Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Acute Care Seminar 1 > Vascular Complications > Flashcards

Vascular Complications Flashcards

1
Q

Carotid Artery Evaluation

A

-Carotid Bruit»Carotid US > CT angio of neck
<70%, asymptomatic = monitor and med manage
<70%, symptomatic = intervention
>70%, asymptomatic = intervention

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Carotid Interventions

A

–Medical management
BP control
Diet (low fat, low cholesterol, low sodium)
Antiplatelets (Plavix vs Aspirin)
Statin therapy
—Surgical
Open vs stent

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Carotid Artery Endarterectomy

A

-Asymptomatic (plaque >70%) or **symptomatic pts
-No previous h/o radiation therapy to neck
-No previous h/o of CEA to same side

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Open (endarterectomy (CEA))

A

-Removal of plaque
-Patch placed (bovine, Dacron)
-Post op Care:
Monitor incision (hematoma, bleeding)
Monitor BP (systolic 110-140)
Follow ECG and troponin (> risk of MI)
Neuro exam

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Nerves most affected after CEA

A

-Facial Nerve (CN VII) –perioral weakness, drool
-Glossopharyngeal (CN IX)- swallow
-Vagus (CN X)- vocal cord (hoarseness)
-Hypoglossal (CN XII)- tongue innervation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Stenting (Carotid Artery Stent (CAS))

A

-Indications:
Plaque not approachable by CEA
High risk for cardiac complications
<70 yo
h/o radiation therapy on affected side
**symptomatic pts NOT candidate
-Puncture site at groin
-Post Op Care
Same as open procedure
> risk of stroke

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

TCAR-Transcarotid Arterial Revascularization

A

-New hybrid procedure (carotid endarterectomy and stenting)
-Minimally invasive
-Small incision above collar bone and groin puncture site (venous)
-Temporary reversal of flow to prevent plaque embolization

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Arterial Structure

A

-Intima-inner most layer, thin wall
-Media-middle layer, thickest
-Adventitia-Outer layer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Aneurysm Definition

A

Localized dilatation of an artery
Diameter >50% of normal diameter (varies-sex, age, bp)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Ectasia Definition

A

Increase artery diameter but <50% of normal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Dissection Definition

A

Abrupt tear along the inside of arterial wall

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Transection

A

Complete cut across artery or vein

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Abdominal Aortic Aneurysm Grading System

A

-Normal <2.5 cm
-Generous 2.5-3.0 cm
-Aneusym

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Abdominal Aortic Aneurysm Grading System

A

-Normal <2.5 cm
-Generous 2.5-3.0 cm
-Aneurysm: Small (3.0-3.5cm), Medium (3.5-4.5cm), Large (>4.5cm)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Thoracic Aorta Locations

A

-Aortic arch
-Ascending
-Descending

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Abdominal Aorta Locations

A

-Infrarenal-Below the renal arteries
-Juxtarenal-infrarenal and involving one or both renal arteries
-Pararenal-involving one or both renal arteries
-Suprarenal-Above the renal arteries

17
Q

Shapes of Aneurysm

A

-Fusiform
Symmetrical bulge around aorta
Most common
-Saccular
Asymmetrical & appears on one side of aorta
Likely r/t trauma or aortic ulcer
-Pseudoaneurysm
“False” aneurysm
Actual disruption of one or more of the wall layers

18
Q

Medical Management of Aneursym

A

-Blood pressure control
-ASA
-Statin therapy
-Quite often missed treatment in pts with PAD/aneurysms
-Nicotine cessation
-Weight loss/increase activity tolerance

19
Q

Possible Warrants of Medical Management: Aneurysms

A

-Aneurysms <5.4 cm, asymptomatic = every 6 months monitoring
-Aneurysms >5.4 cm, asymptomatic = may warrant repair
-Aneurysms <5.4 cm but symptomatic = warrant repair
-Symptoms can include: pulsatile abdominal pain, back pain,

20
Q

Open Repair Surgical Intervention

A

-“Traditional” approach
-Longer length of hospital stay
-For those whose aortic anatomy not suitable for endovascular repair
No landing zone for stent graft
Tortuous aorta
-Definitive treatment
-Less frequent follow ups
-Risks: increased blood loss, MI, hemorrhage, injury to bowel or ureters, paraplegia, wound infection

