Chapter 18

Question 1

What is the inward projection of the intimal layer of a vein wall producing two semilunar leaflets that prevent the retrograde movement of blood flow?

Answer 1

Valve

Question 2

What is a superficial vein?

Answer 2

A vein that is superior to the muscular compartments of the leg or arm; travels within the superficial fascial compartments and has no corresponding companion artery

Question 3

What is a clotted blood within a vein that has generally been present for a period of several weeks or months?

Answer 3

Chronic thrombus

Question 4

What is a deep vein?

Answer 4

A vein that is the companion vessel to an artery and travels within the deep muscular compartments of the leg or arm

Question 5

What is a newly formed clotted blood within a vein, generally less than 14 days old?

Answer 5

Acute thrombus

Question 6

What is the main reason that venous thrombosis in the upper extremities has become more common?

Answer 6

Increased injury to vein walls

Question 7

Unlike the lower extremities, what do the upper extremities NOT have that may allow spontaneous thrombus formation?

Answer 7

Soleal sinuses

Question 8

What is venous thrombosis secondary to compression of the subclavian vein at the thoracic inlet?

Answer 8

Paget-Schroetter syndrome

Question 9

A patient present to the vascular lab for upper extremity venous evaluation with face swelling and prominent veins on the chest and neck. What do these findings suggest?

Answer 9

Superior vena cava thrombosis

Question 10

Transducer compressions are limited over several veins in the upper extremity because of limited access from bony structures. What are the most common veins that are NOT able to be compressed?

Answer 10

Brachiocephalic and subclavian veins

Question 11

What is the most appropriate transducer for mapping of the upper extremity superficial venous system?

Answer 11

10-18 MHz straight linear array

Question 12

Why are the subclavian and jugular veins assessed with the patient lying flat?

Answer 12

To reduce hydrostatic pressure

Question 13

How does the external jugular vein lie in relation to the internal jugular vein?

Answer 13

Posterior

Question 14

With which vein does the brachial vein become the axillary vein at the confluence?

Answer 14

Basilic vein

Question 15

During an upper extremity venous examination, the technologist has made the patient take in a quick, deep breath through pursed lips while viewing the subclavian vein. What is the purpose of this action?

Answer 15

Collapse/coapt the subclavian vein

Question 16

In the upper extremity, in general, which venous system is larger?

Answer 16

Superficial system

Question 17

During an upper extremity venous duplex examination, the technologist notes significant pulsatility in the spectral doppler waveform from the internal jugular vein. What does this finding suggest?

Answer 17

Normal findings for the IJV

Question 18

Which vessel may not be routinely evaluated in a UE venous duplex examination but is often added in the event of significant thrombosis?

Answer 18

External Jugular vein

Question 19

Because of the location of the brachiocephalic veins, documentation of patency of these vessels is usually performed with which of the following?

Answer 19

Grayscale image with additional color-flow and spectral doppler

Question 20

Which vessel connects the basilic and cephalic veins?

Answer 20

Medial cubital vein

Question 21

Which forearm vessels are NOT routinely evaluated during upper extremity venous duplex testing?

Answer 21

Radial and ulnar veins

Question 22

A 34 year old female presents to the vascular lab with a 1-day history of arm swelling and redness. The patient has recently has a PICC line inserted. During the duplex evaluation, the axillary and subclavian veins are incompressible with hypoechoic echoes noted within their lumens. What do these findings suggest?

Answer 22

Acute venous thrombosis

Question 23

A 78 year old male presents to the vascular lab with right arm swelling for the past several days. The patient notes that he is currently being treated for cancer. During the upper extremity duplex examination, decreased pulsatility is noted in the right internal jugular and subclavian veins as well as slow flow formation. What do these findings suggest?

Answer 23

A more proximal obstruction, likely in the brachiocephalic vein or superios vena cava

Question 24

During an upper extremity venous duplex evaluation, color flow is noted filling the axillary vein. However, in a transverse view, the axillary vein is noted to be only partially compressible. Which of the following could explain these findings?

Answer 24

Color priority set too low and color gain is too high

Question 25

A 22 year old male patient preents to the vascular lab with a 3 day history of left arm swelling with no apparent injury or risk factors. Upon further questioning, the patient does state that he has recently begun weight training. What do the vascular technologist suspect in this patient?

Answer 25

Effort thrombosis

Question 26

The ________ veins of the arm are more affected by venous thrombosis than in the legs

Answer 26

Superficial

Question 27

Signs and symptoms of upper extremity venous thrombosis are _______ to symptoms in the lower extremity.

Answer 27

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