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Vascular Quiz Six
Terms in this set (53)
Upper Extremity Venous Anatomy and Imaging
The Digital veins merge to form the venous ___ ___, which form the paired ___ and paired ___ veins. At the elbow these merge to form the paired ___ veins.
Palmar Arches, Radial, Ulnar. Brachial
The Brachial veins merge to form the ___ vein, which turns into the ___ vein past the armpit. This merges with the ___ ___ vein to form the ___ vein, which merges with the contralateral vein to form the ___ ___ ___.
Axillary, Subclavian. Internal Jugular, Brachiocephalic, Superior Vena Cava
The two main Superficial veins are the ___ and ___ veins.
The digital veins form the Cephalic vein on the ___ side of the forearm.
The Cephalic vein travels laterally up the arm to join with the ___ vein.
The Basilic vein ascends ___ up the arm.
The Basilic vein joins with the ___ vein at the point where it becomes the ___ vein.
Swelling or pain in the neck or arm, pulmonary embolus, dilation of the superficial veins in the arm or shoulder, local erythemia, a palpable cord in the arm, or catheter infusion difficulty are all indications that a ___ ___ exam is needed.
Catheter infusion difficulty occurs since 28% of patients who have indwelling subclavian lines develop ___ ___.
Seven causes of venous thrombosis in the arm include:
1. Compression by a mass
2. Venous Thoracic Outlet Syndrome
3. Intimal injury due to trauma, intraluminal catheter, or pacer wire
4. Fibrosis due to radiation therapy
6. IV drug abuse
With inspiration, thoracic cavity pressure ___, so flow in the upper extremity veins ___.
With expiration, thoracic cavity pressures ___ so flow in the upper extremity veins ___.
When performing an upper extremity venous duplex exam, the patient should be in the ___ position.
When performing an upper extremity venous duplex exam, a ___ or ___ MHz linear for the jugular, subclavian, axillary, and brachial veins; a ___ or ___ MHz should be used for the cephalic, basilic, ulnar, and radial veins.
5 Or 7 MHz, 7 Or 10 MHz
A __ ___ pad may be required when scanning the veins in the forearm.
When performing an upper extremity venous duplex exam, the sonographer must look for an echogenic ___ within the lumen, ___ each vein if possible, obtain and record ___ ___, and ___ should be performed.
thrombus, compress, spectral waveforms, augmentation
True or False: respiratory phasicity and cardiac pulsatility is normal in the Internal Jugular veins.
The ___ Subclavian vein will be found at the supraclavicular position.
The ___ Subclavian vein will be found at the infraclavicular position.
The flow in the Subclavian vein will be both ___ and ___.
Special attention must be paid to the ___ of the flow in the Subclavian veins.
While scanning the Axillary vein, if transient compression occurs, ask the patient to ___ their arm.
Which are more likely to be thrombosed, the Cephalic and Basilic arteries, or the Radial and Ulnar arteries?
The Cephalic and Basilic arteries.
Which veins should show cardiac pulsatility when normal?
The Central Veins
The Central Veins include:
The Subclavian, Jugular, Axillary, Iliacs, and IVC
Retrograde flow in the Anterior Jugular vein and Jugular Arch indicates ___ vein obstruction.
Venous and Arterial Mapping
Pre-operative venous mapping assess for 5 procedures:
1. In-situ femoral-distal bypass grafts
2. Reversed femoro-popliteal bypass grafts
3. Coronary artery bypass graft (CABG)
4. Endoscopic perforator ligation
5. Venous closure procedures
A planned in-situ femoral-distal bypass graft will require the ___ veins to be assessed.
A planned reversed femoro-popliteal bypass graft will require the ___, ___, and ___ veins to be assessed.
saphenous, cephalic and basilic
A planned coronary artery bypass graft (CABG) will require the ___ artery to be assessed.
The five vessels that can be harvested for bypass are:
1. Greater Saphenous Vein
2. Lesser Saphenous Vein
3. Cephalic Vein
4. Basilic Vein
5. Radial Artery
The GSV begins at the ___ ___ and ends at the ___.
medial malleolus, CFV/SFJ
___% of the population has a bifid (double) system in the thigh.
A branch of the GSV communicates with the ___ vein in the thigh.
The SSV runs along the ___ aspect of the calf, drains into the ___ vein, and communicates with the ___ via the Giacomini vein.
posterior, popliteal, GSV
Vein diameter will expand by ___ to ___ times when arterialized.
1.5 - 2
Vein diameters of ≥ 2.5 mm have higher ___ rates.
Veins < 2.5 mm have high ___ rates.
When performing a pre-operative exam to map veins for suitability, the patient should be in which position?
Reverse Trendelenberg or upper body elevated.
When performing a pre-operative exam to map veins for suitability, a ___ to ___ MHz linear transducer should be used.
7.5 - 10 MHz
When performing a pre-operative exam to map veins for suitability, scan the entire GSV and measure the ___. Identify ___ systems, irregularities of the ___, and residual ___.
diameter. bifid, wall, thrombus
When performing a pre-operative exam to map veins for suitability, if the GSV is too small, measure the diameter of the ___.
When scanning the Perforator Veins, the patient should be ___ with the leg ___, or the patient can be ___.
sitting, dependent, standing
When scanning the Perforator Veins, the sonographer should scan the fascia for "holes", or disruption of fascial plane by the vein coursing ___ to connect to the ___ venous system.
Perforators tend to be ___.
Skin depression can often be palpated over ___ perforators.
When evaluating the Perforators, begin in a ___ ___ approach and scan straight down to the ___, looking for defects in the deep fascia. Move the transducer over one ___ width and repeat scan, proceeding until the entire calf circumference is scanned.
Transverse Medial, ankle. probe
The ___ artery may be harvested for use as a Coronary artery bypass graft.
The three advantages of using the Radial artery for Coronary artery bypass are:
1. Appropriate caliber
2. Thicker wall (less hyperplasia)
3. Better availability
When performing a pre-operative assessment, bilateral arm pressures should be taken, with a 20mmHg gradient significant for ___ ___ syndrome.
When performing a pre-operative assessment, a full digital evaluation using ___ and ___ should be done, along with the ___ Test for Palmar Arch patency.
PVR (Pulse Volume Recording), PPG (Photoplethysmography), Allen
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