation?

A

Injecting saline and lidocaine to cause local swelling around vein to be “cooked”; acts as heat absorber and prevents burns to underside of skin

29
Q

What is an in situ vein bypass?

A

GSV remains in place, valves are excised with a valvulatome, perforating veins and tributaries are ligated and cut, and prox GSV is cut and sewn into CFA

30
Q

What factors govern (control) arterial flow?

A
  • cardiac output
  • intraluminal wall resistance
  • arterial wall compliance
31
Q

A person who is at rest that has arterial occlusive disease…

A

do not have a lot of blood getting down to capillary bed being in a resting state

32
Q

What are the 4 indirect physiologic testing (blind testing)?

A
  1. Pressure assessment (ABI/segmental pressures)
  2. Plethysmography (PVR and PPG)
  3. Doppler waveform analysis
  4. Exercise stress testing
33
Q

Pros and Cons of using PPG in segmental pressures

A

pros:
convenient, requires less skill, bilateral capability
cons: ambient light interference, no audible pulse, not good for severe disease

34
Q

What is considered normal ABI?

A

0.9-1.3
>1.3= likely calcified
<0.9= abnormal
<0.8= probably claudication (pt is limping)
<0.5= multilevel disease(more than 1 cuff seperated) or long segmental occlusion (2 or more cuffs back to back)
<0.3=ischemic rest pain (pt needs to rest legs off of bed when at rest)

35
Q

What is considered in flow disease?

A

Aorta to iliac arteries

36
Q

What is considered normal TBI (toe brachial index)?

A

Normal = >0.75
abnormal= <0.66
in between is inconclusive

37
Q

When do you see calcified arteries show up in indirect testing?

A
  • In diabetic pt
  • chronic steroid therapy
  • renal dialysis pt
38
Q

In presence of calcified arteries, what methods must you use instead of segmental pressures?

A

PVR, CW doppler or even toe pressures (toe pressures will probably be inaccurate)

39
Q

Who do we exercise for stress testing?

A
  • patients that complain when walking (intermittent claudication)
  • ABI is 0.85-0.4
  • if resting study is normal but pt has pain when walking
40
Q

If pt has symptoms occur only at rest and the resting study. is normal, do we exercise the pt?

A

No bc that is rest pain

41
Q

What are the contraindications for treadmill exercise?

A
  • questionably cardiac status
  • resting ischemia (ABI <0.3)
  • ischemic ulceration
  • poor ambulatory
  • normal resting study with resting symptoms but no claudication
42
Q

What diameter must the GSV be to have a high graft patency rate?

A

Greater than or equal to 2.5mm. less than 2.5mm will have high failure rate
NOTE: >2mm is too small (unsuitable) and must evaluate contralateral GSV (opposite leg)

43
Q

What is the bypass graft evaluation consist of

A
  1. identify graft type and location
  2. perform ABI
  3. Use color and spectral to evaluate blood flow
44
Q

You evaluate the entire graft for:

A
  • stenosis
  • wall irregularity
  • aneurysms/pseudo
  • AV fistulas (in situ only)
  • Partially excised valve leaflets
45
Q

In a 50% graft stenosis what do we have?

A

PSV is greater than or equal to 150cm/sec and velocity ratio of greater than or equal to 2.0
NOTE: if velocity ratio is >= 3.5 and PSV >300cm/s pt needs intervention to prolong graft latency (its failing)

46
Q

PSV for in stent restenosis for Superficial femoral artery (SFA)
for 50%-79% and 80%

A
  • 50-79%: PSV >190 and velocity ratio is 1.5

- 80%: PSV>275

47
Q

What are is a contraindication for UEA?

A

Do not perform arm pressure measurement in arm with a graft, use PVR assessment or CW doppler

48
Q

Symptoms of UEA disease?

A
  • arm and or hand weakness
  • reduced or absent pulses
  • hand numbness/weakness/pain that is positional
  • ischemic fingers
  • cold sensitivity
49
Q

For radial artery harvest (CABG) what must you evaluate?

A

Palmar arch patency

Son. theory (2 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions