Peripheral Vascular System + Ischemia/Infarction Flashcards Preview

Anes 540b: Exam 1 TBD > Peripheral Vascular System + Ischemia/Infarction > Flashcards

Flashcards in Peripheral Vascular System + Ischemia/Infarction Deck (82):
1

When are arterial pulses palpable?

When an artery lives close to the body surface

2

What vascular arches protect circulation to the hand?

1) Deep palmar arch
2) Superficial palmar arch

3

What four arteries are palpable in the leg

1) Femoral artery
2) Popliteal artery
3) Posterior tibial artery
4) Dorsalis pedis artery

4

Which artery protects the circulation of the foot?

Arcuate artery

5

Below what ligament is the femoral artery?

Inguinal ligament

6

What aspects of a pulse should an observer note?

Intensity
Rate
Rhythm

7

What aspects of blood vessels should an observer note when taking pulse?

Tenderness
Tortuosity
Nodularity

8

Carotid pulse indicates systolic pressure =

60

9

Radial pulse indicate systolic pressure =

90

10

A grade of 0 means a pulse is

Absent, unable to palpate

11

A grade of 1+ means a pulse is

Diminished, weaker than expected

12

A grade of 2+ means a pulse is

Brisk, expected

13

A grade of 3+ means a pulse is

Increased

14

A grade of 4+ means a pulse is

Bounding

15

When grading arterial pulses, we look at the right and left

Carotid, brachial, radial, femoral, popliteal, posterior tibial, dorsalis pedis

16

Vascular history = PICCSS

Pain in arms or legs
Intermittent claudication
Cold, numbness, pallor in the legs; hair loss
Color change in fingertips or toes in cold weather
Swelling in calves, legs, or feet
Swelling with redness or tenderness

17

What lymph nodes are located in the arms?

Epitrochlear lymph nodes

18

Is peripheral edema more likely to occur in legs or arms?

Legs

19

What lymph nodes are located in the legs?

Inguinal lymph nodes

20

The S’s of the vascular exam

Size
Symmetry
Skin color

21

Hand to use in brachial pulse?

Left hand

22

Describe position for brachial pulse?

Arm abducted
Elbow slightly flexed
Forearm externally rotated

23

On what aspect can you find the brachial pulse?

Anterior aspect of elbow

24

To find brachial pulse, palpate:

Just medial to biceps tendon + lateral to medial epicondyle of humerus

25

In finding the epitrochlear nodes of the arm, the fourth and fifth fingers fall where?

Above medial epicondyle of humerus

26

What fingers fall on the epitrochlear nodes?

1-3 of left hand

27

If patient has elevated lymph nodes on one side, what condition?

Non-Hodgkins lymphoma

28

What parts of the body do epitrochlear nodes drain?

Drain ulnar forearm, hand

29

What parts of the body do axillary lymph nodes?

Drain breast, upper extremity, thoracic wall

30

Which lymph nodes are affected most commonly by Non-Hodgkin’s lymphoma?

Infraclavicular nodes

31

Which nodes are most commonly affected by skin infections, lymphoma, and skin malignancies?

Epitrochlear nodes

32

Which parts of body drained by inguinal nodes?

Lower abdomen
External genitalia
Anal canal
Lower third of vagina
Lower extremities

33

Max enlargement of normal inguinal lymph nodes?

1-2 cm in size

34

What two nodal groups classified as inguinal lymph nodes?

Horizontal + vertical node group

35

Swelling of tissues d/t accumulation of fluids

Peripheral edema

36

What medications may cause edema?

Amlodipine
Pregabalin

37

When, after pressure is applied to small area, indentation persists for some time after the release of the pressure

Pitting edema

38

What circulation-related issues cause edema?

CHF
HTN
SCA

39

Aging, pregnancy, altitude sickness and alcoholism can all cause

Edema

40

Where should a patient’s hand be during an Allen’s test?

Above the heart

41

During an Allen’s test, within what frame of time should a fist return to normal color?

5-7 seconds

42

What is another name for “Cold Leg”?

