Atypical Vascular Disorders

Question 1

what is an arteriovenous fistula?

Answer 1

abnormal direct communication between an artery and a vein

Question 2

arteriovenous fistulas

size of connection and location is important in the development of ___

Answer 2

CHF

Question 3

traumatic arteriovenous fistulas - ___ connections
congenital arteriovenous fistulas - ___ connections

Answer 3

traumatic arteriovenous fistulas - single connections
congenital arteriovenous fistulas - numerous connections

Question 4

____ located fistulas are less likely to cause CHF but more likely to cause ___

Answer 4

peripherally located fistulas are more likely to cause ischemia

Question 5

___ and ___ predict the resistance a fistula offers

Answer 5

diameter and length

Question 6

arterial proximal to the fistula has greatly ___ flow, especially during diastole

Answer 6

increased flow

Question 7

arterial flow distal to the fistula can be normal or become more ___

Answer 7

pulsatile

Question 8

arteriovenous fistulas

BP in the distal artery is always ___

Answer 8

reduced

Question 9

direction of blood flow may be normal if the fistula resistance exceeds that of the ___

Answer 9

distal vascular bed

Question 10

flow through the fistula is ___

Answer 10

turbulent

Question 11

venous flow approaching the fistula is ___

Answer 11

phasic

Question 12

venous flow moving away from the fistula is ___

Answer 12

phasic and pulsatile

Question 13

chronic, large fistulas may cause ____ in the distal vein

Answer 13

retrograde (valves are incompetent)

Question 14

what is compartment syndrome?

Answer 14

build up of pressure around muscles

Question 15

compartment syndromes are caused by ____

Answer 15

swelling within the osteofascial compartments of the leg, arm, or abdomen

Question 16

compartment syndrome most commonly results from ___

Answer 16

ischemic injury to the capillary bed

Question 17

compartment syndrome

___ are more susceptible to ischemia
___ occurs later

Answer 17

nerves are more susceptible to ischemia

muscle necrosis occurs later

Question 18

4 clinical findings of compartment syndrome

Answer 18

parathesis
pain
weakness of involved muscle
tension of the compartment

Question 19

compartment syndrome treatment involves ___

Answer 19

fasciotomy - cutting the connective tissue layer surrounding muscles to relieve pressure build up

Question 20

what is cystic adventitial disease?

Answer 20

cystic fluid accumulates in the wall of the peripheral artery which causes narrowing or occlusion of the vessel

Question 21

cystic adventitial disease most commonly affects what artery?

Answer 21

popliteal artery

Question 22

cystic adventitial disease is most common in ___

Answer 22

males 40-50 years old

Question 23

3 symptoms of cystic adventitial disease

Answer 23

claudication
bruit
loss of distal pulses during flexion or hand/foot

Question 24

what is popliteal artery entrapment syndrome?

Answer 24

popliteal artery is compressed by the medial head of the gastrocnemius muscle or fibrous bands

Question 25

popliteal artery entrapment syndrome is most common in ___

Answer 25

young athletes

Question 26

popliteal artery entrapment syndrome knee extended + active plantar flexion or passive dorsiflexion of foot =

Answer 26

knee extended + active plantar flexion or passive dorsiflexion of foot = pulses diminish

Question 27

thoracic outlet syndrome (TOS) - arterial component occurs when ___

Answer 27

neurovascular bundle is compressed between the collarbone and first rib

Question 28

thoracic outlet syndrome (TOS) - arterial component symptoms (3)

Answer 28

numbness/tingling of arm pain in shoulders or upper arm weakening grip

Question 29

thoracic outlet syndrome (TOS) - arterial component ___% of the population have asymptomatic compression

Answer 29

20-30%

Question 30

thoracic outlet syndrome (TOS) - arterial component ___ and/or ___ are utilized to detect arterial changes

Answer 30

plethsmographic techniques and/or Doppler analysis

Question 31

thoracic outlet syndrome (TOS) - arterial component ___ is attached to index finger ___ monitors radial artery ___ monitors pulse volume waveforms

Answer 31

PPG sensor is attached to index finger CW Doppler monitors radial artery brachial cuff monitors pulse volume waveforms

Question 32

what is Adson maneuver positioning?

Answer 32

exaggerated military stance with head turned sharply towards the arm being tested

Question 33

thoracic outlet syndrome (TOS) - arterial component treatment consists of (2)

Answer 33

shoulder exercises surgery - resecting the first rib with or without scalene muscle splitting