SUR 105 - Test 3

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SUR 105 - Test 3
2013-02-23 23:46:33
peripheral vascular

peripheral vascular surgeries
Show Answers:

  1. peripheral vascular surgery includes?
    procedures of arteries and veins lying outside immediate area of heart or brain
  2. decrease in or absence of blood to a localized area, usually related to vascular obstruction
  3. function of peripheral vascular system
    to carry blood cell components and and nutrients to all parts of body and to remove waste products of metabolism
  4. organs of peripheral vascular system
    • arteries
    • veins
    • capillaries
  5. 3 layers of blood vessels
    • tunica externa (adventitia)
    • tunica media
    • tunica intima
  6. blood vessel layer that is composed of connective tissue, which protects the vessel from injury and provides structural strength
    tunica externa
  7. blood vessel layer that is composed of inner layers of smooth muscle (under control of ANS) bounded by connective tissue
    tunica media
  8. blood vessel layer that secretes substances that cause vasodilation or constriction, as well as substances that prevent platelet aggregation in the vessel
    tunica intima
  9. carry oxygenated blood away from heart to the rest of the body
    arteries (except pulmonary arteries)
  10. arterial walls
    thick, highly elastic, contain mainly smooth muscle
  11. function of arterioles
    provide vascular resistance, regulating flow of blood into organs and tissues
  12. ventricular contraction
  13. resting phase of the heart
  14. what does vascular dilation do to body temp?
    lowers body temp because it exposes the blood to surface cooling provided by evaporation of sweat from the skin
  15. what occurs during shock and when body's core temp is subnormal?
    peripheral vasoconstriction
  16. microscopic vessels that function as transition and exchange mechanism for oxygen and other substances between the vessel walls and tissue cells
  17. what are capillaries composed of?
    endothelial cells and have no muscle fibers
  18. capillary walls
    one cell thick and allow selected substances to diffuse through capillary membrane into tissue
  19. carry blood back to the heart from the peripheral tissues
  20. walls of veins
    thin, allowing them to expand
  21. why are vascular procedures performed?
    to treat arteriosclerosis, atherosclerosis, and thromboembolic diseases
  22. why is timing of reconstruction and grafting important?
    to minimize the risk of ischemia
  23. 2 pathways in which circulatory system is divided
    • pulmonary system
    • systemic system
  24. what does pulmonary system do?
    carries blood from heart to lungs for oxygenation
  25. provide primary pumping action for the heart
  26. force exerted on the arterial wall by the pumping action of the heart
    blood pressure
  27. higher pressure - occurs during contraction of ventricles
    systolic pressure
  28. lower pressure - occurs during relaxation phase of cardiac cycle
    diastolic pressure
  29. complex hormonal regulation of arterial pressure, influenced by fluid volume and other factors
    renin-angiotensin-aldosterone system
  30. what is viscosity measured by?
    amount of fluid in blood
  31. largest artery in the body
  32. where does aorta terminate?
    at the pelvic bifurcation
  33. 3 major arteries that arise from the top of the aortic arch
    • brachiocephalic artery
    • left common carotid artery
    • left subclavian artery
  34. largest vein in the body
    vena cava
  35. how does vena cava communicate with heart?
    through right atrium
  36. which veins converge to form portal vein?
    superior mesenteric and splenic veins
  37. how much blood can the liver store?
    approximately 450 mL
  38. lymphatic system composed of?
    • ducts (vessels)
    • regional lymph nodes
    • lymph (fluid)
  39. to what does lymph contribute?
    formation of plasma
  40. occlusion of lymphatic duct and thoracic duct can result in?
  41. lymph nodes composed of?
    lymphatic tissue that collects and filters fluid
  42. pulse volume recorder used to measure the arterial pulse waveform during systole
    arterial plethysmography
  43. how many BP cuffs are used during arterial plethysmography?
    3 are placed on the leg and inflated to 65 mmHg
  44. what does doppler scanning do?
    intensifies sounds made by blood flowing through a vessel
  45. radiographic imaging of the artery
  46. used in both peripheral and coronary surgery to map the lumen of a vessel
    intravascular ultrasound
  47. what are vascular clamps designed to do?
    to prevent trauma to blood vessels
  48. what is used to maintain sterile field instead of sponges?
  49. used to burrow a channel through connective tissue to make space for a tubular vascular graft
  50. vascular suture sizes
    3-0 to 11-0
  51. vascular suture materials
    • Mersilene
    • Prolene
    • Gore-Tex
    • silk
  52. used to replace a blood vessel or to patch a vessel
    vascular grafts
  53. what are synthetic grafts made of?
    • Dacron
    • polyester
    • Gore-Tex
  54. most common method of removing thrombi
    Fogarty-type embolectomy catheter
  55. what type of syringe is used to fill balloon of embolectomy catheter?
    tuberculin (1 mL or less)
  56. tubular mesh implant that fits against the walls of the artery
  57. what do stents do?
    • provide physical barrier between atherosclerotic plaque and vessel lumen
    • hold vessel open so blood can flow freely
  58. what are stents made of?
    • stainless steel
    • titanium
    • Nitinol
  59. device used to retract a vessel during surgery - can also occlude blood vessel by acting as a tourniquet
    vessel loop
  60. what are vessel loops made of?
    thin length of Silastic material
  61. drugs that prevent blood from clotting
  62. drugs that encourage clotting
  63. during vascular surgery, what is used to prevent coagulation in the area of the operative vessels?
    heparinized saline solution (1:100)
  64. what drug may be administered just before arterectomy?
    systemic heparin