Acute Arterial Occlusion

43

What is the name of a vascular disease involving a sudden interruption in the arterial blood supply to a tissue, organ, or extremity?

Acute Arterial Occlusion

44

If left untreated, Acute Arterial Occlusion can lead to

Tissue death

45

Three causes of Acute Arterial Occlusion

Trauma
Embolism
Thrombosis of an atherosclerosis artery

46

Six Ps of AAO:

Pain
Pallor
Pulselessness
Paresthesias
Paralysis
Poikilothermia

47

Treatments for AAO:

Inject anticoagulant
Thrombolysis
Embolectomy
Surgical revascularization
Amputation

48

Inflammation and thrombosis of superficial veins that presents as a painful induration with erythema

Superficial thrombophlebitis

49

Side effects include fever, redness, swelling, or pain in area of clot,Skin feels hot or warm, send me feel tender or hard like a cord, worm like vein seen just under the skin

Superficial thrombophlebitis

50

How to diagnose superficial thrombophlebitis

Doppler ultrasound

51

How to treat superficial thrombophlebitis

Antibiotics, NSAIDS, anticoagulation, surgery

52

How to treat DVT

Anticoagulation

53

How to diagnose DVT

D-dimer + Doppler ultrasound

54

Most common place for clots

Popliteal and superficial femoral

55

How often do clots occur in the common femoral?

8%

56

Veins cannot pump enough oxygen-poor blood back to the heart d/t incompetent valves in lower extremities

Chronic venous insufficiency

57

When chronic venous insufficiency occurs post-DVT, it’s called

Postthrombotic syndrome

58

Besides DVT, chronic venous insufficiency May occur after

Phlebitis

59

Main risks of chronic venous insufficiency

Cellulitis + ulcers

60

Treatments include manual compression lymphatic massage therapy, sequential compression pump, ankle pumps, compression stockings, blood pressure medicine

Chronic venous insufficiency

61

Surgeries for chronic venous insufficiency

Linton procedures
subfascial endoscopic perforator vein surgery

62

Leaflets of valves no longer meet properly, valves become incompetent

Varicose veins

63

AV fistulas are created for

Hemodialysis

64

What causes carotid stenosis?

Atherosclerosis

65

Common site for atherosclerosis?

Bifurcation if common carotid artery

66

How to diagnose carotid stenosis

Carotid bruits on exam, then by color flow duplex ultrasound scan of carotid arteries

67

Major treatment for carotid stenosis?

Smoking cessation

68

Initiating event of aortic aneurysm

Tear in intima of vessel wall, blood flows in, separates intima + adventitia

69

Main cause of aortic aneurysm

HTN

70

Older males are more prone to

Aortic aneurysm

71

Risk of rupture in aneurysm greater than 5 cm in a 5 year period is

25-41%

72

Symptoms of aortic aneurysm rupture

Chest, abdominal, back pain
HTN followed by hypotension
Patient in shock

73

Placement of endovascular stent via percutaneous technique through femoral arteries into diseased portions of aorta

Aortic aneurysm endovascular treatment

74

Why must you monitor pressure in right arm in patient with aortic aneurysms?

Aortic cross clamp is just distal to left subclavian artery; Occlusion of sorts will prevent BP monitoring in left arm

75

Where should MAPS be maintained above cross clamp in aortic aneurysm surgery?

100 mmHg

76

Where should MAPS be distal to cross-clamp in aortic aneurysm repair?

50 mmHg

77

You want to make sure perfusion is maintained in aortic aneurysm patient, especially to

Kidneys and spinal cord

78

Neuro protecting during aortic aneurysm case?

Spinal cooling and drainage

79

What can SSEP/EEG monitor during aortic aneurysm case?

CNS viability

80

What does TEE assess during aortic aneurysm case? Use with what as adjunct?

Aortic atherosclerosis and valve function ; PA catheter as adjunct

81

What medication before cross-clamping in aortic aneurysm case?

Mannitol improves renal cortical blood flow + GFR

82

Use of DLT In aortic aneurysm case?

Exposure of thoracic aneurysm