21
Q

Surgical Intervention: Endovascular

A

-Standard stent graft vs surgeon-modified vs manufactured fenestrated stent graft
Graft material polyester (Dacron) or polytetrafluoroethylene (PTFE)
-For those whose body habitus does not support an open repair
-Small percutaneous puncture/smaller femoral incision
—–Disadvantage
Frequent follow ups (every 3-4 months)
Potential for graft movement
Potential for endoleaks

22
Q

Stenotic lower extremities

A

-Atherectomy (shaving of plaque)
-Stent
-Bypass (vein or prosthetic)

23
Q

Compartment Syndrome

A

-Insufficient oxygen supply to muscles and nerves.
-Pain most common (motor and sensory loss=late signs)
-CK -follow serially q4-6hrs >1000 is concern
-Urine: Cr to assess renal function, Urine myoglobin (presence worrisome)
-Compartment Pressure ( >/= 30 mmHg + any of above highly suggestive)

24
Q

Treatment of Compartment Syndrome

A

-Leg elevation
-IV Fluids (sodium bicarb)-prevent further renal failure and muscle breakdown)
-Fasciotomies

25
Q

Peripheral Artery Disease

A

-Narrowed arteries reduce blood flow to arms and legs
-Leg pain when walking (claudication)
-Sign of buildup of fatty deposits (atherosclerosis)
-Atherosclerosis causes narrowing of the arteries that can reduce blood flow (sometimes arms)
-Complications include critical limb ischemia, stroke or MI

26
Q

Symptoms of PAD

A

-Many people of mild to no symptoms
-Claudication
-Coldness in extremities
-Leg numbness/weakness
-Shiny skin on legs
-Skin color changes
-Slower growth of hair and toenails
-Sores
-Acutely pain may get works even at rest

27
Q

Risk factors for PAD

A

-Smoking
-HTN
-HLD
-Obesity
-family hx
-Age
-High levels of amino acids called homocysteine

28
Q

Prevention of PAD

A

-Nicotine cessation
-Low fat diet
-Control blood sugar
-diet
-BP and HLD management
-Exercise

29
Q

Ankle-Brachial Index (ABI)

A

-A way to dx PAD
-Compres BP in the ankle and the BP in the arm
-Also may get BPs taken before and after walking
-Normal ABI is 1.10-1.40
-SBP in ankle/SBP in arm
<0.9 is considered diagnostic of PAD
<0.5 suggests severe PAD

30
Q

Diagnosing PAD

A

-Blood test (lipids, CBC)
-ABI
-US of legs or feet
-Angiography
-Could be normal not to feel DP pulses bilaterally
-Always should be able to feel a PT

31
Q

Treatment for PAD

A

-Lifestyle modifications
-Cholesterol meds
-BP meds (BB)
-Meds to control blood sugar
-Antiplatelt/ Dual therapy
-Meds for leg pain
-Angioplasty and stent placement
-Bypass surgery (uses healthy or synthetic vessel)
-Thrombolytic therapy

32
Q

Peripheral venous disease symptoms

A

-Swelling in legs, feet or ankles
-Prescence of spider veins or varicose veins
-Tired feeling in legs
-Difficulty standing for long
-Burning/numbness in thighs or calves
-Itchy, dry skin
-Same risk factors as PAD

33
Q

Ateriovenous Fistula

A

-Pseudoaneurysm (irregular connection between artery and vein)
-Purplish, bulging veins
-Can cause blood clots to form
-Internal bleeding risk
-Swelling
-Decreased BP
-HF
-Check with duplex US
-CTA or MRA
-Check for bruit
-Treatment can be US guided compression
-catheter embolization
-Surgeyr

34
Q

Varicose Veins

A

Twisted, enlarged veins
-Most common in legs
-Cause is weak vein walls and veins
-PVD
-Treatment could be sclerotherapy (injection of foam into veins)
-Laser treatment
-Catheter based procedures
-High ligation and vein stripping
-Ambulatory phlebectomy
-Avoid long periods of sitting or standing
-Raise legs
-Avoiding tight clothing
-Avoid salt and making lifestyle changes

Acute Care Seminar 1 (31 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions