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33 Cards in this Set
- Front
- Back
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indicators of poor dialysis graft fxn
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High venous pressures and high recirculation values
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why are dialysis grafts prone to failure
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exposure of outflow veins to arterial pressures and flows
frequent needle punctures. |
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tx for thrombosed dialysis graft
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surgical thrombectomy
percutaneous declotting by pharmacologic thrombolysis or thrombectomy |
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signs of dailysis graft failure
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high venous pressures during dialysis sessions
excessive bleeding from the puncture sites arm swelling high recirculation values graft thrombosis. |
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what is a dialysis graft
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surgically created AVF using prosthetic materials
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is churg straus a small, med, or lrg vessel disease
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small
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which BV are most commonly affect in takayasu's arteritis
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left subclavian artery > right subclavian artery > left common carotid artery > right common carotid artery
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initial tx of takayasu's arteritis
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Angioplasty when flow-limiting stenosis is present and disease is inactive
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pathophys of takayasu's arteritis
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granulomatous vasculitis involving thoracic and abdominal aorta and its large branch vessels.
infiltration of adventitia with inflammatory cells -> decreased lumen caliber, stenosis |
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if there is SFA occlusion, how does blood flow through the collaterals
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profunda femoral artery to popliteal
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what collaterals form between the common iliac arteries and IMA
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IMA to hemorrhoidals to internal iliac to external iliac
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what collaterals exist between the SMA and IMA
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midcolic to L colic artery via marginal artery of drummond and arc of riolan
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what collaterals exist between celiac and SMA
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pancreatic-duodenal
arc of beuhler |
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collaterals to bypass a subclavian artery occlusion
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intercostals to distal subclavian artery
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collaterals if there is occlusion between lower abd aorta or aortic bifurcation
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lumbar arteries to internal iliac (vial iliolumbar and superior gluteal branches) or ext iliac artery (via deep iliac circumflex or inferior epigastric arteries)
internal mammary to external iliac artery (via superior and inferior epigastric arteries SMA or IMA to internal iliac artery (via hemorrhoidal and vesicular or rectal arteries) |
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major branches of external carotid artery
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superior thyroid
ascending pharyngeal lingual facial artery greater occipital artery internal maxillary artery (IMAX) |
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what spinal lvl is the celiac artery
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T12-L1 interspace
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what level do the renal arteries come off at
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upper border of L@
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lvl of SMA
lvl of IMA |
L1
L2-3 |
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lvl of artery of adamkiewicz
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from itercostal or lumbar artery from T8-L4 (usually on L)
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what happens if you inject contrast into the artery of adamkiewicz
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may cause transverse myelitis
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indications for tunneled catheter
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continuous use, multiple simultaneous uses
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indication for implantable port
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intermittent use
immunocompromised pts |
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indication for a high flow catheter
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temporary HD
pheresis |
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indications for PICC line
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short term, usually <2-3 months
infrequent blood draw |
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how does heparin affect PT/PTT
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prolongs both
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how does coumadin affect PT/PTT
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prolongs both
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how does ASA affet PT/PTT
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it doesn't (but platelet aggregation is reduced)
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how to reverse heparin
how long till nml |
stop heparin (3-6 hrs)
IV protamine titration (minutes) |
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how to reverse coumadin, how long till nml
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IV vitamin K (3 doses), days
FFP, minutes |
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how to reverse ASA, how long till nml
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give plts (minutes)
stop ASA, 1 wk |
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where do the superior, middle, and inferior rectal arteries come from
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superior - from IMA
middle - from internal iliac inferiro - from pudendal artery |
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what is the arc of riolan
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a short, direct SMA-IMA communication
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