Arteries and Veins

Question 1

What are the functions of arteries

Answer 1

• providing oxygen and nutrients to organs
• correct speed of flow (autoregulation)
• correct pressure (vital for perfusion)

Question 2

How do arteries regulate blood pressure

Answer 2

Arteries can change calibre resulting in adequate pressure.

Question 3

What does blood pressure depend on

Answer 3

Cardiac output and peripheral resistance.

Question 4

What happens to surrounding tissues when blood pressure increases

Answer 4

Fluid leaks out into the surrounding tissues.

Question 5

What happens to the blood when the fluid leaks out into the tissues due to high pressure

Answer 5

There will be an increase protein content in the blood when it reaches the venous system.

Question 6

How does the hydrostatic and osmotic pressure system work across capillaries

Answer 6

Hydrostatic pressure causes fluid to leak out of capillaries. This pressure is greatest at the arterial end and lowest at the venule end. Osmotic pressure counterbalances this and holds blood in the blood vessel.

Question 7

What happens in primary lymphedema

Answer 7

The person is born with fewer lymphatic vessels so is less able to return fluid back to the blood.

Question 8

What happens in secondary lymphedema

Answer 8

The inability to return fluid back to the blood is due to an another factor.

Question 9

What are three indirect methods of measuring arterial function

Answer 9

Organ function, oximetry, TcPO2 (transcutaneous partial pressure of oxygen)

Question 10

What are three direct methods of measuring arterial function

Answer 10

Shygmomanometer, direct puncture and imaging.

Question 11

How do you measure kidney function

Answer 11

Testing the urine.

Question 12

What are some lifestyle factors which cause degeneration of arteries

Answer 12

• smoking
• age
• diabetes

Question 13

What could be a consequence of the degeneration of arteries

Answer 13

They can dilate and become aneurysmic. The aneurysm could then rupture.

Question 14

In what circumstances can blood vessels become damaged

Answer 14

Degenerative disease, occlusive disease, inflammatory disease, iatrogenic injury, trauma

Question 15

What are examples of degenerative diseases that can damage arteries

Answer 15

Arterial aneurysms, traumatic aneurysms, false aneurysms, mycotic aneurysms, ehlers-danlos syndrome, marfans syndrome.

Question 16

How may a traumatic aneurysm occur

Answer 16

A seatbelt may crush the aorta in a car crash and cause a traumatic aneurysm.

Question 17

What is a false aneurysm (pseudoaneurysm)

Answer 17

This does not involve the artery itself. If the artery has a small hole, blood can leak out and create a cavity. The cavity pulsates and gives the impression of being aneurysmic.

Question 18

At what diameter does the risk of rupture of an aneurysm become high

Answer 18

Between 5 and 6 cm.

Question 19

How do you repair an aortic aneurysm

Answer 19

Using an aortic graft which is inserted using open surgery. This does not degenerate unless it becomes infected.

Question 20

In which gender are aortic aneurysms more common

Answer 20

Male

Question 21

What is claudication

Answer 21

Claudication can result from peripheral vascular disease. This is where there is not enough blood supply to the legs and the person cannot walk properly. Often people need to stop to allow blood flow to the legs.

Question 22

How can claudication be compensated for

Answer 22

Collateral circulation

Question 23

What is used to treat peripheral vascular disease

Answer 23

Antiplatelets, lipid lowering drugs, control of blood pressure and smoking cessation.

Question 24

What is vasculitis

Answer 24

Inflammation of the blood vessels

Question 25

What is the most common form of vasculitis

Answer 25

Rheumatoid arthritis.

Question 26

What is used to treat vasculitis

Answer 26

Steroids

Question 27

Other than vasculitis, what are two other examplesinflammatory disease affecting the blood vessels

Answer 27

Takayasus and diabetes,

Question 28

What type of drug use can result in blood vessel damage

Answer 28

Intra-arterial drug use.

Question 29

What are the functions of veins

Answer 29

They return oxygen and nutrient depleted blood back to the heart. They also act as a reservior.

Question 30

What fraction of blood volume is in the venous system

Answer 30

2/3 blood volume

Question 31

What type of flow occurs in veins - active or passive

Answer 31

Passive

Question 32

What are venae comitantes

Answer 32

Veins which are wrapped around arteries.

Question 33

What is an example of an artery which has lots of venae comitantes

Answer 33

The popliteal artery in the leg.

Question 34

What is the function of venae comitantes

Answer 34

To warm up the blood as it returns to the heart.

Question 35

What are three important features of the structure of veins

Answer 35

- thin wall - they distend - they have valves

Question 36

What is the significance of the fact that veins distend

Answer 36

It means they can be used in bypass surgery as they are able to cope with arterial pressure.

