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PV Surgery
Surg Tech Peripheral Vascular
| Question | Answer |
|---|---|
| The patient may be placed in __________ to increase the size of the subclavian vein during insertion of a central venous catheter or venous access port | Trendelenburg |
| The plaque within an artery can be removed with a ___________ and fine vascular DeBakey forceps | freer or Penfield elevator |
| The removal of plaque is called a(n) ___________ | endarterectomy |
| Glass syringes are preferred in drawing up contrast media for angiography because of less accumulation of bubbles (T/F) | True |
| ______ ______ are used to bolster anastomosis sites when tissue is friable | suture pledgets |
| The lumens of veins are (smaller/larger) than the lumens of arteries | larger |
| Gold standard for dx and evaluation of vascular disease | angiography |
| What should you do with vessel loops before handing them to the surgeon? | dip them in saline |
| Vein of choice for distal bypasses of lower extremity | saphenous vein |
| In order for the saphenous vein to be effective as a bypass conduit, the ______ within the vein must be removed or "stripped away" in order to prevent the valves from dictating venous flow direction | valves |
| arteries grow progressively smaller until they become ______ which in turn become ______ | arterioles; capillaries |
| _______ are microscopic vessels designed to exchange nutrients and wastes between the blood and tissue fluid | capillaries |
| After nutrients/waste exchange, capillaries unite to form _____, the smallest of the veins | venules |
| Venues unite to form veins, which eventually become the ______ and ______. | inferior and superior vena cava |
| Primary challenge of performing an angioscopy | clearing the visual field of blood |
| An angioscope should be smaller in diameter than the vessel lumen to avoid ______. | vasospasm |
| Purpose of a central venous catheter "central line/CVC" | facilitate long-term IV administration of chemo, antibiotic therapy, fluids and pain meds |
| Types of central venous catheters | 12F Groshong, Hickman, Broviac |
| Which vein is used for a central line? | right subclavian |
| 3 tunic layers of arterial walls | adventitia, media, intima |
| Tunica adventitia | outer layer of artery consisting of connective tissue; contains vasa vasorum that nourish the cells of the arterial wall |
| Tunica media | middle/thickest layer of artery consisting of elastic fibers and smooth muscles fibers; causes vasoconstriction and vasodilation |
| Tunica intima | inner smooth layer of artery composed of endothelium; platelets flow without being damaged and clotting is prevented |
| Arteriosclerosis obliterans | common disorder of arteries characterized by thickening and loss of elasticity of arterial walls |
| A type of arteriosclerosis is atherosclerosis (T/F) | True |
| Atherosclerosis usually occurs with age and is associated with... | tobacco use, HTN, obesity, DM, high levels of LDL |
| Stents are made out of... | stainless steel mesh, titanium, or polypropylene |
| Selection of a balloon in an angioplasty that's too small may result in | underdilation and early stenosis |
| Selection of a balloon in an angioplasty that's too large may result in | dissection of the vessel |
| In an angioplasty, balloon length should be sufficient to extend ____ to ___ cm beyond the lesion | 1 to 2 |
| Embolus | blood clot, fat, air, or small portion of tumor that circulates through the CV system |
| Thrombus | an embolus that becomes lodged in smaller vessels blocking blood flow to and extremity or organ |
| Catheter used in embolectomy/thrombectomy | Fogarty embolectomy catheter |
| Enzymatic lysis meds | urokinase, streptokinase |
| Instruments for arteriotomy | #11 blade and Potts-Smith scissors |
| Pts suffering from TIAs often demonstrate a weakness of the (opposite/same) side of body | opposite |
| Incision for carotid endarterectomy | cervical parallel and anterior to sternocleidomastoid and centered over carotid bifurcation |
| Which cranial nerve is protected during a carotid endarterectomy? | vagus (X) |
| What suture is used to close an arteriotomy? | double-armed nonabsorbable polypropylene |
| Most important practical consideration when doing a carotid endarterectomy | keep back table and mayo stand sterile until pt leaves OR in the vent the neck needs to be reentered |
| If a AAA ruptures, what are the instruments/supplies you need immediately? | suction, laps, aortic clamps |
| First branch of aortic arch | brachiocephalic (innominate) |
| Second branch of aortic arch | carotid |
| Anticoagulant given just prior to cross-clamping a major artery | heparin |
| Antidote for heparin | protamine sulfate |
| Reversal agent for Coumadin/necessary for clotting | vitamin K |
| Vasodilator med | papaverine |
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