Deck 23: Peripheral Vascular Surgery

Question 1

Which of the following is found only in veins?

A) tunica adventitia
B) tunica intima
C) tunica media
D) valves

Answer 1

D

Question 2

Transient cerebral ischemic episodes are treated surgically by:

A) angioplasty
B) atriovenous fistula and shunt
C) carotid endarterectomy
D) coronary artery bypass

Answer 2

C

Question 3

Javid and Argyle are examples of which type of device used in select vascular procedures?

A) catheters
B) shunts
C) guidewires
D) peel-away sheaths

Answer 3

B

Question 4

Where is the balloon dilator inserted percutaneously in coronary artery angioplasty?

A) radial artery
B) carotid artery
C) femoral artery
D) subclavian artery

Question 5

What is another name for the innominate artery?

A) aorta
B) brachiocephalic
C) left subclavian
D) left common carotid

Question 6

What is the name of the frequently used balloon embolectomy catheter?

A) Robinson
B) Groshong
C) Fogarty
D) Foley

Question 7

Which part of the artery is responsible for vasoconstriction and vasodilation?

A) tunica adventitia
B) tunica intima
C) tunica media
D) vasa vasorum

Question 8

Which vessels are responsible for the exchange of oxygen and metabolic waste?

A) arteries
B) capillaries
C) venules
D) veins

Question 9

Which of the following tunica is NOT part of the structure of an artery?

A) adventitia
B) media
C) intima
D) vaginalis

Question 10

What are urokinase and streptokinase used for in vascular pathology?

A) lysis of embolus
B) vasoconstriction
C) vasodilation
D) hemostasis

Question 11

Into which vessel is a double-lumen Groshong catheter routinely inserted?

A) right carotid artery
B) right femoral artery
C) right jugular vein
D) right subclavian vein

Question 12

How far beyond the atherosclerotic lesion should a balloon in angioplasty reach?

A) 1-2 mm
B) 3-5 mm
C) 1-2 cm
D) 3-5 cm

Question 13

What is the name of the condition that involves plaque or clots escaping from the femoral or iliac veins?

A) deep vein thrombosis
B) carotid stenosis
C) atherosclerosis
D) claudication

Question 14

Which of the following would be the suture technique and type used to anastomose a bifurcated graft limb to an artery?

A) interrupted 5-0 or 6-0 nonabsorbable suture
B) running 5-0 or 6-0 absorbable suture
C) interrupted 5-0 or 6-0 absorbable suture
D) running 5-0 or 6-0 nonabsorbable suture

Question 15

Which is the largest artery in the body?

A) aorta
B) carotid
C) renal
D) subclavian

Question 16

Which diagnostic study is considered the gold standard for evaluation of vascular disease?

A) angiography
B) CT scan
C) radiography
D) PET scan

Question 17

The CORRECT sequence of steps for an arteriotomy for embolectomy or thrombectomy is:

A) #15 blade, Metzenbaum scissors, Yankauer suction, insertion of Fogarty catheter
B) #10 blade, Metzenbaum scissors, insertion of Fogarty catheter
C) #11 blade, Potts-Smith scissors, small bore suction, insertion of Fogarty catheter
D) #12 blade, 14 g angiocath insertion, removal of stylet, insertion of Fogarty catheter

Question 18

What are the serrations of DeBakey and Cooley vascular instruments considered to be?

A) atraumatic
B) traumatic
C) smooth
D) toothed

Question 19

If a DVT from deep veins of the legs enters the cardiopulmonary system, what life-threatening condition will likely occur?

A) aortic dissection
B) cardiac tamponade
C) pulmonary embolus
D) myocardial infarction

Question 20

A newly diagnosed patient in need of vascular access long-term hemodialysis would undergo which procedure?

A) embolectomy
B) endarterectomy
C) arteriovenous fistula and shunt
D) inferior vena cava filter placement

Question 21

Which arterial aneurysm is more likely to rupture due to lack of detection over time?

