Week 11 Part 1

Question 1

Name the veins of the UE starting at the wrist

Answer 1

Level 1 - Cephalic, Radial, Ulnar, Basilic
Level 2 - Median Cubital, Brachial
Level 3 - Axillary, Subclavian, Brachiocephalic, SVC

Question 2

What is the primary cause of UE DVT?

Answer 2

IV’s and Central lines

Question 3

Why do IV’s and Central lines cause UE DVT?

Answer 3

Endothelial Injury

Question 4

What is the term meaning “an illness or condition caused by medical treatment”?

Answer 4

Iatrogenic

Question 5

What is a secondary cause of DVT in the UE?

Answer 5

Effort Thrombosis

Question 6

What is effort thrombosis?

Answer 6

DVT of the UE due to vessel injury caused by straining or great effort

Question 7

Who normally gets effort thrombosis?

Answer 7

Young, Healthy, Athletic people

Question 8

What are some lesser causes for UE DVT?

Answer 8

Tumors, IV Drug Abuse, Post-op Complications

Question 9

What is a symptom of a BCV obstruction?

Answer 9

Facial Edema

Question 10

A person having SVC syndrome would experience edema where?

Answer 10

below the shoulder and down

Question 11

What is the term relating to when a peripheral IV becomes dislodged and fluids or medications leak into the surrounding tissue?

Answer 11

Infiltration

Question 12

What condition should you expect if the pt is experiencing hand edema but the fingers are not swollen?

Answer 12

Lymphedema

Question 13

If a pt has dilated superficial shoulder veins, what should you expect?

Answer 13

almost 100% guarantee of UE DVT

Question 14

SVC syndrome is characterized by what?

Answer 14

Visible venous collaterals in the shoulders and chest

Question 15

The __________ catheter is a large cause of DVT.

Answer 15

Hickman

Question 16

Into what vein is a Hickman catheter inserted and where does the tip end up?

Answer 16

SCV, SVC

Question 17

A long-term central venous catheter is know as a ___________.

Answer 17

Portacath

Question 18

What does PICC stand for?

Answer 18

Peripherally Inserted Central Catheter

Question 19

What remains in a vein after a line is removed?

Answer 19

the Fibrin sheath

Question 20

What promotes the adherence of blood platelets and bacteria on a Fibrin sheath?

Answer 20

Plasma proteins that coat the catheter’s surface

Question 21

How does a Fibrin Sheath appear on an ultrasound?

Answer 21

the same as if the line was still there

Question 22

What are pertinent history questions to ask a pt having an UE ultrasound?

Answer 22

Why being tested?
Any symptoms?
History of DVT?
Trauma or Surgery?
Central lines or IV's (current or past)
Dialysis? (complications?)
Weight lifting? Arm exercises?

Question 23

Which side of the pt should you scan first when doing an UE exam? Why?

Answer 23

The asymptomatic side. To compare to the symptomatic.

Question 24

What position should the pt be in to exam the BCV, SCV, or IJV?

Answer 24

Supine

Question 25

How should the pt's arm be positioned when scanning the SCV to the Brachial Veins?

Answer 25

Arm straight out on your legs

Question 26

T/F. It is easier to see the IJV when the pt is positioned with their head slightly up rather than being completely flat?

Answer 26

False. Supine positioning is much better to visualize the IJV.

Question 27

You are scanning DOWN the arm. What does the SCV change to? Where?

Answer 27

The Axillary vein once the Cephalic vein dumps in

Question 28

Protocol: Start in the ______, scan _______ and _______.

Answer 28

IJV, distally and proximally

Question 29

Protocol: In order to see the BCV, you need to what?

Answer 29

point the probe deep toward the chest

Question 30

Protocol: While visualizing the BCVs, the RT BCV will be ________ and the LT BCV will be ______________.

Answer 30

vertical, pointed slightly to the right of patient

Question 31

Protocol: After visualizing the BCV, You should turn the probe at the __________, pointing the end towards armpit, this will line up the _____________ in long view.

Answer 31

clavicle, PROX SCV

Question 32

Protocol: At the PROX SCV, it should appear __________ on the screen with a bright echo below it. This bright echo is the _______.

Answer 32

horizontal, pleura

Question 33

Define Pleura

Answer 33

Membranes that surround the lungs. Visceral envelops the lung, Parietal lines the inner chest wall. The fluid between these pleura acts as a lubricant.

Question 34

Protocol: After the PROX SCV; move the probe over the clavicle to see the __________.

Answer 34

DIST SCV

Question 35

Protocol: Just past the clavicle, you should notice what?

Answer 35

The CEPHALIC V junction

Question 36

Protocol: After the CEPHALIC V junction, you should visualize the ___________ in both long and trans.

Answer 36

AXILLARY V

Question 37

Protocol: You should notice the __________ junction usually mid-arm, but could split at the antecubital fossa.

Answer 37

BASILIC V

Question 38

Protocol: The ___________ splits just past the antecubital fossa.

Answer 38

BRACHIAL V

Question 39

What can you do to see the SCV and Axillary V compress?

Answer 39

Sniff test

Question 40

Above the axila, a normal UE venous exam should have what characteristics?

Answer 40

Spontaneous PULSATILE Phasic

Question 41

What is the venous signal pulsatile above the axila?

Answer 41

because of the close proximity to the heart

Question 42

Below the axila, ____________ is used to see doppler response.

Answer 42

Augmentation

Question 43

For the distal SCV, Axillary and Cephalic veins, you should show the __________ in the image as a landmark.

Answer 43

Clavicle

Question 44

Stripes/Streaks/Striations are all indicators of what structure in the arm?

Answer 44

Median nerve

Question 45

What does the CEPH V look like?

Answer 45

An eye