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Final Flashcards

(77 cards)

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1
Q

Upper extremity deep veins

A 
Internal  jugular vein
External jugular vein
Brachiocephalic vein
Subclavian vein
Axillary vein
Brachial vein
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2
Q

Upper extremity Superficial Veins

A

Cephalic vein

Basilic veins

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3
Q

IJV lies lateral to the____

A

CCA

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4
Q

IJV’s join with the _____ more medially to form

the _________

A 
SCV's
Brachiocephalic veins (aka: innominate veins)
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5
Q

EJV lies _______ to the IJV

A

superficial

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6
Q

EJV’s drain into the __________

A

SCV’s

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7
Q

what does pulsatile flow reflect?

A

heart contractions

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8
Q

why may the innominate vein be difficult to visualize?

A

sternum

air filled lungs

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9
Q

what may help in determining patency when its hard to visualize?

A

doppler signals

-phasicity is important

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10
Q

the subclavian vein moves laterally from the junction of what?

A

jugular and branchiocephalic veins

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11
Q

where does the subclavian pass?

A

under the clavicle

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12
Q

where does the superficial cephalic vein empty?

A

into the subclavian vein

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13
Q

what does the subclavian run along side?

A

the subclavian artery

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14
Q

the subclavian (SCV) cannot so compression so what do we do?

A

this is because of its position so we use duplex to check for patency and phasicity

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15
Q

where does the axillary start?

A

below the level where the subclavian vein recieves the cephalic vein

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16
Q

wher does the axillary vein travel?

A

through the axilla

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17
Q

whats different about the axillary artery and vein from others?

A

they do not travel directly beside eachother, the armpit is one area where the artery and its accompanying vein have some distance for a SHORT WHILE

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18
Q

where does the basilic vein empty?

A

into the axillary vein (but this is extremely variable)

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19
Q

what do we check in the axillary vein?

A

use duplex doppler to check for patency, phasicity, and augmentation

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20
Q

when augmenting the axillary vein where do we squeeze?

A

below the elbow

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21
Q

what are the brachial veins?

A

2 small paired veins on either side of the artery and may join to form a single vein at the level of the crease

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22
Q

where do the brachial veins split?

A

below the bend of the elbow, they split to form the radial and ulner paired veins

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23
Q

do we comprss the brachial vein?

A

yes

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24
Q

what do we use to examine the brachial vein?

A

duplex doppler to ascertain augmentation and phasicity

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25
what do we assess non compressible veins with?
color and duplex
26
what do we assess for in veins?
for patency, phasicity, and augment where possible
27
where do we take compression images?
axillary vein brachial vein superficial veins(basilic, cephalic)
28
what history do we take in a patient for upper extremity?
recent central line or IV usage | Also if patient has cancer or recent injury
29
what veins show more pulsatility?
veins more proximal to the heart
30
what may loss of pulsatility indicate?
more central venous obstruction
31
what may we do to confirm the presence or absence of obstruction?
compare signals with the opposite arm
32
whats the reason more most clots in the upper extremity?
result of injury to the vein wall | needle punctures or indwelling catheders
33
what is the usual reason for clot in the lower extremity?
stasis
34
why are clots in the arm less common?
The upper extremities have no soleal sinuses as seen in the lower extremities
35
what may a clot in the upper extremity be caused by?
chronic injury to subclavian vein - TOS - coagulopathy - compression by a mass
36
The sequelae of upper extremity DVT are ______ severe than that of lower extremity
less | pathophysiology is the same
37
what is the risk for PE in the upper extremity?
10-12%
38
what is the main pathology that affects the upper limb venous system?
DVT
39
what are the most common sites for DVT in the upper extremity?
subclavian vein | axillary vein
40
what does DVT result in, in the upper extremity?
upper limb swelling with distension of the superficial veins
41
what are the risk factors for upper extermity DVT?
same as lower limb, LOOK AT THESE but there are some extras on another flashcard
42
what can be a cause of upper extremity DVT?
presence of a central venous cathedar or pacemaker lead
43
how many people develop thrombosis with central venous catherdar or pacemaker?
26-67% | most are asymptomatic
44
what are more frequent cases of DVT in upper extremities rather than lower?
- radiation therapy - malignant obstruction - effort induces thrombosis
45
what may cellulitis be associated with?
superficial thrombophlebitis, producing swelling of the limb, pain and redness
46
what else may lead to upper limb swelling?
Arteriovenous malformations ,if extensive
47
Long term catheter access for feeding and or drug administration may damage ____________
the axillary or subclavian veins, leading to DVT
48
when can Phlebitis of the superficial veins(superficial thrombophlebitis) occur?
due to repeated catheter access or intravenous drug abuse
49
is paget-schroetter syndrome common or rare?
rare
50
where is paget-schroetter syndrome seen?
young adults due to effort-induced thrombosis of the subclavian vein
51
why may paget-schroetter syndrome occur?
strenuous upper body exercise or repatative movements like weight lifting
52
Lymphedema
most common following mastectomy with removal of lymph nodes in the axilla as well as the effects of radiotherapy
53
what do superficial veins usually anastomose with?
deep veins
54
what do superficial veins runs through?
2 layers of superficial fascia
55
are there more valves in deep or superficial veins?
valves are less numerous in the superficial veins
56
where does the cephalic vein drain?
empties into the subclavian vein above the level of basilic vein
57
where does the cephalic vein travel?
across the shoulder and down the anterolateral border of the biceps muscles
58
where is the cephalic vein easily found?
Easiest to find in upper arm first, follow it upward as it dumps into subclavian/axillary vein junction and then follow it downward to below antecubital fossa
59
is the basilic vein large or small?
large
60
where does the basilic vein travel?
along the medial border of the biceps, parallel to the brachail vein
61
for the basilic and cephalic vein so we use heavy or light probe pressure?
light probe pressure
62
how do you find the basilic vein?
Easiest to find it from the upper arm first, follow it upward as it dumps into the axillary vein, then follow it downward to the anticubital fossa
63
what are the most common sites for central venous assess device (VAD)?
- subclavian vein | - internal jugular veins
64
is the IJV superficial or deep?
superficial
65
which IJV is prefered?
right as it has a straighter course to the heart
66
if the EJV used?
not preffered only in setting of IJV obstruction and is often tortuous
67
what is the SCV suitable for?
dialysis aphresis catheters chemotherapy
68
what is VAD used for?
administer antobiotics, blood products, other fluids
69
PICC line
Peripherally inserted central catheter Typically inserted in upper arm veins Terminates closer to the heart
70
advantages of PICC line
Decreased complication risk | Can remain in place much longer
71
Portocath
Inserted under the skin in upper chest-appears as a bump | Inserts into SCV,JV or SVC
72
advantages of portocath
- Infused agents spread more quickly to body | - Heparin is infused through port to combat thrombus formation
73
complications of VAD
``` vein damage non target puncture bleeding air embolism cardiac arrythmia infection ```
74
Vein damage
- Appears as irregular intimal surface - May be extravascular accumulation of blood-hematoma - Arteriovenous fistula may occur - Flow between vein and artery
75
Non target puncture
Hematoma formation
76
Bleeding
May be diffuse within tissue
77
Air embolism
Hyperechoic structure within blood stream-acoustic shadow

Vascular (10 decks)

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