  65. heparin is reversed with?
    protamine sulfate
  66. under coagulation, what can IV administration of thrombin cause?
    fatal embolus
  67. removal of atherosclerotic plaque from inside of an artery
  68. rubbery substance that adheres to the tunica intima causing stenosis or occlusion
  69. injection of contrast medium into a selected artery and its branches to determine exact location of strictures, occlusion or malformation
  70. used in conjunction with angioplasty to allow surgeon to see the position of stricture and to place catheter in correct position
    intraoperative angiography
  71. incision in artery
  72. obstructive arterial disease causing stiffness and loss of elasticity of artery wall
  73. insertion of arterial catheter or stent into an artery to establish patency and normal blood flow
    transluminal angioplasty
  74. severe pain related to obstructed arterial flow
  75. metal, umbrella-shaped filter inserted into inferior vena cava to prevent emboli from entering pulmonary system
    vena cava filter
  76. occur when one or more thrombi move from venous system into pulmonary vascular system
    pulmonary emboli
  77. what is vena cava filter made of?
    • titanium
    • stainless steel
    • Nitinol
  78. 2 techniques used to create vascular access for renal hemodialysis
    • arteriovenous shunt
    • arteriovenous fistula
  79. when is hemodialysis necessary for survival
    when kidneys' filtering ability drops below 5%
  80. procedure in which blood is shunted outside the body for filtering and cleansing
    extracorporeal hemodialysis
  81. direct anastomosis between artery and vein
    arteriovenous fistula
  82. goal of thrombectomy
    to remove a stationary clot in a blood vessel, restoring circulation and prevents emboli
  83. stationary clot in arterial or venous system
  84. thrombus that breaks away from vessel wall
  85. vascular obstruction
  86. surgical removal of atherosclerotic plaque from carotid artery
    carotid endarterectomy
  87. what arteries are clamped (in order) in a carotid endarterectomy?
    • internal carotid artery
    • common carotid artery
    • external carotid artery
  88. in what order are arteries unclamped in carotid endarterectomy?
    • external carotid artery
    • internal carotid artery
    • common carotid artery
  89. condition in which a section of the abdominal aorta becomes thin and bulges because of atherosclerotic plaque and progressive weakening of aortic wall
    abdominal aortic aneurysm
  90. most common causes of abdominal aortic aneurysm
    • atherosclerosis
    • degeneration of muscular layer of vessel
  91. goal of AAA
    to implant graft extending from aorta to both iliac arteries
  92. aneurysm in which blood seeps between layers of vessel, causing it to tear and split
    dissecting aneurysm
  93. graft is implanted between the aorta and femoral arteries to bypass the iliac arteries to treat aortoiliac occlusive disease
    aortofemoral bypass
  94. prep area for aortofemoral bypass
    from axillary line to midthighs
  95. procedure which creates circulation between femoral arteries and axillary artery
    axillofemoral bypass
  96. implantation of prosthetic graft that connects femoral artery on the affected side to the opposite femoral artery
    femorofemoral bypass
  97. why is femorofemoral bypass performed?
    to bypass unilateral atherosclerotic disease in iliac artery
  98. what kind of anastomosis is used in femorofemoral bypass?
  99. surgical alternative to use of a synthetic graft to bypass diseased femoral artery in which saphenous vein is not removed but left in anatomical position - uses saphenous vein as shunt
    in situ saphenous femoropopliteal bypass
  100. why is in situ saphenous femoropopliteal bypass performed?
    to produce vascular continuity with an autograft
  101. what arteries are involved in in situ saphenous femoropopliteal bypass?
    femoral and popliteal arteries
  102. synthetic graft or autograft implanted between femoral and popliteal arteries
    femoropopliteal bypass
  103. procedure in which saphenous vein is removed to provide autograft for peripheral or coronary artery bypass
    saphenous vein graft
  104. goal of saphenous vein graft
    to remove vein yet retain its structural and physiological soundness
  105. why is greater saphenous vein used more successfully for bypass?
    • its connective tissue layer thickens with increased pressure
    • strong and able to withstand increased arterial pressure
  106. what does surgical treatment of varicose veins involve?
    removal of dilated and tortuous veins and their tributaries to prevent symptoms and improve cosmetic appearance
  107. ballooning of an artery as a result of weakening of arterial wall
  108. dilation of artery using endovascular techniques
  109. most common form of arteriosclerosis - causes plaque to form on inner surface of artery
  110. Y-shape of an artery or graft
  111. type of ultrasonography that amplifies sounds that pass through tissue and produces visual image of blood flow
    Doppler duplex ultrasonography
  112. diagnostic tool that measures electrical activity of the brain
  113. term referring to pressure, flow, and resistance in the cardiovascular system
  114. blockage in artery that leads to ischemia and tissue death
  115. term meaning "in the natural position or normal place, without disturbing or invading surrounding tissues"
    in situ
  116. diagnostic tool in which transducer is introduced into an artery and ultrasound is used to translate physical characteristics of lumen into visible image
    intravascular ultrasound
  117. decrease in or absence of blood to localized area, usually related to vascular obstruction
  118. inside of hollow structure
  119. term that literally means "through the skin" - in surgery, device introduced through puncture site instead of making incision
  120. pooling of blood in veins caused by inactivity or disease
  121. length of mesh tape used to loop around blood vessel for retraction
    umbilical tape
  122. thinning and enlargement of veins as result of stasis