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Anes 540b: Exam 1 TBD > Peripheral Vascular System + Ischemia/Infarction > Flashcards

Peripheral Vascular System + Ischemia/Infarction Flashcards

1
Q

When are arterial pulses palpable?

A

When an artery lives close to the body surface

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2
Q

What vascular arches protect circulation to the hand?

A

1) Deep palmar arch

2) Superficial palmar arch

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3
Q

What four arteries are palpable in the leg

A

1) Femoral artery
2) Popliteal artery
3) Posterior tibial artery
4) Dorsalis pedis artery

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4
Q

Which artery protects the circulation of the foot?

A

Arcuate artery

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5
Q

Below what ligament is the femoral artery?

A

Inguinal ligament

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6
Q

What aspects of a pulse should an observer note?

A

Intensity
Rate
Rhythm

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7
Q

What aspects of blood vessels should an observer note when taking pulse?

A

Tenderness
Tortuosity
Nodularity

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8
Q

Carotid pulse indicates systolic pressure =

A

60

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9
Q

Radial pulse indicate systolic pressure =

A

90

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10
Q

A grade of 0 means a pulse is

A

Absent, unable to palpate

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11
Q

A grade of 1+ means a pulse is

A

Diminished, weaker than expected

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12
Q

A grade of 2+ means a pulse is

A

Brisk, expected

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13
Q

A grade of 3+ means a pulse is

A

Increased

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14
Q

A grade of 4+ means a pulse is

A

Bounding

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15
Q

When grading arterial pulses, we look at the right and left

A

Carotid, brachial, radial, femoral, popliteal, posterior tibial, dorsalis pedis

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16
Q

Vascular history = PICCSS

A

Pain in arms or legs
Intermittent claudication
Cold, numbness, pallor in the legs; hair loss
Color change in fingertips or toes in cold weather
Swelling in calves, legs, or feet
Swelling with redness or tenderness

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17
Q

What lymph nodes are located in the arms?

A

Epitrochlear lymph nodes

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18
Q

Is peripheral edema more likely to occur in legs or arms?

A

Legs

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19
Q

What lymph nodes are located in the legs?

A

Inguinal lymph nodes

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20
Q

The S’s of the vascular exam

A

Size
Symmetry
Skin color

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21
Q

Hand to use in brachial pulse?

A

Left hand

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22
Q

Describe position for brachial pulse?

A

Arm abducted
Elbow slightly flexed
Forearm externally rotated

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23
Q

On what aspect can you find the brachial pulse?

A

Anterior aspect of elbow

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24
Q

To find brachial pulse, palpate:

A

Just medial to biceps tendon + lateral to medial epicondyle of humerus

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25
Q

In finding the epitrochlear nodes of the arm, the fourth and fifth fingers fall where?

A

Above medial epicondyle of humerus

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26
Q

What fingers fall on the epitrochlear nodes?

A

1-3 of left hand

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27
Q

If patient has elevated lymph nodes on one side, what condition?

A

Non-Hodgkins lymphoma

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28
Q

What parts of the body do epitrochlear nodes drain?

A

Drain ulnar forearm, hand

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29
Q

What parts of the body do axillary lymph nodes?

A

Drain breast, upper extremity, thoracic wall

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30
Q

Which lymph nodes are affected most commonly by Non-Hodgkin’s lymphoma?

A

Infraclavicular nodes

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31
Q

Which nodes are most commonly affected by skin infections, lymphoma, and skin malignancies?

A

Epitrochlear nodes

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32
Q

Which parts of body drained by inguinal nodes?

A 
Lower abdomen
External genitalia 
Anal canal
Lower third of vagina
Lower extremities
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33
Q

Max enlargement of normal inguinal lymph nodes?

A

1-2 cm in size

34
Q

What two nodal groups classified as inguinal lymph nodes?

A

Horizontal + vertical node group

35
Q

Swelling of tissues d/t accumulation of fluids

A

Peripheral edema

36
Q

What medications may cause edema?

A

Amlodipine

Pregabalin

37
Q

When, after pressure is applied to small area, indentation persists for some time after the release of the pressure

A

Pitting edema

38
Q

What circulation-related issues cause edema?

A

CHF
HTN
SCA

39
Q

Aging, pregnancy, altitude sickness and alcoholism can all cause

A

Edema

40
Q

Where should a patient’s hand be during an Allen’s test?

A

Above the heart

41
Q

During an Allen’s test, within what frame of time should a fist return to normal color?

A

5-7 seconds

42
Q

What is another name for “Cold Leg”?

