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Vascular > Final > Flashcards

Final Flashcards

1
Q

Upper extremity deep veins

A 
Internal  jugular vein
External jugular vein
Brachiocephalic vein
Subclavian vein
Axillary vein
Brachial vein
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2
Q

Upper extremity Superficial Veins

A

Cephalic vein

Basilic veins

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3
Q

IJV lies lateral to the____

A

CCA

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4
Q

IJV’s join with the _____ more medially to form

the _________

A 
SCV's
Brachiocephalic veins (aka: innominate veins)
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5
Q

EJV lies _______ to the IJV

A

superficial

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6
Q

EJV’s drain into the __________

A

SCV’s

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7
Q

what does pulsatile flow reflect?

A

heart contractions

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8
Q

why may the innominate vein be difficult to visualize?

A

sternum

air filled lungs

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9
Q

what may help in determining patency when its hard to visualize?

A

doppler signals

-phasicity is important

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10
Q

the subclavian vein moves laterally from the junction of what?

A

jugular and branchiocephalic veins

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11
Q

where does the subclavian pass?

A

under the clavicle

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12
Q

where does the superficial cephalic vein empty?

A

into the subclavian vein

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13
Q

what does the subclavian run along side?

A

the subclavian artery

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14
Q

the subclavian (SCV) cannot so compression so what do we do?

A

this is because of its position so we use duplex to check for patency and phasicity

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15
Q

where does the axillary start?

A

below the level where the subclavian vein recieves the cephalic vein

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16
Q

wher does the axillary vein travel?

A

through the axilla

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17
Q

whats different about the axillary artery and vein from others?

A

they do not travel directly beside eachother, the armpit is one area where the artery and its accompanying vein have some distance for a SHORT WHILE

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18
Q

where does the basilic vein empty?

A

into the axillary vein (but this is extremely variable)

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19
Q

what do we check in the axillary vein?

A

use duplex doppler to check for patency, phasicity, and augmentation

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20
Q

when augmenting the axillary vein where do we squeeze?

A

below the elbow

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21
Q

what are the brachial veins?

A

2 small paired veins on either side of the artery and may join to form a single vein at the level of the crease

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22
Q

where do the brachial veins split?

A

below the bend of the elbow, they split to form the radial and ulner paired veins

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23
Q

do we comprss the brachial vein?

A

yes

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24
Q

what do we use to examine the brachial vein?

A

duplex doppler to ascertain augmentation and phasicity

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25
Q

what do we assess non compressible veins with?

A

color and duplex

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26
Q

what do we assess for in veins?

A

for patency, phasicity, and augment where possible

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27
Q

where do we take compression images?

A

axillary vein
brachial vein
superficial veins(basilic, cephalic)

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28
Q

what history do we take in a patient for upper extremity?

A

recent central line or IV usage

Also if patient has cancer or recent injury

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29
Q

what veins show more pulsatility?

A

veins more proximal to the heart

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30
Q

what may loss of pulsatility indicate?

A

more central venous obstruction

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31
Q

what may we do to confirm the presence or absence of obstruction?

A

compare signals with the opposite arm

32
Q

whats the reason more most clots in the upper extremity?

A

result of injury to the vein wall

needle punctures or indwelling catheders

33
Q

what is the usual reason for clot in the lower extremity?

A

stasis

34
Q

why are clots in the arm less common?

A

The upper extremities have no soleal sinuses as seen in the lower extremities

35
Q

what may a clot in the upper extremity be caused by?

A

chronic injury to subclavian vein

  • TOS
  • coagulopathy
  • compression by a mass
36
Q

The sequelae of upper extremity DVT are ______ severe than that of lower extremity

A

less

pathophysiology is the same

37
Q

what is the risk for PE in the upper extremity?

A

10-12%

38
Q

what is the main pathology that affects the upper limb venous system?

A

DVT

39
Q

what are the most common sites for DVT in the upper extremity?

A

subclavian vein

axillary vein

40
Q

what does DVT result in, in the upper extremity?

A

upper limb swelling with distension of the superficial veins

41
Q

what are the risk factors for upper extermity DVT?

