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Vascular II & Physics II > Vascular Ch. 18 > Flashcards

Vascular Ch. 18 Flashcards

1
Q

3 differences in protocol techniques for upper extremity and lower extremity

A
  1. thrombi in lower extremity often caused by stasis: NOT SO IN THE UPPER EXTEMITY (NO SOLEAL SINUSES) 2. superficial veins affected more in arms than in legs 3. venous anatomy of upper extremity is more variable than lower extremity
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2
Q

Why is thrombi in LOWER extremity often caused by stasis and not so in the upper extremity

A

no soleal sinus

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3
Q

Does superficial thrombosis have greater clinical significance in arm than the leg

A

yes

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4
Q

Facial swelling or dilated chest wall collaterals is suggestive of

A

superior vena cava thrombosis

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5
Q

PE symptoms include

A

chest pain, tachypnea, tachycardia

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6
Q

Why is upper extremity thrombosis more common

A

injury to vessel wall

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7
Q

What causes injury to vessel wall in upper extremity

A

more frequent introduction of needles and catheters into arm veins

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8
Q

What is PICC and does it cause thrombosis

A

peripherally inserted central catheter, yes

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9
Q

Where is catheter inserted and positioned

A

through basilic or cephalic vein, positioned near right atrium

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10
Q

What is paget-schroetter syndrome

A

venous thrombosis associated with compression of subclavian vein at the thoracic outlet

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11
Q

Another name for Paget-Schroetter syndrome

A

effort thrombosis

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12
Q

Typical patients of paget-schroetter syndrome

A

young, athletic, muscular males

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13
Q

What position do you examine internal jugular and subclavian veins

A

lying flat, supine

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14
Q

Why does the patient need to lay flat for IJV and subclavian vein

A

removes the impact of hydrostatic pressure which tends to collapse these veins

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15
Q

Are compressions performed with brachiocephalic veins

A

no

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16
Q

What is the landmark for the subclavian vein

A

the cephalic vein because it terminates into subclavian after it passes under clavicle

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17
Q

Why should color and spectral doppler be documented for subclavian vein

A

most helpful to document patency and doppler signals will be both pulsatile and phasic

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18
Q

In the cephalic vein, thrombus at this level will have

A

the same gray scale appearance as thrombus within the brachial vein

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19
Q

Normal vein walls will ______ with transducer pressure

A

completely compress (performed in transverse)

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20
Q

In diagnosis, normal vein walls should be

A

smooth, thin, anechoic vessel lumen

21
Q

What changes SLIGHTLY with respiration

A

vein diameter

22
Q

Superficial vein thrombus will have same appearance as

A

DVT

23
Q

What is the appearance of superficial vein thrombosis

A

hypoechoic areas may be present around vein due to inflammation

24
Q

_______ forming around a catheter may cause doppler signals to ________

A

nonocclusive thrombus, become continuous

25
Q

Spectral doppler waveforms should demonstrate

A

respiratory phasicity, augmentation with distal compression, and pulsatility (common near heart)

26
Q

What vessels may have pulsatility

A

IJV, subclavian and brachiocephalic veins

27
Q

Color and spectral doppler flow for COMPLETE thrombus

A

no signal or color filling will be obtained

28
Q

What may result in continuous flow

A

partial thrombus, proximal thrombus, extrinsic compression

29
Q

What are commonly encountered in the arm

A

indwelling venous catheters

30
Q

How do catheters appear within vessel lumen

A

bright, straight, parallel echoes

31
Q

How does thrombus appear around catheters surface

A

echogenic material

32
Q

Spectral doppler with venous catheter

A

diminished and/or continuous

33
Q

Treatment considerations for thrombus around catheter

A

anticoagulation, catheter removal, thrombolytic therapy

34
Q

Upper extremity veins may not be compressible at every level due to their course ______, but should be compressed when possible

A

behind bones

35
Q

Doppler is even more vital in evaluation when

A

compression is not possible

36
Q

Which is true regarding thrombus in the legs

A

more in arms

37
Q

What frequently causes thrombus in upper extremity

A

injuries to vessel walls

38
Q

Venous thrombus associated with compression of subclavian vein at the thoracic outlet

A

paget-schroetter syndrome

39
Q

Landmark for axillary

A

cephalic vein

40
Q

What is normally most helpful to document patency in subclavian vein

A

color and spectral doppler

41
Q

All of the following are normal grayscale findings except

A

hyperechoic

42
Q

Hyperechoic tissue adjacent to thrombus in superficial vein due to

A

inflammation

43
Q

IJV and subclavian veins examined with patient lying flat

A

potentially collapse, removed impact from hydrostatic pressure

44
Q

Catheters appear as

A

bright, straight, parallel echoes within vessel lumen

45
Q

Thrombus in the cephalic vein has same gray scale appearance as thrombus in

A

brachial vein

46
Q

Doppler should be symmetrical

A

can’t compress it

47
Q

Nonocclusive thrombus forming around catheter may cause

A

doppler signal to become continuous

48
Q

What are the 5 treatments for venous catheters

A

anticoagulants, catheter removal, thrombolytic therapy, conservative treatment, surgical compression of thoracic inlet with or without venous reconstruction

49
Q

3 upper extremity vessels with pulsatility

A

IJV, subclavian, brachiocephalic

Vascular II & Physics II (21 decks)

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