Anatomy of Venous Ulceration Flashcards
At the inguinal ligament, what does the left external iliac artery become?
left femoral artery, then the left popliteal artery, which then bifurcates into the left anterior tibial artery and the left posterior tibial artery
What is the dorsalis pedis artery a continuation of?
ant. tibial artery
What do the medial and lateral plantar arteries bifurcate from?
posterior tibial artery
What is the name for a dorsal arch?
arcuate artery
What does untreated occlusion of an end artery result in?
infarction of the occluded area
What should you not use when performing surgery in the vicinity of end arteries?
local anaesthetic solution containing adrenaline
How can experienced doctors limit blood loss at the scene?
pressing on a pulse point (or applying a tourniquet) proximal to the injury
Where can a pulse in the neck be felt?
bifurcation of the common carotid artery
anterior to sternocleidomastoid muscle at level of upper border of thyroid cartilage
Where is the brachial artery pulse palpated?
medial to biceps tendon in the cubital fossa
Where is the radial artery pulse palpated?
lateral to tendon of flexor carpi radialis
Where is the femoral pulse palpated?
inferior to midpoint of inguinal ligament
Where is the popliteal pulse palpated?
in popliteal fossa (immediately posterior to knee joint)
Where is the posterior tibial pulse palpated?
between the posterior border of the medial malleolus & the achilles tendon
Where is the dorsalis pedis pulse palpated?
medial to tendon of extensor hallucis longus distal to the ankle joint
What two main categories of problems can ischaemia cause in blood vessels?
reduced arterial perfusion pressure
increased venous drainage pressure
What does reduced arterial perfusion pressure cause?
left ventricular failure
arterial bleed (injury)
arterial rupture (aneurysm)
occlusion of lumen (atherosclerosis: PVD)
arterial spasm
external compression of arterial supply (e.g. tumour/compartment syndrome/crossing legs!!/inflammation/ tamponade)
What does increased venous drainage pressure cause?
right (or congestive) cardiac failure
DVT
external compression (e.g. tumour…)
Where is the cubital fossa?
anterior aspect of elbow region
What does the basilic vein drain into?
brachial vein at level of mid-arm
What does the cephalic vein drain into?
the axillary vein which becomes the subclavian vein at the lateral border of rib 1
8% of patients have no connecting veins in the what?
cubital fossa
What does the great saphenous vein drain into?
femoral vein
What does the small saphenous vein drain into?
popliteal vein
What type of veins does the calf muscle pump involve?
deep veins
In what direction does venous blood normally flow?
normally flows from the superficial veins into the deep veins AND from distal to proximal
What happens when valves are incompetent?
Reverse flow into superficial veins which can then dilate (varicose veins)
Varicose veins are a predisposing factor for which 2 things?
development of DVT and venous ulceration
What actually causes skin ulceration to happen?
chronic venous insufficiency causing superficial microcirculatory deficiencies
What type of infarction is caused if the small peripheral artery is occluded?
small wedge infarction
What type of infarction is caused if the segmental artery is occluded?
infarction of bronchopulmonary segment
What type of infarction is caused if the lobar artery is occluded?
middle lobe infarction
What type of infarction is caused if the pulmonary artery is occluded?
infarction of one entire lung
complete occlusion of the what arrests the circulation?
pulmonary trunk by a saddle embolus
Give 3 complications of skin biopsy.
bleeding (damage to superficial veins)
motor or sensory nerve damage
loss of function
Location of the sentinel node is determined using what?
preoperative lymphoscintigraphy
How should you close a wound of an elliptical excision?
simple interrupted sutures
Describe the distance from the great saphenous vein to the patella?
one hands breadth MEDIAL to medial border of patella
Where is the great saphenous vein in relation to the malleolus?
immediately ANTERIOR to the MEDIAL malleolus
What type of fascia is relatively tough and has a sheet-like, white, sometimes glistening, appearance?
deep fascia
What does this describe: fibrous bands connecting deep fascia to skin – sometimes numerous?
skin ligaments
Where should you look for aggregates of adipocytes?
limb superficial veins in superficial fascia
