Upper Extremity Disease1

Question 1

Raynauds disease is caused by

Answer 1

vasospasm

Question 2

Causes of upper extremity ischemia due to intrinsic arterial disease

Answer 2

atherosclerosis, radiation arteritis, azotemic arteriopathy, dissection, fibromuscular ds

Question 3

Causes of upper extremity ischemia due to inflammatory disease

Answer 3

connective tissue disorders, Buerger ds, Takayasu arteritis, temporal (giant cell) arteritis, hypersensitivity angiitis

Question 4

Causes of upper extremity ischemia due to non-inflammatory medical disease

Answer 4

thrombophilic states, myeloproliferative disorders, cold injury, hepatitis-associated vasculitis, cryoglobulinemia, vinyl chloride exposure

Question 5

Causes of upper extremity ischemia due to embolism

Answer 5

cardiac, proximal aneurysm, arterial thoracic outlet syndrome, atheroembolism, paradoxic embolus

Question 6

Causes of upper extremity ischemia due to trauma

Answer 6

iatrogenic, blunt, penetrating, hypothenar hammer syndrome, vibration

Question 7

Tx of Raynauds

Answer 7

calcium channel blockers

Question 8

Which Calcium channel blocker is most often used in Raynauds

Answer 8

nifedipine - low cost good oral absorption

Question 9

What other medications can be used to treat Raynauds

Answer 9

alpha blockers, angiotensin II receptor antagonists, prostaglandins, PDE inhibitors and endothelin receptor antagonists

Question 10

Tx of Takayasu�s

Answer 10

corticosteroids

Question 11

How is acute thrombosis of the upper extremity treated

Answer 11

catheter-directed thrombolysis

Question 12

How is the left subclavian artery approached surgically

Answer 12

anterolateral thoracotomy

Question 13

How is the proximal right subclavian artery approached

Answer 13

median sternotomy

Question 14

Name the landmarks of the 3 segments of the axillary artery

Answer 14

1. lateral border of the first rib to the pectoralis minor 2. behind the pec minor 3. lateral border of the pec minor to teres major

Question 15

Describe steal syndrome

Answer 15

hand ischemia follow creation of an AV fistula

Question 16

Why does steal syndrome occur

Answer 16

narrowing in the medium and small arteries of the forearm and hand due to atherosclerosis and vessels are more susceptible to ischemia

Question 17

MC sx�s of steal syndrome

Answer 17

pain, paresthesias, motor weakness, digital ulceration, gangrene

Question 18

Tx of steal syndrome

Answer 18

ligation of the AV access causing ischemia