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Vascular Quiz Four
Terms in this set (90)
Upper Extremity Arterial Anatomy and Diseases
The Subclavian Artery becomes the ___ Artery at the Thoracic Outlet.
The Axillary Artery has 8 arteries that branch off of it:
Lateral Thoracic Artery
Anterior Humeral Artery
Posterior Humeral Artery
When the Axillary Artery exits the armpit, it becomes the ___ Artery.
The Brachial Artery bifurcates into the ___ and ___ Arteries below the elbow fossa.
The Radial Artery runs along the ___ side of the arm.
The Ulnar Artery runs along the ___ side of the arm.
The Radial Artery is the main supplier of the ___ Palmar Arch.
A small branch completes the circuit of the ___ Palmar Arch.
The Ulnar Artery is the main supplier of the ___ Palmar Arch. A small branch completes the circuit of the ___ Palmar Arch.
Symptoms of upper extremity arterial disease include weakness, pain, or numbness of the arm or hand with ___ or ___, reduced or absent ___, ___ of the fingers, and ___ sensitivity.
exercise, position, pulses, ischemia, cold
Five types of upper extremity disease are:
Thoracic Outlet Syndrome
Four symptoms of digital ischemia are:
pain, pallor, cyanosis, and numbness.
___ ___ results from episodic digital vasospasm.
A patient with ___ Raynaud's Syndrome will have normal arteries; it is purely a vasospastic disorder.
A patient with ___ Raynaud's Syndrome will have an underlying systemic disorder (autoimmune or connective tissue).
A patient with Raynaud's Syndrome will have episodic vasospastic attacks that occur in response to two stimuli:
Raynaud's Syndrome is more common in ___, and begins between the ages of ___ and ___.
Primary Raynaud's Syndrome is caused by the vasoconstriction of the ___ arteries; vessels are ___ between episodes.
Patients with Primary Raynaud's Syndrome complain of ___ fingers or toes, especially in response to ___ ___ or ___ ___.
cold, cold temperatures, emotional stress
Primary Raynaud's Syndrome is usually ___-lateral, symmetrical, and usually involves ___ fingers. Diagnosis is made from the patient's ___.
bi, all. history
Secondary Raynaud's Syndrome is due to conditions associated with abnormal vessel walls or increased viscosity of blood, including ___ tissue disease, ___ disorders (i.e polycythemia vera), ___ causes, ___ disorders, or ___ related damage.
connective, blood, arterial, neurovascular, drug
Secondary Raynaud's Syndrome may be ___-lateral, patchy, and asymmetrical, with symptoms that are ___ severe than Primary Raynaud's Syndrome.
There are two types of arteritis that affect the upper extremity arterial system:
Takayasu's Arteritis is a rare disease caused by an ___ disorder.
Takayasu's Arteritis affects the ___ ___ branches.
aortic arch (subclavian, carotid, ascending aorta)
Buerger's Disease is also known as ___ ___.
Buerger's Disease is an inflammatory condition of the ___ ___ and / or ___ arteries that leads to the ___ of small vessels.
palmar arch, digital, obstruction
Is Buerger's Disease found in male or female smokers?
Intermittent pain, numbness, tingling, weakness, or coldness in the upper extremity caused by the compression of nerves or blood vessels in the thoracic outlet describes:
Thoracic Outlet Syndrome.
The space between the rib cage (thorax) and the collar bone (clavicle) through which blood vessels and nerves supplying the arm run is called the:
95% of the time Thoracic Outlet syndrome is caused by:
Less than 5% of time Thoracic Outlet syndrome is caused by:
Thoracic Outlet Syndrome may lead to ___, ___, and aneurysm of the ___ or ___ arteries.
thrombosis, fibrosis, subclavian or axillary
Thoracic Outlet testing is performed when the patient complains of arm pain or numbness that is related to ___.
Thoracic Outlet testing is used to rule out compression of the ___ or ___ arteries.
subclavian or axillary
When performing Thoracic Outlet testing, a ___ study must first be performed.
During the baseline Thoracic Outlet test, segmental systolic pressures are taken at the ___ and ___ bilaterally.
During the baseline Thoracic Outlet test, obtain pulse volume recordings or CW waveforms from four arteries:
axillary, brachial, radial, and basilic arteries.
After the baseline Thoracic Outlet test, obtain ___ with the patient in multiple positions, especially the one the patient indicates is ___.
The five positions for the Thoracic Outlet are:
90 degrees abduction to torso
180 degrees above head
The Allen Test is used to see if the ___ ___ is patent.
The Allen Test is a Pre-op Assessment for ___ artery harvest (CABG) or ___ access placement.
The Allen Test is performed by compressing the ___ and ___ arteries, the hand is ___, and one of the arteries is released. Repeat on the other side.