A) femoral
B) iliac
C) popliteal
D) radial

Question 22

Use of an angioscope larger than the diameter of the vessel being scoped will most likely result in which of the following?

A) aneurysm
B) dissection
C) vasodilation
D) vasospasm

Question 23

What is done with the aneurysm sac in AAA repair?

A) excised and discarded
B) excised and sent as specimen
C) inverted and tacked to back of graft
D) anterior wall sutured over the proximal graft

Question 24

The atheromatous core removed from the carotid artery during endarterectomy is more commonly known as:

A) adventitia
B) marrow
C) plaque
D) thrombus

Question 25

What are the operative mortality rates of patients with ruptured abdominal aortic aneurysm (AAA) and shock?

A) 10% to 20%
B) 20% to 40%
C) 50% to 60%
D) > 80%

Question 26

What is the configuration of the saphenous vein when stripped from the leg?

A) cut into small sections and left in situ
B) only the intimal layer removed
C) valves only dissected and vein left in situ
D) vein avulsed and turned completely inside out

Question 27

What are the prep borders for a unilateral vein stripping procedure?

A) toes to groin circumferentially
B) ankle to knee circumferentially
C) knee to groin circumferentially
D) ankle to mid-thigh circumferentially

Question 28

What is the main obstacle of performing angioscopy?

A) light
B) valves
C) strictures
D) clear visibility

Question 29

Dermal atrophy, hemorrhage, ulceration, and cellulitis are complications of:

A) abdominal aortic aneurysm
B) carotid stenosis
C) pulmonary embolus
D) varicose veins

Question 30

Which diagnostic study provides the most detailed information for surgical planning in AAA repair?

A) angiogram
B) aortogram
C) CT scan
D) ultrasound

Question 31

Which of the following is the BEST choice for distal bypass graft in the lower extremity?

A) Dacron
B) Gore-Tex
C) PTFE
D) saphenous vein

Question 32

Peripheral vessel angioplasty stents may be made of all of the following EXCEPT:

A) titanium
B) fascia lata
C) polypropylene
D) stainless steel mesh

Question 33

A #11 blade and forward angle or reverse angle Potts-Smith scissors are frequently used for:

A) arteriotomy
B) embolectomy
C) skin incisions
D) suture cutting

Question 34

Balloon angioplasty performed in the cardiac catheterization lab is used to treat:

A) atherosclerotic thickening
B) stenotic dissection
C) venous insufficiency
D) valvular regurgitation

Question 35

What are the operative mortality rates of patients with unruptured AAA scheduled for elective repair?

A) 1% to 2%
B) 2% to 3%
C) 3% to 5%
D) 5% to 10%

Question 36

What are vessel loops and umbilical tapes commonly used for in vascular cases?

A) anastomosis
B) ligation
C) retraction
D) suturing

Question 37

What is the name of the condition that manifests by deep aching pain in the lower extremity during rest periods?

A) capitation
B) coarctation
C) claudication
D) contraction

Question 38

Which of the following are used on tips of hemostats to prevent breaking of fine gauge monofilament suture when tagged?

A) suture boots
B) hemoclips
C) peel-away sheaths
D) vessel loops

Question 39

Which vascular device is double-lumened for administration of chemotherapy, antibiotic therapy, and IV fluids?

A) Argyle
B) Fogarty
C) Groshong
D) Javid

Question 40

What is the specimen in an AAA procedure?

A) blood clot
B) vessel wall
C) thrombus
D) aneurysm sac

Question 41

Names frequently associated with vascular instrumentation include DeBakey and Cooley, both of whom were cardiothoracic surgeons and pioneers of cardiothoracic and peripheral vascular surgery.

Question 43

Suture pledgets are used to bolster anastomosis sites when tissue is friable.

Question 44

The lumens of veins are larger than the lumens of arteries.

Question 45

Glass syringes are preferred in drawing up contrast media for angiography because of less accumulation of bubbles.

Question 46

Knowledge of the peripheral vascular system is required of the first assistant, but not of the surgical technologist.