Question 37

What is the function of valves in veins

Answer 37

To spread the pressure in the vein so that the venous column is divided into shorter segments and the pressure does not all collect at the bottom.

Question 38

What is the purpose of Doppler imaging for taking venous measurements

Answer 38

It allows the direction of blood flow to be visualised so that reflux in the valves can be detected.

Question 39

What is plethysmography

Answer 39

A method of venous measurement which allows assessment of change in volume.

Question 40

How does ultrasound mapping work in venous assessment

Answer 40

Veins should compress easily on ultrasound. if they do not, this means there may be a clot present in the vein.

Question 41

What is venography

Answer 41

It is a method where dye is injected into the veins and allows the blood flow through the veins to be visualised. it is similar to angiography.

Question 42

What can go wrong in the veins

Answer 42

Venous hypertension or venous obstruction

Question 43

What are the causes of venous hypertension

Answer 43

- right heart failure - deep vein incompetence - superficial vein incompetence

Question 44

What is deep vein incompetence

Answer 44

it is where a thrombus which had formed in the deep veins dissolves and damages the valves.

Question 45

What are the causes of venous obstruction

Answer 45

Deep venous thrombosis and mechanical obstruction

Question 46

What causes deep vein thrombosis

Answer 46

Any one of Virchow's triad (stasis, hypercoagulability and endothelial damage)

Question 47

What is an example of a cause of mechanical venous obstruction

Answer 47

A cancerous tumour causing pressure on the vein and subsequent obstruction.

Question 48

What occurs to the jugular vein in right heart failure

Answer 48

It distends.

Question 49

What condition can superficial venous incompetence lead to

Answer 49

Varicose veins

Question 50

What is a tell-tale sign of varicose veins

Answer 50

Discolouration of the ankles.

Question 51

What happens to cause varicose veins

Answer 51

There is increased pressure of blood at the ankles due to the lack of competence of the venous valves. There is leakage of fluid from he blood and the pressure increases further. Blood can also leak out and collect at the ankles leading to discolouration.

Question 52

In what circumstances does ulceration occur

Answer 52

When the area is so nutritionally deplete that healing cannot occur.

Question 53

What is used to treat varicose veins

Answer 53

Surgical procedures.

Question 54

How is open surgery to treat varicose veins performed

Answer 54

A cut is made in the groin and the saphenous vein is disconnected. The varicose vein is then pulled out.

Question 55

What is the name of the surgical procedure to remove a vein

Answer 55

Phlebectomy

Question 56

How does foam sclerotherapy work as a treatment for varicose veins

Answer 56

Foam is created and injected into the vein to irritate it and cause it to close up.

Question 57

What is the disadvantage of foam sclerotherapy

Answer 57

Discolouration

Question 58

What is the current most commonly used procedure for treatment of varicose veins

Answer 58

Radiofrequency ablation

Question 59

How does radiofrequency ablation for treatment of varicose veins work

Answer 59

A catheter is inserted into the vein and the vein is treated with heat until it closes off. The vein hardens.

Question 60

How does endovenous laser treatment for varicose veins work

Answer 60

A fibre-optic laser is inserted into the diseased vein. Laser energy causes the vein to collapse so it becomes harmless fibrous tissue.

Question 61

How does vein glue work in the treatment of varicose veins

Answer 61

Glue is injected into the vein through a catheter. The catheter is withdrawn and the glue hardens. The vein is sealed.

Question 62

Which is more of a problem to deal with - arterial bleeding or venous bleeding

Answer 62

Venous bleeding

Question 63

What are the most common causes of venous bleeding

Answer 63

Trauma and iatrogenic

Question 64

In which veins does the worst bleeding occur

Answer 64

The vena cava and pelvic veins

Question 65

What happens in phlegmasia

Answer 65

In this condition, blood van enter the leg through the arterial system but cannot get out again

Question 66

How is phlegmasia treated

Answer 66

Blood needs to be compressed out of the leg so the leg needs to be elevated

Question 67

What is the end result of phlegmasia if left untreated

Answer 67

Venous gangrene.

Question 68

What happens if there is a blockage in the superior vena cava

Answer 68

Large venous collaterals form in compensation to try and get blood back to the heart. This causes very high pressure in the veins.

Question 69

What diseases of the veins can occur

Answer 69

- varicose veins - blocked iliac vein leading to phlegmasia and gangrene - blocked superior vena cava - neck engorgement - haemorrhoids - caput medusa

Question 70

What lifestyle factor can cause venous disease

Answer 70

Intravenous drug use

Question 71

What factors can cause venous disease

Answer 71

- intravenous drug use - trauma - iatrogenic injury