Class 12: UE Anatomy Flashcards
where is the axillary artery?
from the 1st rib & level of humerus head
where does the subclavian artery exit?
through the thoracic outlet
where is the brachial artery?
from the axilla to the antecubital fossa
where are the radial and ulnar arteries in relation to each other?
radial artery is lateral to ulnar; ulnar artery is medial to radial
what is a sign of claudication in the upper extremities?
- weakness with exercise
- weakness, pain, or numbness in relation to position of hand
5 UEA diseases
- atherosclerotic arterial disease
- thromboembolism
- arteritis
- raynaud’s syndrome
- thoracic outlet syndrome (TOS)
what is another name for atherosclerotic arterial disease?
plaque
is a thromboembolism acute or chronic occlusion?
acute occlusion
what is raynaud’s syndrome?
episodic digital vasospasm with symptoms of digital ischemia
what are 4 symptoms of digital ischemia?
- pallor
- cyanosis
- numbness
- pain
what are the types of raynaud’s syndrome?
- primary
- secondary
what is primary raynaud’s syndrome caused by?
episodic vasoconstriction of digital arteries that occur dt cold temp & emotional stress
age and sex primary raynaud’s syndrome most commonly occur in?
women
usually starts bw 15-25 yo
primary raynaud’s is usually bilateral. T/F?
true
primary raynaud’s is usually asymmetrical. T/F?
false
primary raynaud’s usually involves all fingers. T/F?
true
how is primary raynaud’s syndrome diagnosed?
clinical hx
what causes secondary raynaud’s disease?
conditions associated with abnormal vessel walls or increased blood viscosity
- CT disease
- blood disorders
- arterial causes
- neurovascular disorders
- drug related
secondary raynaud’s disease is usually unilateral. T/F?
true
which type of raynaud’s usually has more severe symptoms?
secondary
two types of arteritis?
- takayasu’s arteritis
- buerger’s disease
how common is takayasu’s arteritis?
rare
what causes takayasu’s arteritis?
autoimmune disorder
what vessels are affected by takayasu’s arteritis?
aortic arch branches
what is buerger’s disease also known as?
thromboangiitis obliterans
what is thromboangiitis obliterans?
an inflammatory condition of palmar arch &/or digital arteries
what can buerger’s disease lead to?
thrombosis –> obstruction of small vessels
buerger’s disease occurs with which demographic?
male smokers
what is the thoracic outlet?
the space bw the first rib & collar bone
what is thoracic outlet syndrome?
intermittent pain, numbness, tingling, weakness, coldness in UE dt compression of nerves and vessels in the thoracic outlet
what is TOS caused by?
compression of nerves or blood vessels in the thoracic outlet
what is the most common cause of TOS?
nerve compression 95%
what can TOS lead to? (3)
thrombosis
fibrosis
aneurysm of subc/axillary artery
when is thoracic outlet testing performed?
when patient complains of arm pain/numbness that is position related
what does thoracic outlet testing rule out?
compression of subc or axillary arteries
how do you perform a baseline study for thoracic outlet testing?
- find segmental pressures at arm & forearm bilat
- get PVR or CW waveforms at axillary, brachial, radial, & ulnar arteries
a 10 mmHg drop bw one segmental pressure to the next indicates significant stenosis. T/F?
false – 20 mmHg
what are the 5 thoracic outlet testing positions?
- abducted 90 degrees to torso
- elevated 180 degrees above head
- pledge/military position
- stick-up position
- symptomatic position
what is the pledge or military position?
arm abducted 90 degrees & elbows bent at 90 degrees. eval with head turned toward then away from hand
what is the stick-up position?
thoracic outlet testing position
- elbows at side, towards back
- hands up
- shoulders pressed down & back
what is the most important position for thoracic outlet testing?
the symptomatic position
what is the allen test & what is it used for?
test for palmar arch patency
- pre-op assessment for radial artery harvest or hemodialysis access placement
