upper exremity vein protocol Flashcards
patient positioning- upper extremity veins?
- examined with bed flat and patient in supine
- It is especially important that the bed be flat while the jugular and subclavian veins are examined because they will collapse if the head of the bed is up
- Once these vessels are imaged, the bed can be raised to allow for imaging of the arm veins
external jugular vein in relation to the internal jugular vein?
external jugular vein lies superficial and posterior to the internal jugular
where does the external jugular meet the internal jugular?
low in the neck to form the subclavian and brachiocephalic veins
Following the brachiocephalic (innominate) vein is usually difficult because of?
the sternum and air-filled lings that block ultrasound
what kind of probe can improve visualization of the brachiocephalic vein region?
small footprint probes that operate at lower frequencies
what kind of flow is normal at the innominate vein?
- pulsatile phasic flow is normal due to proximity to the heart
subclavian vein course?
moves from its junction with th jugular and brachiocephalic veins toward the arm as it passes under the clavicle
what is the subclavian vein?
- a large deep vein that runs alongside the subclavian artery at a deeper caudal location
One way to check for collapsibility of the subclavian vein?
- examiner has patient take a quick breath in with lips pursed, this allows vein to collapse while doppler is on
- there will be a “spike like augmentation” of the flow patters
with the subclavian vein a nonphasic flow patters indicated?
a more proximal obstruction
- compare the flow patterned with opposite side
- image the vein with colour doppler in its length
Absence or diminished subclavian vein flow or change in flow due to deep inspiration is indicated for?
central venous stenosis or occlusion
what is the cephalic vein?
- a superficial cein that empties into the subclavian vein and travels superficially without an accompanying artery
- runs across the shoulder and down the anterior-lateral border of the biceps muscle
where is the median cubital vein located?
- at the level of the anticubital fossa
- there is a branch-median cubital vein that will connect the cepalic to the basilic vein that travels in the medial portion of the arm
After communicating with the median cubital vein, what vein continues into the forearm?
the cephalic vein
There are commonly two branches of the cephalic vein in the forearm, what are they?
- one will tracel down the volar (palmar) aspect of the forearm to the wrist
- one will roll onto the dorsal aspect of the forearm as it approaches the wrist
median cubital vein connects what?
the superficial veins at the elbow level
where does the subclavian vein become the axillary vein?
- below the level where the subclavian vein receives the cephalic vein
- the subclavian becomes the axillary
where is the axillary vein located?
- travels through the axilla- compressible and augmentable
- in most parts of the body the deep vein will travel directly alongside the artery of the same name
where is the brachial vein located?
- continues down the arm as 2 small paired veins on either side of the brachial artery
the brachial veins form?
a short single vein at the antecubital fossa
what happens to the brachial vein at the antecubital fossa?
At this level, the Brachial veins split into a pair of Radial and a pair of Ulnar veins that accompany the artery of the same name
radial veins course?
course along the volar aspect of the forearm on the radial side towards the thumb (lateral)
what accompanies the radial veins?
2 very small veins that accompany the artery all the way into the hand near the thumb
Ulnar veins located?
From the level of the brachial vein, the ulnar veins travel along the volar aspect of the forearm and enter the hand at the wrist on the ulnar side (medial)
To examine the Basilic vein we?
we go back to the midportion of the upper arm and find its distal end from the axillary vein
The Basilic V will travel without an artery along the?
medial forearm and will, for a time, parallel the Brachial veins-appears larger
At a point near the anticubital fossa what is seen?
the Basilic vein joins with the Median cubital vein, which crosses over the top of the Brachial artery and vein like a freeway overpass to eventually connect to the Cephalic vein
basilic vein vs. brachial vein?
- Basilic V is larger, singular and more medial than the brachial veins
- It is compressible,use light probe pressure for color image
