Venous UE

Question 1

Paired radial veins (lateral)

Unite with paired ulnar veins (medial) to form

Answer 1

Paired brachial veins.

Question 2

Brachial veins become

Answer 2

Axillary vein at axilla

Question 3

Axila becomes

Answer 3

Subclavian vein

Question 4

________ vein and _______ vein join to form Innominate / brachiocephalic vein.

Answer 4

Subclavian vein and jugular vein

Question 5

Cephalic vein

Answer 5

Superficial vein

Runs down lateral aspect the entire length of the arm

Goes into subclavian vein

Question 6

Basilic vein

Answer 6

Superficial vein

Comes off axillary through the medial aspect. Sometimes it comes off lower by the brachial veins.

It runs medially

Question 7

Medial antecubital vein

Answer 7

Superficial vein that is a common site for IV.

Connects cephalic and basilic vein. Runs diagonal through antecubital fossa.

Question 8

Brachial plexus

Answer 8

Nerve bundle. Very prominent. May look like a dvt. Near brachial vein. When turn long, nerve stretches out and fades away.

Question 9

2 Innominate / brachiocephalic veins confluence to form

Answer 9

Superior vena cava

Question 10

SVC is on right side of body making the ____ Innominate vein longer than the _____

Answer 10

Left longer than right

Question 11

Deep veins

Answer 11

SVC, Innominate, jugular, subclavian, axillary, brachial, radial, ulnar

Question 12

Superficial veins

Answer 12

Basilic, Cephalic, Median cubital

Question 13

Virchow’s triad

Answer 13

1. Trauma to vessel (endothelial damage):
   •IV drugs
   •PICC line (MC in basilic and sometimes cephalic)
2. Venous Stasis:
   •thoracic outlet
   •SVC syndrome

3.Hypercoagulability:
•Pregnancy
•Cancer
•inherited state (factor V Leiden)

Question 14

Thrombus Symptoms

Answer 14

• Pain/edema
• Local erythemia
• Palpable cord (superficial)
• Dyspnea (short of breath)
• Chest pain (with PE)
• Catheter infusion difficulty (patient has trouble pushing fluid through the line or difficult time drawing blood back through the line)

Question 15

Normal prox UE venous

Answer 15

Phasic: changes with respiration

Cardiac pulsatility in subclavian and jugular.

Question 16

Respiration variation

Answer 16

Inspiration in UE decreases intrathoracic pressure but increases intrabdominal pressure as the diaphragm descends.
Inc inflow of blood from arm and head veins.

Exhalation half’s flow in UE

(Opposite in legs)

Question 17

Paget Schroetter Syndrome

Aka

Stress or Effort Thrombosis

Answer 17

MC presentation of axillary-subclavian DVT in the ambulatory population

Thrombosis in subclavian or axillary vein secondary to intense repetitive activity.
Ex: heavy lifting or strenuous throwing of baseball or football.

Can also be caused by clavicular compression in subclavian v. (Venous form of thoracic outlet syndrome) compressed between clavicle and 1st rib.
Over time collaterals build up and may look like Swiss cheese.

• Acute arm swelling with prominent superficial veins.
• vague discomfort with minimal swelling
• can develop extensive collateral

Scan in rest position and symptomatic position. Look for venous distention distal to area of compression. Or loss of normal flow pattern.

Question 18

Superior vena cava syndrome

Answer 18

Obstruction of flow through SVC due to thrombosis or extrinsic compression.

Increase venous pressure

Symptoms : facial edema, dilation is neck veins, bilateral arm swelling.

Can open it back up with a stent.

Question 19

Lulos flow

Answer 19

Commonly seen in jugular