Surg 105--Chapter 31 (Fuller) Flashcards
Ballooning of an artery as a result of weakening of the arterial wall. May be caused by artherosclerosis, infection, or a hereditary defect in the vascular system.
aneurysm
Dilation of an artery using endovascular techniques. May include insertion of a supportive stent inside the artery to maintain blood flow.
angioplasty
A disease characterized by thickening, hardening, and loss of elasticity of the arterial wall.
arteriosclerosis
An incision made in an artery, usually to perform an anastomosis with a graft or another artery or to remove plaque or a thrombus.
arteriotomy
A naturally occurring or surgically created connection between an artery and a vein. In surgery, it is created to prepare a vessel for hemodialysis.
arteriovenous (av) fistula
The most common form of arteriosclerosis, which causes plaque to form on the inner surface of an artery.
atherosclerosis
The Y-shape of an artery or graft.
bifurcation
The lowest pressure exerted on the arterial wall during the resting phase of the cardiac cycle.
diastolic pressure (diastole)
A type of ultrasonography that amplifies sounds that pass through tissue and produces a visual image of blood flow.
doppler duplex ultrasonography
A diagnostic tool that measures the electrical activity of the brain. May be used during surgery to determine the patient’s neurophysiological response.
electroencephalogram (EEG)
A moving substance in the vascular system. May consist of air, a blood clot, atherosclerotic plaque, or fat.
embolus
The surgical removal of plaque from inside an artery.
endarterectomy
A term meaning “outside the body.”
extracorporeal
A process in which blood is shunted out of the body and passes through a complex set of filters for the treatment of end-stage renal disease (and in some cases poisoning), also called renal replacement therapy (RRT).
hemodialysis
A term referring to the pressure, flow, and resistance in the cardiovascular system.
hemodynamic
An abnormal increase in blood pressure.
hypertension
An abnormally low blood pressure.
hypotension
A blockage in an artery that leads to ischemia and tissue death.
infarction
A term meaning “in the natural position or normal place, without disturbing or invading surrounding tissues.”
in situ
A diagnostic tool in which a transducer is introduced into an artery and ultrasound is used to translate the physical characteristics of the lumen into a visible image.
intravascular ultrasound
The decrease in or absence of blood to a localized area, usually related to vascular obstruction.
ischemia
The inside of a hollow structure, such as a blood vessel.
lumen
A term that literally means “through the skin.” In this approach, an incision is not made; rather a catheter or other device is introduced through a puncture site.
percutaneous
Pooling of blood in the veins caused by inactivity or disease; can cause distention of the veins.
stasis (venous)
A tubular device placed inside an artery for dilation, support, and to prevent stricture.
stent
The highest pressure exerted on the inside arterial wall during contraction of the heart.
systolic pressure
Any organic or nonorganic material blocking an artery; generally refers to a blood clot or atherosclerotic plaque but also includes fat or air.
thrombus
A length of mess tape used to loop around a blood vessel for retraction.
umbilical tape
Thinning and enlargement of veins as a result of stasis (pooling of blood in the vessel).
variscosity
A device used to retract a vessel during surgery. A length a thin Silastic tubing or cotton tape is passed around the vessel.
vessel loop
What is an endarterectomy?
The removal of atherosclerotic plaque from the inside of the artery.
What is an angioplasty?
The insertion of an arterial catheter or stent into an artery to establish patency and normal blood flow.
What is a thrombectomy?
The removal of a stationary clot in a blood vessel. Restores circulation and prevents emboli.
Why are vascular procedures performed?
To treat arteriosclerosis, atherosclerosis, or thromboembolic disease.
Why is timing important during reconstruction and grafting procedures?
Often require temporary clamping of large blood vessels or those which contribute the main blood supply to vital organs. Timing is important to minimize the risk of ischemia to tissue.
What are the layers of the blood vessels?
- tunica externa
- tunica media
- tunica intima
Composed of connective tissue which protects the vessel from injury and provides structural strength.
tunica externa
Composed of inner layers of smooth muscle bounded by connective tissue.
tunica media
Smooth muscle is under the control of the _____.
autonomic nervous system
Secretes substances that cause vasodilation or constriction, as well as substances that prevent platelet aggregation in the vessel.
tunica intima
Carry oxygenated blood from the heart to the rest of the body.
arteries
Carries deoxygenated blood to the lungs
pulmonary artery
Arteries are _____, _____, and contain mostly _____.
thick walled
highly elastic
smooth muscle
The elastic nature of the arteries allows them to contract during _____, and relax during _____.
systole (ventricular contraction)
diastole (the resting phase of the heart)
What is blood pressure?
The force exerted on the arterial wall by the pumping action of the heart.
What is the higher pressure that occurs during contraction of the ventricles?
systolic pressure
The lower pressure that occurs during the relaxation phase of the cardiac cycle.
diastolic pressure
What is the largest vein in the body?
vena cava
What are vascular clamps designed to do?
prevent trauma to blood vessels
How many blood pressure cuffs are used for arterial plethysmography?
3 are placed on the leg and inflated to 65 mm Hg
_____ is used more often than _____ to maintain dry operative field
suction
sponges
What is a stent?
Tubular mesh implant that fits against the wall of an artery. Provides a physical barrier between the atherosclerotic plaque and the vessel lumen. Hold the blood vessel open.
What are stents made of?
stainless steel, titanium, or a metal alloy called Nitinol
What is a vessel loop?
Used for retraction of blood vessels. May also be used to occlude blood vessels by acting as a tourniquet
What are vessel loops made of?
thin length of Silastic material
What is used to reverse heparin?
protamine sulfate
Intravenous administration of thrombin can cause a _____.
fatal embolus
What is the difference between preoperative and intraoperative angiography?
Preop–injection of a contrast medium into a selected artery and its branches to determine the exact location of strictures, occlusion, or malformation.
Intraop–used in conjunction with angioplasty to allow the surgeon to see the position of the stricture and to place the catheter in the correct location.
A metal, umbrella-shaped filter inserted into the inferior vena cava to prevent emboli from entering the pulmonary system.
vena cava filter
What is the goal of a thrombectomy?
To remove a stationary clot in a blood vessel.
What type of catheter is used to remove a thrombus?
embolectomy catheter
What can be used for vasospams?
lidocaine and papaverine
During a carotid endarterectomy, what arteries are clamped and in what order and in what order are they unclamped?
- -internal, common and external carotid arteries are clamped (ice)
- -external, internal, and common carotid artery clamps are open and closed (eic)
- -external, common, and internal carotid artery clamps are removed (eci)
What is an Abdominal Aortic Aneurysm?
A condition in which a section of the abdominal aorta becomes thin and bulges
What is the surgical goal of an Abdominal Aortic Aneurysm?
implant a graft extending from the aorta to both iliac arteries. restores circulation to the lower extremities and pelvis
what is the most common cause of an Abdominal Aortic Aneurysm?
because of atherosclerotic plaque and progressive weakening of the aortic wall
What is a Femerofemoral?
A synthetic graft or autograft is implanted between the femoral and popliteal arteries.
What is a femerofemoral performed?
Indicated for atherosclerosis of the femoral artery
What kind of anastomosis is used in a femerofemoral?
end-to-side anastomosis
What is “in situ” saphenous femoropopliteal bypass?
Surgical alternative to the use of a sythetic graft to bypass a diseased femoral artery. The saphenous vein is used.
What is the goal of situ saphenous femoropopliteal bypass?
produce vascular continuity with an autograft
What 2 arteries are involved in the situ saphenous femoropopliteal bypass?
popliteal and femoral