A

Acute Arterial Occlusion

43
Q

What is the name of a vascular disease involving a sudden interruption in the arterial blood supply to a tissue, organ, or extremity?

A

Acute Arterial Occlusion

44
Q

If left untreated, Acute Arterial Occlusion can lead to

A

Tissue death

45
Q

Three causes of Acute Arterial Occlusion

A

Trauma
Embolism
Thrombosis of an atherosclerosis artery

46
Q

Six Ps of AAO:

A 
Pain
Pallor
Pulselessness
Paresthesias
Paralysis
Poikilothermia
47
Q

Treatments for AAO:

A 
Inject anticoagulant
Thrombolysis
Embolectomy
Surgical revascularization
Amputation
48
Q

Inflammation and thrombosis of superficial veins that presents as a painful induration with erythema

A

Superficial thrombophlebitis

49
Q

Side effects include fever, redness, swelling, or pain in area of clot,Skin feels hot or warm, send me feel tender or hard like a cord, worm like vein seen just under the skin

A

Superficial thrombophlebitis

50
Q

How to diagnose superficial thrombophlebitis

A

Doppler ultrasound

51
Q

How to treat superficial thrombophlebitis

A

Antibiotics, NSAIDS, anticoagulation, surgery

52
Q

How to treat DVT

A

Anticoagulation

53
Q

How to diagnose DVT

A

D-dimer + Doppler ultrasound

54
Q

Most common place for clots

A

Popliteal and superficial femoral

55
Q

How often do clots occur in the common femoral?

A

8%

56
Q

Veins cannot pump enough oxygen-poor blood back to the heart d/t incompetent valves in lower extremities

A

Chronic venous insufficiency

57
Q

When chronic venous insufficiency occurs post-DVT, it’s called

A

Postthrombotic syndrome

58
Q

Besides DVT, chronic venous insufficiency May occur after

A

Phlebitis

59
Q

Main risks of chronic venous insufficiency

A

Cellulitis + ulcers

60
Q

Treatments include manual compression lymphatic massage therapy, sequential compression pump, ankle pumps, compression stockings, blood pressure medicine

A

Chronic venous insufficiency

61
Q

Surgeries for chronic venous insufficiency

A

Linton procedures

subfascial endoscopic perforator vein surgery

62
Q

Leaflets of valves no longer meet properly, valves become incompetent

A

Varicose veins

63
Q

AV fistulas are created for

A

Hemodialysis

64
Q

What causes carotid stenosis?

A

Atherosclerosis

65
Q

Common site for atherosclerosis?

A

Bifurcation if common carotid artery

66
Q

How to diagnose carotid stenosis

A

Carotid bruits on exam, then by color flow duplex ultrasound scan of carotid arteries

67
Q

Major treatment for carotid stenosis?

A

Smoking cessation

68
Q

Initiating event of aortic aneurysm

A

Tear in intima of vessel wall, blood flows in, separates intima + adventitia

69
Q

Main cause of aortic aneurysm

A

HTN

70
Q

Older males are more prone to

A

Aortic aneurysm

71
Q

Risk of rupture in aneurysm greater than 5 cm in a 5 year period is

A

25-41%

72
Q

Symptoms of aortic aneurysm rupture

A

Chest, abdominal, back pain
HTN followed by hypotension
Patient in shock

73
Q

Placement of endovascular stent via percutaneous technique through femoral arteries into diseased portions of aorta

A

Aortic aneurysm endovascular treatment

74
Q

Why must you monitor pressure in right arm in patient with aortic aneurysms?

A

Aortic cross clamp is just distal to left subclavian artery; Occlusion of sorts will prevent BP monitoring in left arm

75
Q

Where should MAPS be maintained above cross clamp in aortic aneurysm surgery?

A

100 mmHg

76
Q

Where should MAPS be distal to cross-clamp in aortic aneurysm repair?

A

50 mmHg

77
Q

You want to make sure perfusion is maintained in aortic aneurysm patient, especially to

A

Kidneys and spinal cord

78
Q

Neuro protecting during aortic aneurysm case?

A

Spinal cooling and drainage

79
Q

What can SSEP/EEG monitor during aortic aneurysm case?

A

CNS viability

80
Q

What does TEE assess during aortic aneurysm case? Use with what as adjunct?

A

Aortic atherosclerosis and valve function ; PA catheter as adjunct

81
Q

What medication before cross-clamping in aortic aneurysm case?

A

Mannitol improves renal cortical blood flow + GFR

82
Q

Use of DLT In aortic aneurysm case?

A

Exposure of thoracic aneurysm

Anes 540b: Exam 1 TBD (2 decks)

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