APE 5: Peripheral Vasculature and the Autonomic Nervous System Flashcards

1
Q

Where is the subclavian artery found?

A

Between the clavicle and the first rib

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2
Q

What is the origin of the right and left subclavian artery?

A
Right= from the brachiocephalic trunk
Left= from the arch of aorta
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3
Q

How is the subclavian artery divided, based on its position relative to the anterior scalene?

A

First part= origin of subclavian artery to medial border of anterior scalene
Second part= posterior to anterior scalene
Third part= lateral border of anterior scalene to lateral border of first rib

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4
Q

Where does the subclavian artery become the axillary artery?

A

At the lateral border of the first rib

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5
Q

Where does the axillary artery become the brachial artery?

A

At the distal border of the teres major

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6
Q

How is the axillary artery divided, based on its position relative to the pectoralis minor muscle?

A

First part= proximal to pec minor
Second part= posterior to pec minor
Third part= distal to pec minor

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7
Q

What does the brachial artery bifurcate into?

A

The radial and ulnar arteries

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8
Q

Where does the brachial artery normally bifurcate into the radial and ulnar arteries?

A

About 1cm distal to the bend of the elbow, roughly at the level of the neck of the radius

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9
Q

Which three structures lie in the cubital fossa?

A

Biceps tendon, brachial artery and median nerve

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10
Q

Why would a clinician become very familiar with the brachial artery?

A

To measure blood pressure

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11
Q

What are the borders of the cubital fossa?

A

Lateral border= medial border of the brachioradialis muscle
Medial border= lateral border of pronator teres muscle
Superior border= hypothetical lines between epicondyles of humerus

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12
Q

What is the route of the ulnar artery in the forearm?

A

Descends to the anterior compartment and enters the palm anterior to the flexor retinaculum

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13
Q

What is the route of the radial artery?

A

Crosses the lateral aspect of the wrist beneath tendons that pass to the thumb, and passes into the posterior aspect of the hand

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14
Q

What is the anatomical snuffbox?

A

Triangular area bounded by tendons

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15
Q

Give 2 reasons why a clinician will be familiar with the radial artery?

A
  • taking a pulse

- arterial blood gas

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16
Q

Which 2 palmar arteries are there?

A

Superficial and deep

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17
Q

What are venae comitantes?

A

A pair (or more) of veins

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18
Q

Which vein drains the blood from the upper half of the body?

A

The superior vena cava

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19
Q

What does the superior vena cava bifurcate into?

A

The left and right brachiocephalic veins

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20
Q

What are the two superficial veins of the upper limb?

A

Cephalic and basilic

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21
Q

What is the positioning of the cephalic and basilic veins?

A
Cephalic= lateral, radial side
Basilic= medial, ulnar side
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22
Q

Where does the cephalic vein drain into the deep venous system?

A

In the delto-pectoral groove

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23
Q

Where does the basilic vein drain into the deep venous system?

A

Cubital fossa

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24
Q

What is the antecubital fossa and where does it lie?

A

A shallow depression anterior to the elbow, where the median cubital vein is found

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25
Q

Why would a clinician be familiar with the ante-cubital fossa?

A

Venupuncture

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26
Q

What does the abdominal aorta divide into?

A

The two common iliac arteries

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27
Q

At which vertebral level does the abdominal aorta bifurcate?

A

L4

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28
Q

What are the two divisions of the common iliac artery?

A

Internal and external

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29
Q

What does the internal iliac artery supply?

A

The pelvis

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30
Q

Where does the external iliac artery pass into?

A

The inguinal ligament

31
Q

What is the position of the femoral artery?

A

Medial to the femmoral nerve

Lateral to the femoral vein

32
Q

Where can the pulse of the femoral artery be felt?

A

At the mid-inguinal point

33
Q

What is the importance of the femoral artery at the mid-inguinal point?

A

It is where blood samples are taken for blood gas determination and taking pulse

34
Q

Where is the inguinal ligament found?

A

Between the pubic symphysis and the ASIS

35
Q

Which profession is commonly associated with penetrating wounds involving the femoral artery?

A

Butchers

36
Q

Where does the profunda femoris artery arise from?

A

The lateral and posterior part of femoral artery, 2-5cm below the inguinal ligament

37
Q

What does the profunda femoris artery supply?

A

The head and neck of the femur

38
Q

What would a fracture to the head and neck of the femur cause?

