vessels Flashcards
A 32-year-old pregnant woman speaks to her midwife about her varicose veins. She has had these for a few weeks now, and they came on during pregnancy. Recently, she has noted areas of red-brown pigmentation around the veins on the back of her middle calf.
What is the most likely underlying cause of this?
Haemosiderin deposition leads to the hyperpigmentation seen in patients with varicose eczema/venous ulcers
Lipodermatosclerosis
describes a thickening of the skin in varicose veins, causing a hard or tight feeling. It does not change the colour of the skin.
Atrophie blanche
This describes hypopigmentation seen in venous ulcers, where the healing of the skin is impaired due to poor blood flow, and light scar areas develop.
Acanthosis nigricans
It is an area of skin darkening and hyperpigmentation which is often seen at crease areas of the body, such as armpits or the groin. It is associated with metabolic disorders, including gestational diabetes in pregnancy
what are varicose veins
Varicose veins are dilated, tortuous, superficial veins that occur secondary to incompetent venous valves, allowing blood to flow back, away from the heart. They most commonly occur in the legs due to reflux in the great saphenous vein and small saphenous vein
complications of varicose veins
a variety of skin changes may be seen: varicose eczema (also known as venous stasis) haemosiderin deposition → hyperpigmentation lipodermatosclerosis → hard/tight skin atrophie blanche → hypopigmentation bleeding superficial thrombophlebitis venous ulceration deep vein thrombosis
external carotid splits into what
temporal and maxillary artery
Three in front Superior thyroid Lingual Facial Two behind Occipital Posterior auricular Deep Ascending pharyngeal
most common cause of secondary hypertension
renal disease
last step in the formation of an atheroma
Smooth muscle proliferation and migration from the tunica media into the intima
at the origin of the external carotid what lies directly posterolateral to it
internal carotid
Which of the nerves listed below is at greatest risk of injury with a laceration to the upper lateral margin of the popliteal fossa?
common peroneal
Which arterial vessel usually supplies both the sinoatrial (SA) node and the atrioventricular (AV) node?
right coronary artery
Which one of the following structures separates the subclavian artery from the subclavian vein?
Scalenus anterior
How many valves lie between the superior vena cava (SVC) and the right atrium?
none
There are no valves which is why it is relatively easy to insert a CVP line from the internal jugular vein into the right atrium.
A patient presents with superior vena caval obstruction. How many collateral circulations exist as alternative pathways of venous return?
what are they
4
Azygos venous system
Internal mammary venous pathway
Long thoracic venous system with connections to the femoral and vertebral veins (2 pathways)
