Ch 28

Front 1

process of remodeling the lumen of a blood vessel

Back 1

angioplasty

Front 2

incision made in the artery

Back 2

arteriotomy

Front 3

formation of thick, yellowish plaque that infiltrates and deposits in the inner layer of the arterial wall

Back 3

atherosclerosis

Front 4

a Y shape in an artery or graft

Back 4

bifurcation

Front 5

clot of blood, air, or organic material that moves freely in the vascular system

Back 5

embolus

Front 6

surgical removal of atherosclerotic plaque from the inside of an artery

Back 6

endaterectomy

Front 7

outside the body

Back 7

extracorporeal

Front 8

in the natural position

Back 8

in situ

Front 9

lack of blood and therefore oxygen in tissue

Back 9

ischemia

Front 10

any organic or nonorganic material blocking an artery

Back 10

thrombus

Front 11

what organs are in the peripheral vascular system?

Back 11

arteries, veins, and capillary networks

Front 12

the systemic system begins where?

Back 12

with the great arteries that arise from the heart

Front 13

all arteries except what kind carry oxygenated blood?

Back 13

pulmonary arteries

Front 14

the three layers of a blood vessel

Back 14

tunica adventitia (outside), tunica media (middle), tunica intima (inner)

Front 15

what is the intima layer made of?

Back 15

squamous epithelium

Front 16

which vessel carries blood AWAY from the heart?

Back 16

artery

Front 17

which vessel carries blood TOWARD the heart?

Back 17

veins

Front 18

which is lower? venous blood pressure or arterial pressure? why?

Back 18

venous is lower because the venous pumping mechanism is weaker than the heart

Front 19

the force that is exerted on the arterial wall by the pumping action of the heart.

Back 19

blood pressure

Front 20

the highest pressure that occurs when the heart beats

Back 20

systolic

Front 21

the lowest pressure that occurs during the relaxation phase of the cardiac cycle

Back 21

diastolic

Front 22

what two sets are required for vascular surgery?

Back 22

vascular and general

Front 23

vascular instruments include...

Back 23

vascular clamps, fine-tipped needle holders, atraumatic forceps such as cushing or debakey, sharp dissecting scissors, right angle clamps, and retractors

Front 24

what is critical during all vascular procedures?

Back 24

suction

Front 25

what kind of sutures are commonly used to create a circumferential anastomosis

Back 25

double-armed

Front 26

vascular suture materials include

Back 26

polypropylene, expanded polytetrafluoroethylene (PTFE), Ethibond, and silk

Front 27

why should you never retrieve instruments from the field during a vascular case?

Back 27

could potentially rip apart an anastomosis of a vessel or graft and cause hemorrhage

Front 28

synthetic grafts are made of what?

Back 28

dacron, polyester, or goretex

Front 29

natural materials used for grafts are what?

Back 29

banked human umbilical cord, bovine grafts, and autografts

Front 30

used in both peripheral and coronary surgery to map the lumen of a vessel

Back 30

intravascular ultrasound

Front 31

intensifies the sounds made by blood flowing through a vessel

Back 31

doppler scanning

Front 32

combines doppler scanning with ultrasound

Back 32

doppler duplex ultrasonography

Front 33

used to measure the waveform of the arterial pulse during systole?

Back 33

pulse volume recording (Arterial Plethysmography)

Front 34

what is slid along the free ends of a vessel loop?

Back 34

rumel tourniquet

Front 35

what is added to irrigation

Back 35

heparin

Front 36

what does heparinized irrigation prevent?

Back 36

the formation of thrombi at the surgical site and reduces the risk of embolus

Front 37

intravenous administration of thrombin can cause what?

Back 37

a fatal embolus

Front 38

heparin is reversed with what?

Back 38

protamine sulfate

Front 39

what is injected into the vessel to prevent vasaspasm?

Back 39

lidocaine or papaverine

Front 40

injection of contrast media into a selected artery and its branches to determine the exact location of strictures, occlusion, or malformation

Back 40

angiography

Front 41

angioplasty is performed during a what?

Back 41

angiography

Front 42

during an angioplasty contrast media is injected to verify the correct placement of what?

Back 42

stent, embolectomy catheter, or intravascular shaving device

Front 43

small metal implant designed to fit against the wall of an artery

Back 43

stent

Front 44

stents are made of what?

Back 44

stainless steel, titanium, or metal alloy called nitinol

Front 45

common type of balloon expandable stent

Back 45

pulmaz stent

Front 46

in this procedure, a stricture in the artery is expanded with a balloon catheter

Back 46

balloon angioplasty

Front 47

an infarction leads to what?

Back 47

ischemia

Front 48

common causes of thrombi

Back 48

trauma, obesity, childbirth, genetic predisposition, pulmonary emboli

Front 49

what does anticoagulation therapy do?

Back 49

prevents new clots from forming

Front 50

what instruments will you always need for vascular surgeries?

Back 50

#11 blade, #7 handle, hep saline, suction, potts smith, freer elevator

Front 51

patients with end-stage renal disease require frequent what?

Back 51

hemodialysis

Front 52

direct anastomosis between an artery and a vein

Back 52

arteriovenous fistula

Front 53

metal umbrella shaped filter to prevent emboli from entering the pulmonary system

Back 53

vena cava filter

Front 54

surgical removal of atherosclerotic plaque from the carotid artery

Back 54

carotid endarterectomy

Front 55

what retractors should be available for a carotid endarterectomy?

Back 55

2 dull weitlaners, dull rakes, and army-navy

Front 56

what instruments should the scrub have ready before an endarterectomy?

Back 56

#11 blade, potts and demartel scissors, neurosurgical elevators (penfield), freer elevator and straight hemo

Front 57

what arteries are clamped during a carotid endarterectomy and in what order are they opened and closed?

Back 57

external, common, and internal arteries in that order

Front 58

surgical goal is to remove the vein while retaining its structure and physiological soundness

Back 58

saphenous vein harvesting

Front 59

creates circulation between the femoral arteries and the axillary artery

Back 59

axillofemoral bypass

Front 60

anastomosis of axillofemoral bypass is preformed with what type of suture

Back 60

5-0 or 6-0 polypropylene

Front 61

a synthetic graft or autograft is implanted between the femoral and popliteal arteries

Back 61

femoral popliteal bypass

Front 62

surgical alternative to using a synthetic graft to bypass a diseased femoral artery

Back 62

in situ saphenous vein bypass

Front 63

end to end anastomosis during an in situ saphenous vein bypass is formed with what?

Back 63

6-0 or 7-0 nonabsorbable sutures with a double arm or single arm needle

Front 64

this is performed to bypass unilateral atherosclerotic disease in the iliac artery

Back 64

femorofemoral bypass

Front 65

dilated and tortuous veins and their tributaries are surgically removed?

Back 65

varicose vein excision

Front 66

condition in which a section of the abdominal aorta bulges because of atherosclerotic plaque and progressive weakening of the aortic wall

Back 66

abdominal aortic aneurysm

Front 67

surgical goal is to remove the aneurysm and implat a graft extending from the aorta to both iliac arteries

Back 67

abdominal aortic aneurysmectomy

Front 68

what type of graft is usually used during a AAA

Back 68

bifurcated graft