A

Death from avascular necrosis

39
Q

What are the borders of the femoral triangle?

A

Superior border= inguinal ligament
Lateral border= medial border of sartorius muscle
Medial border= medial border of adductor longus muscle

40
Q

What is the arrangement of the neurovascular structures in the femoral triangle?

A
N- femoral nerve
A- femoral artery
V- femoral vein
E- empty space
L- lymph canal
(outside to inside)
41
Q

What is the importance of the empty space in the femoral triangle?

A

Allows veins and lymph vessels to distend, so they can cope with diff levels of flow

42
Q

Where does the femoral artery cross?

A

The posterior aspect of the thigh

43
Q

Where is the femoral artery accessed?

A

The base of the femoral triangle

44
Q

Which medical procedures use the femoral artery?

A

Coronary angiography

45
Q

When does the femoral artery become the popliteal artery?

A

When it enters the popliteal fossa

46
Q

What are the two branches of the popliteal artery?

A

Anterior and posterior tibial arteries

47
Q

What does the anterior tibial artery branch into?

A

Dorsalis pedis artery

48
Q

What does the posterior tibial artery branch into?

A

Fibular artery

49
Q

Where does the fibular artery run?

A

It descends along the medial side of the fibula

50
Q

What is a popliteal aneurysm and how can it be detected?

A
  • dilation of popliteal artery
  • compresses tibial nerve
  • detected by palpable pulsation in popliteal fossa (swelling behind the knee)
51
Q

What are the 2 superficial veins of the lower limb?

A

Great and small saphenous veins

52
Q

Where does the great saphenous vein run?

A

Posterior to the knee and anterior to the medial malleolous

53
Q

What is the great saphenous vein used for?

A

Emergency fluid resuscitation

54
Q

Where does the small saphenous vein run?

A

Starts at the continuation of the veins in the lateral side of the dorsum of the foot, then runs proximally, posterior to the lateral malleolus

55
Q

Where does the small saphenous vein drain into?

A

The popliteal fossa

56
Q

What happens when veins have incompetent connections to the deep system?

A

They become varicosed

57
Q

What does the pooling of blood in the deep veins of the lower limb result in and what can it be caused by?

A

Deep Vein Thrombosis

Can be caused by sitting on a long flight for example

58
Q

What is the saphenous vein often used for?

A

Graft to bypass a narrowing of the coronary arteries

59
Q

What is found in the neurovascular bundle of the neck?

A

Common carotid artery, internal jugular vein and vagus nerve

60
Q

What are the borders of the carotid triangle/anterior triangle of the neck?

A
Superiorly= inferior border of mandible
Laterally= anterior border of sternocleidomastoid
Medially= sagittal line down the midline of the neck
61
Q

What are the 2 common carotid arteries and what do they supply?

A
External= supplies the face
Internal= enters the skull and supplies the brain
62
Q

What are the two different origins of the subclavian artery on the right and left?

A
Right= brachiocephalic trunk
Left= aorta
63
Q

What is the first, and largest, branch of the subclavian artery?

A

Vertebral artery

64
Q

Where does the vertebral artery run?

A

Posteriorly towards transverse foramen of 6th cervical vertebra and then cranially through the foramina of the transverse processes

65
Q

Where do the vertebral arteries give rise to the posterior cerebral arteries?

A

After they enter the foramen magnum

66
Q

What do the posterior cerebral arteries contribute to?

A

The Circle of Willis

67
Q

Where does the external jugular vein run?

A

From the base of the skull, on a level with the angle of the mandible, to where it drains into the deep venous system

68
Q

Why is the external jugular vein important in clinical examination?

A

Used for venous access during cardiac arrest

69
Q

Where does the internal jugular vein begin?

A

In the posterior compartment of the jugular foramen at the base of the skull

70
Q

Why is the internal jugular vein commonly used for clinical intervention?

A

Observed for pulsations to give an estimation of right atrial pressure

71
Q

What landmarks are used to identify the position of the internal jugular vein?

A

On either side of thyroid gland, above clavicle, found in the carotid triangle

72
Q

What are the 2 components of the autonomic nervous system and what is their outflow?

A

Sympathetic- thoraco-lumbar outflow

Parasympathetic- cranio-sacral outflow

73
Q

How does the sympathetic chain communicate with the spinal nerves?

A

Via white and grey rami communicantes

74
Q

Which of the sacral nerves carry parasympathetic outflow?

A

S2-4