Chapter 15 Preoperative Mapping Flashcards
Week 1
What is the purpose of preoperative mapping?
to identify anatomy and perfusion for surgical repairs
What Vessels are mapped?
- Epigastric Artery
Deep Superior
Deep Inferior - Internal Mammary Artery
- Radial Artery
- Great Saphenous Vein
- Small Saphenous Vein
- Cephalic Vein
- Basilic Vein
What are we looking for when using duplex ultrasound?
- Patency
- Vein Wall compressibility
- Depth throughout
- Diameter throughout
- Length throughout
- continuity
- Abnormalities
What kind of abnormalities are we looking for during a vein map?
- Focal velocity elevations
- Calcifications
3 Thrombus - Atherosclerosis
- Wall thickening
Where does the Deep superior epigastric artery arise from?
The terminal internal mammary artery branch
Where does the Deep inferior epigastric artery arise from?
the External Iliac Artery ( EIA) in lower abdomen)
Where do the branches of the DIEA and the DSEA anastomose?
in the “watershed” area of the abdomen.
midway between the DSEA and the DIEA
What do the DSEA and the DIEA contribute to?
the rectus abdominis muscle
When the rectus abdominis muscle is utilized during surgery what is it then called?
Transverse rectus abdominis myocutaneous (TRAP) flap
What are the purposes of Epigastric Artery mapping?
- to identify the location and patency of epigastric arteries and perforators
- to identify perfusion of the rectus abdominis.
What is another name for the Internal mammary artery?
Internal thoracic artery
Where does the Internal mammary artery arise from?
the subclavian artery, descending 1 cm posteriorly, 1 cm from the sternum
Why do we map the Internal mammary artery?
to determine the suitability for TRAM flap anastomosis for breast reconstruction and coronary bypass graft.
How big should the internal mammary artery be to be able to harvest?
2 mm in diameter
What is a normal flow in the internal mammary artery?
Low resistant flow
Where does the Radial artery originate from?
originates from the brachial artery
travels laterally into the hand.
terminates in the deep palmar arch.
What is the purpose of mapping the radial artery?
Determines suitability of radial artery as a graft for coronary artery bypass & dialysis access ( inflow artery).
What does the Modified Allen Test check for?
Patency of the palmer arch.
What is an adequate diameter to harvest the radial artery?
> 2.0mm
What are the purposes of vein mapping in the extremities?
- determines suitability for use as a graft for coronary arteries and dialysis access sites.
What is different about the basilic vein?
usually branches at the elbow making it difficult to follow more distally.
What are normal findings for mapping?
- complete vein wall compressibility
- no evidence of thrombosis
- 2-3 mm diameter
What are some limitations of Vein mapping?
- Depth
- Scarring
- Effects of radiation treatment
Which of the following is not a vessel that is normally mapped?
the ulnar artery