A

same as lower limb, LOOK AT THESE but there are some extras on another flashcard

42
Q

what can be a cause of upper extremity DVT?

A

presence of a central venous cathedar or pacemaker lead

43
Q

how many people develop thrombosis with central venous catherdar or pacemaker?

A

26-67%

most are asymptomatic

44
Q

what are more frequent cases of DVT in upper extremities rather than lower?

A
  • radiation therapy
  • malignant obstruction
  • effort induces thrombosis
45
Q

what may cellulitis be associated with?

A

superficial thrombophlebitis, producing swelling of the limb, pain and redness

46
Q

what else may lead to upper limb swelling?

A

Arteriovenous malformations ,if extensive

47
Q

Long term catheter access for feeding and or drug administration may damage ____________

A

the axillary or subclavian veins, leading to DVT

48
Q

when can Phlebitis of the superficial veins(superficial thrombophlebitis) occur?

A

due to repeated catheter access or intravenous drug abuse

49
Q

is paget-schroetter syndrome common or rare?

A

rare

50
Q

where is paget-schroetter syndrome seen?

A

young adults due to effort-induced thrombosis of the subclavian vein

51
Q

why may paget-schroetter syndrome occur?

A

strenuous upper body exercise or repatative movements like weight lifting

52
Q

Lymphedema

A

most common following mastectomy with removal of lymph nodes in the axilla as well as the effects of radiotherapy

53
Q

what do superficial veins usually anastomose with?

A

deep veins

54
Q

what do superficial veins runs through?

A

2 layers of superficial fascia

55
Q

are there more valves in deep or superficial veins?

A

valves are less numerous in the superficial veins

56
Q

where does the cephalic vein drain?

A

empties into the subclavian vein above the level of basilic vein

57
Q

where does the cephalic vein travel?

A

across the shoulder and down the anterolateral border of the biceps muscles

58
Q

where is the cephalic vein easily found?

A

Easiest to find in upper arm first, follow it upward as it dumps into subclavian/axillary vein junction and then follow it downward to below antecubital fossa

59
Q

is the basilic vein large or small?

A

large

60
Q

where does the basilic vein travel?

A

along the medial border of the biceps, parallel to the brachail vein

61
Q

for the basilic and cephalic vein so we use heavy or light probe pressure?

A

light probe pressure

62
Q

how do you find the basilic vein?

A

Easiest to find it from the upper arm first, follow it upward as it dumps into the axillary vein, then follow it downward to the anticubital fossa

63
Q

what are the most common sites for central venous assess device (VAD)?

A
  • subclavian vein

- internal jugular veins

64
Q

is the IJV superficial or deep?

A

superficial

65
Q

which IJV is prefered?

A

right as it has a straighter course to the heart

66
Q

if the EJV used?

A

not preffered only in setting of IJV obstruction and is often tortuous

67
Q

what is the SCV suitable for?

A

dialysis
aphresis
catheters
chemotherapy

68
Q

what is VAD used for?

A

administer antobiotics, blood products, other fluids

69
Q

PICC line

A

Peripherally inserted central catheter
Typically inserted in upper arm veins
Terminates closer to the heart

70
Q

advantages of PICC line

A

Decreased complication risk

Can remain in place much longer

71
Q

Portocath

A

Inserted under the skin in upper chest-appears as a bump

Inserts into SCV,JV or SVC

72
Q

advantages of portocath

A
  • Infused agents spread more quickly to body

- Heparin is infused through port to combat thrombus formation

73
Q

complications of VAD

A 
vein damage
non target puncture
bleeding
air embolism
cardiac arrythmia
infection
74
Q

Vein damage

A
  • Appears as irregular intimal surface
  • May be extravascular accumulation of blood-hematoma
  • Arteriovenous fistula may occur
  • Flow between vein and artery
75
Q

Non target puncture

A

Hematoma formation

76
Q

Bleeding

A

May be diffuse within tissue

77
Q

Air embolism

A

Hyperechoic structure within blood stream-acoustic shadow

Vascular (10 decks)

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