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Vascular Board > Misc Arterial > Flashcards

Misc Arterial Flashcards

1
Q

What is an abnormal connection between high-pressure arterial system and low-pressure venous system; marked anatomic and hemodynamic changes?

A

arteriovenous fistulae (AVF)

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2
Q

An AVF can be created how?

A

congenital or traumatic

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3
Q

The potential for cardiac failure increases when a fistula is located where?

A

Close to the heart

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4
Q

A fistula located peripherally is more likely to cause?

A

ischemia

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5
Q

AVF may involve prox and distal arteries/veins as well as collateral arteries/veins. What values predicts resistance?

A

diameter and length

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6
Q

Flow through the AVF has _____ velocities, _____ resistant flow

A

higher, lower

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7
Q

What is compartment syndrome?

A

After a tibial artery repair there may be swelling. The compartment is bound by bone, fascia and interosseous membrane, which does not allow for expansion.

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8
Q

Compression on the tibial arteries can result in what?

A

necrosis of the muscles causing severe pain, tenderness, foot drop and other neurological changes

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9
Q

What is important to determine about a pseudoaneurysm?

A

location of the neck, size, and location

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10
Q

How long should the compression on the pseudoaneurysm neck last?

A

alternating compression and rest periods, compressions lasting 10-15 min each
procedure lasts up to 30 to 60 minutes

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11
Q

When compressing on the pseudoaneurysm, what should be used to monitor arterial pulses are continued during compression?

A

distal monitoring of the great toe

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12
Q

What occurs when the popliteal artery is compressed by the medial head of the gastrocnemius muscle or fibrous bands?

A

popliteal artery entrapment syndrome

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13
Q

Who does popliteal artery entrapment syndrome affect most often and what are possible symptoms?

A
  • young men
  • symptoms of arterial occlusion or intermittent claudication
  • repeated trauma may result in aneurysm, thrombosis, emboli
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14
Q

What tests can be preformed to determine popliteal artery entrapment syndrome?

A

a) flow to great toe monitored with an end point detector such as a PPG
b) knee extended and active plantar flexion of the foot with PPG pads may diminish or obliterate suggesting entrapment.

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15
Q

What is the terminal branch of the internal mammary artery?

A

deep superior epigastric artery

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16
Q

The rectus abdominis muscle, sub-q fat, arteries, preforators, overlaying skin all make up what?

A

transverse rectus abdominis myocutaneous (TRAM) flap

17
Q

Why is the epigastric artery mapped?

A

surgeon wants to use the best arterially supplied muscle section for TRAM flap for autogenous breast reconstruction

18
Q

What artery arises off the subclavian artery, descending on posterior side of carilage of upper 6 ribs, about 1 cm from sternum?

A

internal mammary artery (internal thoracic artery)

19
Q

Why is the internal mammary artery mapped?

A
  • Utilized as a recipient site for free flaps in breast reconstruction
  • Also can be used as a graft to the left anterior descending (LAD) coronary artery
20
Q

What can the radial artery be used for?

A

coronary artery bypass

21
Q

What is the process of mapping the radial artery?

A
  • use PPG’s and monitor pulses with and without compression of the radial artery. If pulse disappears, no need to continue
  • observe for focal elevated PSV, abnormal doppler, intimal thickening, aneurysm, calcification
  • measure radial artery prox, mid, and dist
22
Q

Preoperative vein mapping is done to determine suitability of veins for?

A

extremity or coronary bypass

dialysis access/graft

23
Q

What vein is typically mapped in the legs?

A

GSV, sometimes LSV/SSV

24
Q

What vein is typically mapped in the arms?

A

cephalic and basilic veins

25
Q

How should the vein AP diameter be obtained?

A

outer edge to outer edge

26
Q

What should the vein dimensions be at least?

A

2-3 mm

basilic vein is often larger than cephalic vein

27
Q

What occurs when the neurovascular bundle is compressed by shoulder structures in certain arm positions?

A

thoracic outlet syndrome

28
Q

Most symptoms of TOS are due to neurogenic compression of brachial plexus (97%); a small percentage is due to what?

A

subclavian vein or artery compression

29
Q

Symptoms of TOS:

A

numbness/tingling of arm
pain/aching of shoulder/forearm
exercise/upward positions increase discomfort/symptoms
25-30% have asymptomatic compression

30
Q

What arm positions are used to evaluate TOS?

A

a) resting position- hand in lap
b) arm at 90 degrees
c) arm at 180 degrees
d) exaggerated military stance
e) Adson maneuver positioning
- head turned to rt
- head turned to lt
f) causative position described by patient

31
Q

What treatment is used for TOS?

A

shoulder exercises or surgical treatment to resect rib with/without scalene splitting

Vascular Board (21 decks)

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