Vascular quick pics

Question 1

Present

Answer 1

presentation: Abnormal, Tortuous, dilated veins of the superficial venous system. clearly in the distribution of the LSV in the medial side of the thigh and calve. These can be primary: which 99% are, which replies a failure of the valves and reflux down the superficial venous system. They can be secondary; as a result of blockage in the deep viens and increased pressure on the venous system higher up.

Question 2

Answer 2

Question 3

Answer 3

Question 4

Answer 4

Question 5

Answer 5

Question 6

Answer 6

palpate graft across pubic symphysis (reinforcement rings?) ?bilateral femoral pulses distal to the graft=working

Question 7

Answer 7

Question 8

Answer 8

LEFT: Long saphenous vein harvest; (+ stenotomy scar=CABG), arteria graft in the leg (+ scar over femoral artery=Femer-O-popliteal bypass/distal) pulse over scar=in situ graft // RIGHT: PTFE prosthetic material, scar at access site/terminal site. Access popliteal artery from medial above the knee or below the knee (NOT THE BACK)

Question 9

Answer 9

extra anatomically tunnelling (fem-anterior tivia)

Question 10

arterial supply of the upper limb (anatomy)

Answer 10

Question 11

Thoracic aorta anatomy

Answer 11

Question 12

External iliac artery anatomy (coeliac trunk to ext iliac)

Answer 12

Question 13

Lower limb arterial supply anatomy

Answer 13

Question 14

position of anterior tibial pulse

Answer 14

Question 15

Arterial anomalies

Answer 15

• Dominant peroneal artery; Reported to be present in 5% of the population, there is absent dorsalis pedis pulse on examination and a pulse just anterior to the lateral malleolus as the foot is supplied by branches of the peroneal vessel
• Persistent sciatic artery; Rare condition , characterised by a persistent sciatic arterial supply to the lower limb and absence of femoral vessels. May present with claudication

Question 16

Answer 16

transmetatarsal amputation

Question 17

Answer 17

• Charcot joints; painless but hugely deformed joint abnormality

Question 18

Answer 18

raynaud’s phenomenon

Question 19

Answer 19

Venous malformations:

• Bluish
• Often raised
• Painful sometimes
• By far the most common
• Not pulsatile
• No Bruit
• No signal with hand held Doppler
• No cardiac compromise

Question 20

Answer 20

Arteriovenous malformations; like a fistula

• Rare
• Pulsatile dilated veins
• Bruit
• Obvious signal on hand held Doppler
• May be overgrowth of limb (or steal and no growth)
• May be significant shunt and Cardiac failure; high output cardiac failure due to shunt

Question 21

Answer 21

lymphoedema

• PRIMARY
• SECONDARY
  
  • COMMONEST WORLDWIDE IS FILARIASIS
  • COMMONEST IN UK IS IATROGENIC
  • CANCER
  • OTHER INFECTIOUS CAUSES

Question 22

Answer 22