CEA. Flashcards

1
Q

carotids

A

almost identical to coronaries; disease in one is linked to disease in another

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2
Q

carotid disease

A

smooth muscle proliferates, plaque, thrombus - middle cerebral artery

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3
Q

s/s

A

bruit, listen w bell, pt hold breath and turn head slightly toward you; hx of TIA - confusion, dysphagia, unilateral motor weakness, expressive aphasia; amaurosis fugal - monocular blindness: like a shade over the eye

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4
Q

dx

A

with physical exam, carotid doppler, hx: TIA, visual disturbance, numbness, tingling, doppler, MRA

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5
Q

tx

A

check for CAD; if coronary surgery: TIA, if carotid surgery: MI
stent the carotids; plaque will embolize; cath has an umbrella device, then balloon and stent, remove umbrella.

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6
Q

post-op complications

A

stroke - leading cause of disability, 3rd leading cause of death
hemodynamic instability
intra-cerebral hemorrhage
MI

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7
Q

procedure

A

clamp carotids, clean quick, patch w vein or synthetic, some shunt, some use EEG

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8
Q

considerations

A

neuro checks: CN - 5: facial drooping, 7: smile, 9: swallow/gag, 10: talk, 11: shoulder shrug, 12: tongue deviation
bleeding/swelling could compromise airway
choking: eat upright, small bites, liquids
hemodynamic instability: hypotension b/c baroreceptors; htn b/c denervation of the carotid sinus
intra-cerebral hemorrhage
stroke
MI: common to have both diseases

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9
Q

NEVER PUT SURGICAL SITE

A

DOWN B/C GRAVITY

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10
Q

NEVER DO BOTH SIDES

A

AT THE SAME TIME

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11
Q

DO THE WORST

A

SIDE FIRST

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