Test 3 Flashcards
A bypass graft evaluation begins with patient history, surgical record, and type of graft. (T/F)
True
A femoral-femoral graft is also called a jump graft. (T/F)
True
The purpose of this procedure is done to provide access for dialysis. (T/F)
The superficial cephalic and basilic veins are evaluated (mapping) as part of a preop workup for hemodialysis access placement. pg. 209
Radial artery to cephalic vein fistula is the most common. (T/F)
True
The goal of lower extremity arterial testing is to evaluate for arterial disease. (T/F)
True
pg 159
Indirect physiological testing includes: PVR, segmental pressures, waveform analysis, and exercise stress. (T/F)
True
Palpations of pulses with a rating system from 0-3. (T/F)
True
Pg 161
Four cuff method is better at differentiating inflow from femoral artery diease. (T/F)
True
Systolic pressure in the arm is used to calculate the ABI, which pressure (lower or higher) of the brachials will you use to calculate ABI?
Higher
An ABI of 1.4 is highly suggestive of calcified arterial disease. (T/F)
True
Blood pressure cuffs should have a width how much greater compared to the limbs?
20%
What is the important criteria during an imaging arterial system?
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What plane should you do arterial imaging in?
Saggital
What angle is good for a Doppler study?
45-60 degrees
How long does it take to compress a psuedoaneursym?
20-30 min (30-60min)
What would the arm pressures be if there is evidence of a subclavian steal?
20 mmHg difference
If a patient is complaining of an intermittent claudication, their ABI should be ___.
0.59
What does claudication feel like?
pain and discomfort while walking
Where does the SFA lie in reference to the profunda?
Anterior to the profunda
What are the branches off the popliteal artery?
Anterior Tibials
Posterior Tibials
Do segmental pressures typically overestimate or underestimate?
Underestimate disease
A normal toe pressure is ___ mmHg or greater.
> .75- normal
For what reason do PVR’s usually have greater amplitudes than the thigh?
cuff artifact
What disease is suggested when ankle pressures fall after exercise and return back to normal in 5 minutes?
single segment occlusive disease
What might the ankle systolic pressure be if the patient has ischemic lesions?
will not heal if below 55mm Hg
What is the protocol for a graft?
Prox flow Prox anastomosis Prox/MID/DST graft DST anastomosis DST flow
What type of graft is in-situ?
uses the GSV and all the vein valves are removed then the proximal and distal ends are connected to the artery.
-pop-fem and sometimes pop-Tibials
What is a reverse vein graft?
the GSV is removed and turned upside down without removal of valves then sewn back in.
A follow up surveillance of grafts allow the surgeon early detection of ___.
aneurysms, psudoaneurysms, perigraft abscess, defects, stenosis, occlusion
What is the structure used to mechanically hold the artery open?
Stent
What is a less invasive way to repair an aortic aneurysm?
EVAR (endovascular treatment of abdominal aortic aneurysm) - teflon covered stent graft in the AAA
What are the complications of stenting?
endoleak-inadequate seal to prox or distal wall
graft infection
vessel rupture
embolization
Atherosclerotic stenosis is common in the subclavian artery but not in the ___ artery (upper ext).
Axillary, brachial, ulnar, radial are usually spared
What autoimmune disease process can affect the subclavian arteries?
Takayasu’s and giant cell arteritis. pg. 226
What is another name for Buerger’s disease?
Thromboangiitis obliterans
What is the name of the small emboli that connect through the digits?
Thrombo-emboli
What is the vasospastic disorder brought on by cold exposure, chemicals, or vibration injury?
Raynauds
What are both names for Raynaud’s?
Episodiac, prolonged digital vasospasm
Which gender has the largest incidence of Raynaud’s?
Females
9x more than men
What is intermittent pain, numbness or weakness related to arm position?
TOS
Where do you place a PPG pad on your fingers?
Sensor on pad
What is the best testing method for Raynaud’s disease?
Cold submersion test
What is the test for palmer artery perfusion?
Allen test
What upper extremity artery has no vein accompaning it?
Cephalic
Basilic
What graft cannot be penetrated by ultrasound?
Vectra
What vessels are involved with Bueger’s disease?
Digital Arteries
What is the standard recovery time for a cold immersion test?
5 min- normal
10 min- abnormal
What is the anatomy of the lower extremity? (picture)
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What is the anatomy of the upper extremity arterial anatomy? (picture)
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4 arterial studies with PVR’s, continuous wave, and pressures; determine where the disease is located.
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