6: Angiology

Question 1

Coronary Artery Bypass Graft (CABG)

Answer 1

Replacement of a segment of coronary artery after obstruction

Question 2

What is the most common vein used in a CABG and why?

Answer 2

Great saphenous vein - comparable diameter to coronary A;s, easy to remove from lower limb, lengthy portions without branches or valves

Question 3

Second most common vessel to use in a CABG

Answer 3

Radial artery

Question 4

Coronary angioplasty

Answer 4

Inserting a small balloon cath into the lumen of a coronary artery -> flattens obstructing plaque against wall and increases size of lumen to improve bloodflow

Question 5

Difference between regions 1, 2, and 3 of subclavian A

Answer 5

1: medial to anterior scalene
2: deep to anterior scalene
3. Lateral to anterior scalene

Question 6

Two terminal branches of the internal thoracic A

Answer 6

1. Musculophrenic

2. Superior epigastric

Question 7

Three vascular planes/branch segments of the descending aorta

Answer 7

1. Unpaired visceral branches
2. Paired lateral visceral branches
3. Paired segmental parietal branches

Question 8

What does the pulmonary trunk produce?

Answer 8

Two pulmonary arteries

Question 9

Pulmonary embolism

Answer 9

Obstruction of a pulmonary A by an embolus - a blood clot, fat globule, or air bubble

Question 10

How does an embolus usually enter the pulmonary arteries?

Answer 10

Passes through a vein through right side of heart into pulmonary arteries

Question 11

What do pulmonary veins begin as?

Answer 11

Intersegmental veins between bronchopulmonary segments

Question 12

What do “smallest cardiac V’s” communicate with?

Answer 12

Internal chambers of heart directly

Question 13

What do the azygos, hemiazygos, and accessory hemiazygos V drain?

Answer 13

1. Azygos: posterior intercostal V’s from right side of posterior thoracic wall
2. Hemiazygos and accessory hemiazygos: posterior intercostal V’s from left side of posterior thoracic wall

Question 14

What does the thoracic duct originate as?

Answer 14

Chyle cistern

Question 15

What does the thoracic duct drain vs right lymphatic duct?

Answer 15

1. Thoracic duct: LEs, pelvis, abdomen, L thorax, L UE, L head and neck
2. Right lymphatic duct: R thorax, R UE, R head and neck

Question 16

Where do the thoracic duct and right lymphatic ducts empty?

Answer 16

1. Thoracic duct: junction of L IJ + L subclavian V’s

2. Right lymphatic duct: brachiocephalic V near its origin

Question 17

Two main trunks that both the thoracic duct and right lymphatic duct drain in the thorax

Answer 17

1. Subclavian trunk

2. Bronchomediastinal trunk

Question 18

What does the subclavian trunk drain?

Answer 18

UE, axilla

Question 19

What does the bronchomediastinal trunk drain?

Answer 19

LNs: parasternal, paratracheal, paraesophageal, superior phrenic, brachiocephalic

Question 20

What does the jugular trunk drain?

Answer 20

Cranial and cervical LNs

Question 21

Where is the thymus located?

Answer 21

Anterior superior mediastinum

Question 22

Seven groups of LNs in the thorax

Answer 22

1. Axillary
2. Parasternal
3. Tracheobronchial
4. Intercostal
5. Phrenic
6. Anterior mediastinal
7. Posterior mediastinal

Question 23

What forms anterior vs posterior intercostal arteries?

Answer 23

Anterior: internal thoracic A
Posterior: aorta