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msk-derm > Limb Vasculature > Flashcards

Limb Vasculature Flashcards

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Dermatology Board Prep flashcards
1
Q

Where is the subclavian artery in the thoracic outlet?

A

Posterior to anterior scalene muscle

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2
Q

Where is the subclavianvein in the thoracic outlet?

A

Anterior to the anterior scalene muscle

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3
Q

What is A?

A

Thoracoacromial artery

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4
Q

What is B?

A

Anterior circumflex humeral artery

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5
Q

What is C?

A

Posterior circumflex humeral artery

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6
Q

What is D?

A

Superior thoracic artery

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7
Q

What is E?

A

Lateral thoracic artery

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8
Q

What is F?

A

Subscapular artery

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9
Q

Where does the brachial artery begin?

A

The inferior border of teres major, anterior to triceps and brachialis

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10
Q

What is the main blood supply to the superficial palmar arch?

A

Ulnar artery

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11
Q

What is the main blood supply to the deep palmar arch?

A

Radial artery

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12
Q

What is the clinical presentation of thoracic outlet syndrome?

A

Upper extremity pallor, paresthesia, weakness, muscle atrophy, and pain

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13
Q

What are the most common compression sites in thoracic outlet syndrome?

A

Interscalene triangle (most common), also in subcoracoid space

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14
Q

What mechanisms can cause thoracic outlet syndrome?

A

trauma, hemorrhage/hematoma/displaced fracture, repetitive motions (via swelling and compression), repetitive arm/shoulder motion, anatomic variations, tumors/large lymph nodes, injury to back/neck, poor posture

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15
Q

What demographics are most susceptible to neurogenic thoracic outlet syndrome?

A

Teens-60 year olds, female sex predominance

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16
Q

What are symptoms of neurogenic thoracic outlet syndrome?

A

upper extremity paresthesia, neck pain, trapezius pain, chest pain, occipital headache

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17
Q

What demographics are most susceptible to venous thoracic outlet syndrome?

A

Male sex predominance, aged 15-45, physically active

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18
Q

Where does subclavian vein compression commonly occur in venous thoracic outlet syndrome?

A

Costoclavicular space

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19
Q

What demographics are most susceptible to arterial thoracic outlet syndrome?

A

It is the most rare, no sex predominance, mostly young adults

20
Q

What is the upper extremity presentation in venous thoracic outlet syndrome?

A

Swelling, cyanosis, heaviness, pain

21
Q

What conditions are associated with venous thoracic outlet syndrome?

A

Raynaud’s-like symptoms, pulmonary embolism from DVT

22
Q

Where is the subclavian artery compressed in arterial thoracic outlet syndrome?

A

Within the costoclavicular space, possibly by an anomalous first rib, or at the level of the pectoralis minor tendon/humeral head in athletes

23
Q

What tests are used to evaluate for thoracic outlet syndrome?

A

Plain radiographs, MRI, CT, venous doppler, angiogram, EMG

24
Q

What is the treatment for thoracic outlet syndrome?

A

Conservative treatment with PT, postural changes, and surgery if there are neurologic changes or vascular changes that lead to ischemia

25
Q

What is the roos test?

A

Have patient lift up arms at a 90 degree angle and open/close fists for two minutes. Report any pain/fatigue/numbness/tingling. It is sensitive, but not specific, for thoracic outlet syndrome

26
Q

What are perforating veins?

A

Veins that penetrate the deep fascia and drain into the deep venous system that have valves for unidirectional blood flow

27
Q

What is the clinical presentation of DVT?

A

Throbbing pain, leg swelling/edema, redness/erythema, increased warmth, pain while walking or bearing weight

28
Q

What are risk factors for DVT?

A

Surgery with anesthetic, hospitalization, C-section, estrogen therapy, pregnancy/postpartum, leg injury with reduced mobility for > 3 days, active cancer, IBD, SLE

29
Q

What is the treatment for a DVT?

A

anticoagulation

30
Q

What are acute and chronic complications of a DVT?

A

Acute: pulmonary embolism (fatal or non-fatal)

Chronic: post-thrombotic syndrome, venous ulceration

31
Q

What is a popliteal cyst?

A

A fluid-filled distention of a preexisting bursa in the medial popliteal fossa

32
Q

What is the clinical presentation of a ruptured Baker’s cyst?

A

Can be asymptomatic, can cause leg edema or bruising, can have knee pain

33
Q

What is the best way to visualize a Baker’s cyst?

A

MRI (best) or ultrasound/venous doppler

34
Q

What is the treatment for a ruptured Baker’s cyst?

A

Treat with analgesics for pain, sometimes glucocorticoid injections. Edema resolves on its own.

35
Q

What borders the popliteal fossa?

A

Biceps femoris superolaterally

Semimembranosus muscle and semitendinosus superomedially

Medial and lateral heads of gastrocnemius inferomedially and laterally

36
Q

What is the clinical presentation of popliteal artery entrapment?

A

Claudication pain, uncommon for pain at rest

37
Q

What are the causes of popliteal artery entrapment?

A

Anatomic anomalies or muscle hypertrophy in the setting of normal anatomy

38
Q

What tests are used to evaluate popliteal artery entrapment?

A

Ankle-brachial index (ratio of ankle BP to arm BP), ultrasound with doppler, MRI, angiography

39
Q

What is the treatment for popliteal artery entrapment?

A

Surgery if symptoms persist

40
Q

What is atherosclerosis?

A

A disease where plaque made of fat/cholesterol/calcium/etc builds up in your arteries, hardens, and narrows arteries limiting blood flow

41
Q

What are symptoms of peripheral artery disease?

A

Muscle pain with exertion, feeling of ache/cramp/numbness/fatigue, pain resolves with rest even standing

42
Q

What is the most sensitive extremity finding of peripheral artery disease?

A

Lack of palpable pulses

43
Q

What is the treatment for peripheral artery disease?

A

Modify risk factors, exercise

44
Q

What chronic disease state is SLE one of the strongest risk factors for?

A

Cardiovascular disease

45
Q

Which of the following signs symptoms are typically associated with venous thoracic outlet syndrome?

a) neurologic changes
b) swelling
c) paresthesias
d) increased warmth

A

b) swelling

46
Q

A ruptured popliteal cyst is associated with which of the following?

a) ischemic changes in limb
b) abnormal ankle-brachial index
c) calf pain
d) diminshed dorsalis pedis pulse

A

c) calf pain

47
Q
A

msk-derm (41 decks)

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