peripheral vascular system
refers to a closed system of blood vessels that transport blood away from the heart to the body tissues then back again to the heart
blood vessels that branch from the arteries then get smaller and become capillaries
microscopic vessels designed to exchange nutrients and wastes between the blood and tissue fluid around the cells in specialized areas called capillary beds
layers of arteries
tunica adventia, tunica media, tunica intima
external layer of the arteries that consists of connective tissue
middle arterial layer that consists of elastic fibers and smooth muscle; is the thickest layer
internal arterial layer that is composed of a lining of endothelium
composed of the same 3 layers as arteries, but with different thicknesses; middle layer is poorly developed with less smooth muscle; carry deoxygenated blood towards the heart; have larger lumen and thicker adventia; contain valves to prevent back-flow
directly supply blood to the myocardium
common iliac arteries
aorta bifurcates into the right and left?
supply structures in the neck and head area external to the skull
internal iliac arteries
pelvis and perineum receive blood from where?
blood supply to meninges?
blood supply to spinal cord?
drains blood from the brain and meninges and deep regions of the face and neck
drain superficial tissues of the upper extremities
great saphenous vein
longest vein in the body
longest artery in the body
anterior and posterior tibial veins unite to form?
excision of thickened arteromatous tunica intima of an artery
abdominal aortic aneurysm
fusiform; occasionally one or both renal arteries may arise from here without involving the superior mesenteric artery, may also extend beyond the bifurcation of common iliac arteries into external/internal iliac arteries
cutting type needle for cardiovascular/ used for anastomosis of abdominal aortic aneurysm
Dietrich set of instruments
vascular dilators, bulldogs, CV forceps, Potts coronary scissors and vascular clamps; useful for most vascular procedures
5-0 or 6-0
femoral vascular anastomosis would use what suture?
also known as Prolene clamps (mosquito with 1/4 in section of a small-French red rubber catheter on the tips) are essential when double-armed polypropylene sutures are used
mid-abdomen to toes, with leg prepped circumferentially
carotid endarterectomy prep
prep extends from the lower ear of the affected side, across the midline of the neck to just below the clavicle; if saphenous vein graft is to be procured, lower limb of choice must also be prepped; Foley catheter may be required
abdominal aorta prep (aneurysmectomy)
axillary line to the mid-thigh
used for the suppression of arterial vasospasm
opening or cut into the arterial wall
positioning for carotid endarterectomy
supine with head turned approximately 45 degrees to unaffected side, head should rest on a donut headrest or rolled 6 in stockinette and maybe a shoulder roll for neck extension
to reroute an obstruction in the distal portion of the femoral artery
Why is a femoral-popiteal bypass done?
vascular clamps, angled and bulldog
What clamps are used during a carotid endarterectomy?
common carotid, external carotid, then internal carotid
What is the order the clamps are removed?
6-0, 7-0 Prolene, 3-0, 4-0 silk ties 18", closure- suture of surgeon's choice
What suture is used for a carotid?
sharp enough to penetrate muscle or other tissue but less likely to penetrate gloved hands
3-0 or 4-0
suture for aorta?
4-0 or 5-0
suture for iliac artery?
5-0 or 6-0
suture for femoral or popliteal arteries?
6-0 or 7-0
suture for posterior tibial, brachial, radial or ulnar arteries?
suture for common carotid, internal carotid, subclavian arteries
polypropolene, Dacron, polyester, and PTFE
materials used in PV surgery (usually)
supplies oxygenated blood to the liver, stomach, abdominal esophagus, spleen, and superior half of both pancreas and duodenum
What does the celiac artery supply?
retractors for PV cases
Weitlaner self-retaining retractor, Balfour retractor
to reinforce an anastomosis of an abdominal aortic aneurysm and prevent the suture from tearing the tissue
What are pledgets used for?
the anterior and posterior tibial veins
Which vein drains the deep veins of the foot?
internal carotid and vertebral arteries
What supplies blood to the head and the brain?
Castroviejo needle holders
these are used by surgeons with DeBakey pickups for anastomosis...
relaxation phase of the heartbeat
contraction phase of the heartbeat
Where does the right common carotid originate from?
what is the contrast solution used for intraoperative arteriogram?
lack of oxygenated blood to an area or an organ of the body
types of vascular grafts
autogenous (great saphenous vein), synthetic materials including Dacron, PTFE, Gore-tex, Impra, knit polyester, woven polyester, knitted velour, also can be bifurcated or tubular
a type of catheter that is small in diameter and balloon-tipped; used to facilitate removal of an embolus
the force that blood exerts against the internal walls of blood vessels
double-armed sutures on swaged needles
What is used for anastomosis in PV surgery?