Chapter 15- Misc Conditions/Tests Flashcards
the compression of nerves, arteries, or veins
thoracic outlet syndrome
What is thoracic outlet syndrome usually a result of?
result of an extra first rib or old fracture of collarbone. This reduces the space of vessels and nerves
The different types of thoracic outlet syndromes-
Neurogenic- most common- pain and weakness
Venous- swelling, pain, and bluish discoloration
Arterial- pain coldness and paleness of are
Symptoms of thoracic outlet syndrome
numbness, tingling, pain in shoulder or arm-worse when they raise their arm
What kind of person is most susceptible to popliteal artery entrapment syndrome?
a young athletic male
the compression or occlusion of the pop artery due to abnormal relationship with medial head of gastrocnemium
popliteal artery entrapment syndrome (PAES)
What is the most common symptom for popliteal artery entrapment?
intermittent claudication. often bilateral.
What is the most common type of patient with buerger’s disease?
a male who is a heavy smoker.
Name type twos of arteritis diseases.
Buergers and Takayasu
What are the main differences versus buergers and takayasu arteritis?
Buergers affects the small vessels in the upper and lower extremities versus takayasu affects the large vessels such as aorta.
What would a patient with Buerger’s disease present with?
hand or foot ischemia, rest pain or ulcerations.
Takayasu arteritis is often referred to as??
the pulseless disease. (upper extremities)
imnflammation of the arterial wall of the superficial temporal artery
temporal arteritis
If temporal arteritis goes uncured, it can lead to…
blindness
Temporal arteritis often has what sonographic appearance?
halo around the vessel.
Patients with Raynaud’s phenomenon may present with….
whiteness, redness, or bluish skin discoloration, numbness and pain or digits. Once the vasospasm resolves the area then turns red and may have a burning sensation.
What are the difference between primary and secondary Raynauds?
Primary- just vasospasm, no eiotlogy
Secondary. secondary to connective tissue disorder, smoking, gangrene, necrosis.
When doing a PPG waveform, if we see a peaked waveform, what should we suspect?
Raynauds
Why is a pseudo (false) aneurysm not considered a true aneurysm?
It does NOT involve all three layers like a true aneurysm would.
Describe what a pseudoaneurysm is?
A defect or hole in the arterial wall often from trauma or hospital acquired.
What is the most common area for a pseudo-aneurysm to form?
CFA (usually used for arterial access)
How do we sonographically diagnose a pseudo aneurysm?
Look for the neck as well as “ to and fro” waveform which is the blood flow coming in and out of the “sac”`
What is the most common treatment for a pseudo aneurysm?
Thrombin injection- physician injects it into the sac and thrombus occurs within seconds.
What is the primary risk of treating a pseudo aneurysm with a thrombin injection
thrombin migration into the artery.
an abnormal connection between artery system and venous system
Arteriovenous fistula
If a patient has an AVF (fistula) more closer or central to the heart, what does that put the patient at risk for?
potential heart failure
How would The connection between the artery and vein in an AVF look on Doppler?
very high velocity, aliasing TURN UP PRF
On the arterial side closest to the AVF, what would this look like on Doppler?
very disturbed
What are the symptoms of compartment syndrome?
Tenderness, pain, nerve injury
What is the treatment for compartment syndrome?
fasciotomy (the fascia is cut to relieve tension or pressure.
What is the technique called that determines whether a wound is capable of healing?
Transcutaneous oximetry.
Explain the process of the transcutaneous oximetry
Electrode heats skin to 45 degrees C.
Increases blood flow
Heat melts the lipid fatty layer
Increased amounts of oxygen escapes into skin
This oxygen creates a chemical reaction and converts this to a current (our number)
If a patient has a PO2 of >50 mm, their wound is likely to heal
true
If a patient has a PO2 of less than 30 mm/hg, there is a good chance the would will NOT heal..
True
What is a Hydrophone?
this is a microphone that detects sound waves underwater.
The ___ (ulnar/radial) artery is the main supplier to the hand
ulnar (side near pinky)
What does the Allen’s test do?
assesses patency of the palmar arch.
What is the time in which the normal color should return when doing the allen test.
10 seconds
What is radial artery mapping usually used for?
suitability for the radial artery to be used as a graft for coronary artery bypass
When doing the radial artery mapping, the radial artery should be > ___ mm
> 2mm
What would arterial mapping of the epigastric artery be used for?
to identify the adequate arterial supplied muscle for autogenous breast reconstruction
THe _____ (4 letters) flap is ued for autogenous breast reconstruction
TRAM
What would the mapping of the internal mammary artery be used for?
Recipient site for free flaps in reconstructive breast surgery.
Graft to the left anterior descending artery in coronary bypass grafting
Which two arteries do we do mappings for since they can be used for a coronary bypass grafting?
Internal mammary artery (internal thoracic)
Radial artery
How large does the GSV need to be when doing a mapping?
> 2-3 mm
Which vessel is typical larger? The basilic or cephalic?
Basilic