Radial, Ulnar, exsanguinated
Duplex of Upper Extremity Arteries & Hemodialysis Grafts
If used to evaluate arteries or grafts after surgery, upper extremity duplex scanning can be limited by the presence of wound ___, skin ___, sutures, open ___, or the presence of an ___.
dressings, staples, wounds, IV
It can be difficult to evaluate the ___ site of grafts with Duplex scanning.
When performing an upper extremity arterial exam, the patient should be ___ in the ___ bed position, with the arm close to examiner and arm ___ rotated.
supine, semi-Fowler's, externally
When performing an upper extremity arterial exam, use a ___ MHz transducer for the upper arm, and a ___ MHz transducer for the lower arm.
5 MHz, 7.5 MHz
Claudication symptoms due to plaque are much ___ common in the arteries of the arms than those of the legs.
When scanning the Subclavian Artery and the upper arm, bring the patient's arm ___.
When scanning the antecubital fossa and forearm, bring the patient's arm ___ with the palm ___.
Normal upper extremity arterial waveforms should be ___-phasic or ___-phasic, with a reverse component in ___ ___.
tri, bi, early diastole
If the arm has been heated or exercised intensely, the waveform of the arteries may be ___-phasic. In all other cases, this is pathological.
Waveforms at a stenosis will have ___ velocities.
Post-stenotic waveforms will display ___ ___.
___ is a treatment used in cases of renal failure, in which a machine filters waste products from the blood.
Hemodialysis is usually required ___ times per week for ___ to ___ hours each treatment.
A vascular ___ is required for hemodialysis treatments.
Surgeons create a ___ or insert a ___ ___ to allow for hemodialysis.
fistula, access graft
A ___ is a connection between an artery and a vein.
An ___ ___ is synthetic material placed between an artery and a vein to allow for dialysis puncture.
Sonography is used to assess grafts and fistulas at risk for ___.
The preferred type of hemodialysis graft is the:
The Brescia-Cimino-AV graft forms a fistula between the ___ artery and the ___ vein or the ___ artery and the ___ vein.
Radial to Cephalic, Ulnar to Basilic
Is the Brescia-Cimino-AV graft autogenous or artificial?
The Brescia-Cimino-AV graft has ___-term patency, and a ___ complication rate.
A Straight graft is made of ___, aka ___.
PTFE (Poly-tetrafluoroethylene), aka Gortex
A Straight graft can connect the Radial artery to the median ___ or the ___ vein.
A Straight graft can connect the distal Brachial artery to the proximal ___ or ___ vein.
A Straight graft may be ___, and the length of patency is ___ than that of the Brescia-Cimino-AV graft.
A Straight graft in the upper arm connects the ___ artery to the ___ vein.
The ___ graft is the worst type of graft as it is tortuous, and so prone to ___.
A Looped graft may connect the Brachial artery to 4 different veins:
Cephalic, Median Cubital, Basilic, or Axillary.
A Looped graft may connect the Superficial Femoral artery to the:
Greater Saphenous vein.
When evaluating a hemodialysis graft, ID and evaluate 5 areas:
Body of the graft
When evaluating a hemodialysis graft, observe for ___, leaks at ___ site, peri-graft ___ collections, and other abnormalities.
aneurysms, puncture, fluid
When evaluating a hemodialysis graft, evaluate the ___ increases, ___ indicating stenosis, or ___ ___ changes.
velocity, turbulence, flow channel
There are six hemodialysis graft complications:
Stenosis at various locations in graft
Aneurysm or pseudo-aneurysm
Elevated right heart pressure
Stenosis within an access graft happens at four locations:
Proximal and distal anastomoses
Stenosis at the venous outflow location of an access graft occurs for two reasons:
intimal hyperplasia or thrombus.
While there are no standardized systolic velocities for hemodialysis grafts, peak systolic velocities and end diastolic velocities within the graft are normally quite ___ with ___ resistance.
Low peak systolic velocities in graft may suggest an arterial ___ problem.
The two most common sites for stenosis are:
___ ___ Syndrome occurs when flow is stolen from distal circulation to the venous circulation via the hemodialysis graft.
The symptoms of Arterial Steal Syndrome are: ___ with exertion of affected extremity, ___ of the affected extremity, and skin is ___ distal to the graft.
pain, pallor, cool
A pseudo-aneurysm may be caused by graft ___ or problems at the site of graft ___.
A pseudo-aneurysm is not a problem if less than ___cm in size
A pseudo-aneurysm and hematoma may both be cause by the puncture of the hemodialysis graft, but a pseudo-aneurysm will have ___ ___ under Color Doppler, while a hematoma will not.
___ ___ can occur when there is stenosis at the venous end of a hemodialysis graft, which causes retrograde flow.
Venous Hypertension will present with hand ___ and venous ___.
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