Class 12: UE Anatomy Flashcards

1
Q

where is the axillary artery?

A

from the 1st rib & level of humerus head

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2
Q

where does the subclavian artery exit?

A

through the thoracic outlet

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3
Q

where is the brachial artery?

A

from the axilla to the antecubital fossa

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4
Q

where are the radial and ulnar arteries in relation to each other?

A

radial artery is lateral to ulnar; ulnar artery is medial to radial

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5
Q

what is a sign of claudication in the upper extremities?

A
  • weakness with exercise
  • weakness, pain, or numbness in relation to position of hand
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6
Q

5 UEA diseases

A
  1. atherosclerotic arterial disease
  2. thromboembolism
  3. arteritis
  4. raynaud’s syndrome
  5. thoracic outlet syndrome (TOS)
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7
Q

what is another name for atherosclerotic arterial disease?

A

plaque

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8
Q

is a thromboembolism acute or chronic occlusion?

A

acute occlusion

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9
Q

what is raynaud’s syndrome?

A

episodic digital vasospasm with symptoms of digital ischemia

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10
Q

what are 4 symptoms of digital ischemia?

A
  • pallor
  • cyanosis
  • numbness
  • pain
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11
Q

what are the types of raynaud’s syndrome?

A
  1. primary
  2. secondary
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12
Q

what is primary raynaud’s syndrome caused by?

A

episodic vasoconstriction of digital arteries that occur dt cold temp & emotional stress

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13
Q

age and sex primary raynaud’s syndrome most commonly occur in?

A

women
usually starts bw 15-25 yo

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14
Q

primary raynaud’s is usually bilateral. T/F?

A

true

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15
Q

primary raynaud’s is usually asymmetrical. T/F?

A

false

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16
Q

primary raynaud’s usually involves all fingers. T/F?

A

true

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17
Q

how is primary raynaud’s syndrome diagnosed?

A

clinical hx

18
Q

what causes secondary raynaud’s disease?

A

conditions associated with abnormal vessel walls or increased blood viscosity
- CT disease
- blood disorders
- arterial causes
- neurovascular disorders
- drug related

19
Q

secondary raynaud’s disease is usually unilateral. T/F?

A

true

20
Q

which type of raynaud’s usually has more severe symptoms?

A

secondary

21
Q

two types of arteritis?

A
  1. takayasu’s arteritis
  2. buerger’s disease
22
Q

how common is takayasu’s arteritis?

A

rare

23
Q

what causes takayasu’s arteritis?

A

autoimmune disorder

24
Q

what vessels are affected by takayasu’s arteritis?

A

aortic arch branches

25
Q

what is buerger’s disease also known as?

A

thromboangiitis obliterans

26
Q

what is thromboangiitis obliterans?

A

an inflammatory condition of palmar arch &/or digital arteries

27
Q

what can buerger’s disease lead to?

A

thrombosis –> obstruction of small vessels

28
Q

buerger’s disease occurs with which demographic?

A

male smokers

29
Q

what is the thoracic outlet?

A

the space bw the first rib & collar bone

30
Q

what is thoracic outlet syndrome?

A

intermittent pain, numbness, tingling, weakness, coldness in UE dt compression of nerves and vessels in the thoracic outlet

31
Q

what is TOS caused by?

A

compression of nerves or blood vessels in the thoracic outlet

32
Q

what is the most common cause of TOS?

A

nerve compression 95%

33
Q

what can TOS lead to? (3)

A

thrombosis
fibrosis
aneurysm of subc/axillary artery

34
Q

when is thoracic outlet testing performed?

A

when patient complains of arm pain/numbness that is position related

35
Q

what does thoracic outlet testing rule out?

A

compression of subc or axillary arteries

36
Q

how do you perform a baseline study for thoracic outlet testing?

A
  • find segmental pressures at arm & forearm bilat
  • get PVR or CW waveforms at axillary, brachial, radial, & ulnar arteries
37
Q

a 10 mmHg drop bw one segmental pressure to the next indicates significant stenosis. T/F?

A

false – 20 mmHg

38
Q

what are the 5 thoracic outlet testing positions?

A
  1. abducted 90 degrees to torso
  2. elevated 180 degrees above head
  3. pledge/military position
  4. stick-up position
  5. symptomatic position
39
Q

what is the pledge or military position?

A

arm abducted 90 degrees & elbows bent at 90 degrees. eval with head turned toward then away from hand

40
Q

what is the stick-up position?

A

thoracic outlet testing position
- elbows at side, towards back
- hands up
- shoulders pressed down & back

41
Q

what is the most important position for thoracic outlet testing?

A

the symptomatic position

42
Q

what is the allen test & what is it used for?

A

test for palmar arch patency
- pre-op assessment for radial artery harvest or hemodialysis access placement