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Sugery - AS PACES > Vascualr > Flashcards

Vascualr Flashcards

1
Q

Anatomical location of the SFJ

A

2 finger breaths below and lateral to the pubic tubercule

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2
Q

Definition of a varicose vien

A

Torturous dilated vien of the superficial venous system

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3
Q

Cause of varicose veins

A 
Primary/idiopathic
- RF: prolanged standing, OCP, pregnancy obesity 
Secondary 5% 
- valve destruction: DVT, thrombophlebitis 
- obstruction: pelvis mass, DVT 
- Avm 
- klippel - trenaunary - weber 
- parkes - weber syndrome
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4
Q

Klippel- trenaunary - weber syndrome

A

Abnormality of the deep venous syndrome causing

  • varicose vein
  • port wine stain
  • bony and soft tissue hypetrophy of the limbs
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5
Q

Parkes-weber syndrome

A

Multiple AVM with limb hypetrophy

AVM can lead to highout out heart failure

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6
Q

Types of minimally invasive therapies for varicose viens

A

Injection sclerotherapy - 1% Na tetradecyl sulphate

Endovenous laser or radio frequency abalation

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7
Q

Indication for minimally invasive therapy for varicose veins

A

Small below knee varicosities not involving the Great saphenous vien or short saphenous vien

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8
Q

Indications for surgical management of varicose viens

A

SFJ Incompetence
Major perforator incompetence
Symptomatic: ulceration, skin changes, pain

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9
Q

Surgical intervention for varicose veins

A

Trendelenburg: saphenofemoral ligation
SSV Ligation: in the popliteal fossa
LSV STRIPPING - No longer performed
Multiple adulation
Cockett’s operation: perforator ligation
SEPS: subfascial endoscopic perforator surgery

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10
Q

Complications of varicose viens

A 
Early: heamatoma, wound sepsis, nerve damage
Late
- superficial thrombophlebitis 
- DVT 
- reoccurrence: 10% at 15years
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11
Q

Cause of chronic venous insufficiency

A

Reflux following DVT - 90%

Obstruction following DVT - 10%

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12
Q

Surgical management of chronic venous insufficiency

A

Reflux
- trahere transplantation: axillary vein transplant
- kistner operation: valvuloplasty of damaged valve
Obstruction
- Palma operation

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13
Q

Leriche syndrome

A

Buttock claudication and wasting
Erictile dysfunction
Absent femoral pulses

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14
Q

Risk factor for peripheral vascular disease

A

Modifiable: smoking, BP, DM control, Hyperlipidemia, decreased exercise
Non-modifable: FHx, PMH, Male, increased age, ethnicity

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15
Q

Fontaine classification for chronic limb ischemia

A
  1. Asymptomatic - 0.8-1

2. Claudication - a (>200m) b(

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16
Q

Doppler sounds

A

Normal - triphasic
Mild stenosis - biphasic
Severe stenosis - Monophasic

17
Q

Increased risk of AAA rupture

A

High BP
Smoker
Strong FH
Female

18
Q

Defintion of AAA

A

Abnormal dilatation of the abdominal aorta to >50% of its normal diameter = >3cm

19
Q

Indication for AAA operation

A 
Symptomatic/evidence of complication 
Rupture 
Asymptomatic 
- greater or equal to 5.5cm 
- expanding greater than 1cm a year
20
Q

Complication of AAA

A 
Death 
MI 
Renal failure 
Spinal or mesenteric ischemia 
Distal trash from thromboembolism 
Anastomotic leak 
Graft infection 
Aortoenteric fistula
21
Q

Signs of chronic venous insufficiency

A 
HAS LEGS 
haemosiderosis 
Atrophie Blanche 
Swelling 
Lipodermatosclerosis 
Eczema 
Gaiters ulcers 
Stars - venous
22
Q

Indication for surgical management of popliteal aneurysm

A

Symptomatic
Aneurysm containing thrombus
Aneurysm greater than 2 cm

23
Q

Definition of a true aneurysm

A

Dilation of a blood vessel involving all layers of its wall and is >50% of its normal diameter

24
Q

Definition of a false aneurysm

A

Collection of blood vessels around a vessel wall that communicates with the vessel lumen

25
Q

Detention or vessel dissection

A

Vessel dilatation caused by blood splaying apart the media to form a channel within the walls

26
Q

Complication of aneurysm

A 
Luminal:
- thrombosis leading to distal embolism
- infection of artery thrombosis 
Mural - rupture, fistulation 
Extra-mural- external pressure e.g. DVT
27
Q

Management of false anneurysm

A

Ultrasound compression
Thrombin injection
Surgical repair

28
Q

Indication for amputation

A

Dead: PVD, Thromboangitis obliterans
Dangerous: infection, sepsis, malignancy
Damaged: trauma, burns, frost bites
Damned nuisance: pain, neurological damage

29
Q

Complications of endarterectomy

A

3% risk of stroke or death
Heamatoma
MI
nerve Injury
- hypoglossal: ipsilateral tongue deviation
- great auricular: numb ear lobe
- recurrent laryngeal: hoarse voice, bovine voice

30
Q

Definition of gangrene

A

Irreversible tissue death from poor vascular supply

31
Q

Cause of gangrene

A 
DM
embolism and thrombosis 
Raynauds 
Thromboangitis obliterans 
Injury: extreme cold, heat, trauma or pressure
32
Q

Definition of Raynaud’s phenomenon

A

Characteristic cold induced changes associated with vasospasm

33
Q

Definition of Raynaud’s disease

A

Primary Raynaud’s phenomenon occurring in isolation

34
Q

Raynaud’s syndrome

A

Secondary Raynaud’s phenomenon associated with other disease

35
Q

Secondry causes of Raynaud’s

A

Blood: polycythemia, cyroglobulinemia, cold agglutins
Aterial: atherosclerosis, Thromboangitis obliterans
Drugs: beta-blockers, OCP, ergotamine
Cervical rib: thoracic outlet obstruction
Autoimmune: SLE, RA, systemic sclerosis
Trauma: vibration injury

36
Q

Cause of venous ulcers

A 
Valvular disease 
Varicose veins 
Deep vein reflux 
Outflow obstruction 
Muscle pump failure 
Stroke 
Neuromuscular disease

Sugery - AS PACES (7 decks)

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