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Questions and Answers
A patient presents with a compromised blood supply to the pelvic organs. Which arterial structure is MOST likely involved upstream of this issue?
A patient presents with a compromised blood supply to the pelvic organs. Which arterial structure is MOST likely involved upstream of this issue?
- Popliteal artery
- Superficial femoral artery
- Profunda femoris artery
- External iliac artery (correct)
Following a traumatic injury near the inguinal ligament, a patient's common femoral artery is severed. Which of the following represents the MOST immediate distal continuation of blood flow from the external iliac artery that is now compromised?
Following a traumatic injury near the inguinal ligament, a patient's common femoral artery is severed. Which of the following represents the MOST immediate distal continuation of blood flow from the external iliac artery that is now compromised?
- Superficial femoral artery (correct)
- Popliteal artery
- Profunda femoris artery
- Anterior tibial artery
A surgeon needs to access the deep femoral artery. Which of the following describes its anatomical relationship to the superficial femoral artery?
A surgeon needs to access the deep femoral artery. Which of the following describes its anatomical relationship to the superficial femoral artery?
- It courses posterior and lateral to the superficial femoral artery. (correct)
- It courses anterior and medial to the superficial femoral artery.
- It is a direct continuation of the superficial femoral artery.
- It branches directly from the popliteal artery.
A patient experiences reduced blood flow to the anterior compartment of the lower leg. Compromise of which artery would MOST directly cause this?
A patient experiences reduced blood flow to the anterior compartment of the lower leg. Compromise of which artery would MOST directly cause this?
If the tibioperoneal trunk is blocked, which arteries would be MOST immediately affected by the blockage?
If the tibioperoneal trunk is blocked, which arteries would be MOST immediately affected by the blockage?
Which of the following sequences correctly traces the path of blood flow from the aortic arch to the dorsalis pedis artery?
Which of the following sequences correctly traces the path of blood flow from the aortic arch to the dorsalis pedis artery?
If a patient has a blockage in the superficial femoral artery (SFA) after it bifurcates from the common femoral artery, which of the following arteries would be directly affected (reduced blood flow)?
If a patient has a blockage in the superficial femoral artery (SFA) after it bifurcates from the common femoral artery, which of the following arteries would be directly affected (reduced blood flow)?
At which vertebral level does the abdominal aorta typically bifurcate into the right and left common iliac arteries?
At which vertebral level does the abdominal aorta typically bifurcate into the right and left common iliac arteries?
The tibioperoneal trunk bifurcates into which two arteries?
The tibioperoneal trunk bifurcates into which two arteries?
The internal iliac artery is also known as which of the following?
The internal iliac artery is also known as which of the following?
The dorsalis pedis artery is a direct continuation of which artery?
The dorsalis pedis artery is a direct continuation of which artery?
Which artery runs behind the medial malleolus?
Which artery runs behind the medial malleolus?
The peroneal artery terminates into branches that communicate with which arteries?
The peroneal artery terminates into branches that communicate with which arteries?
From which arteries do the digital arteries of the foot arise?
From which arteries do the digital arteries of the foot arise?
Which of the following is TRUE regarding the anterior tibial artery?
Which of the following is TRUE regarding the anterior tibial artery?
The medial and lateral plantar arteries are formed from the termination of which artery?
The medial and lateral plantar arteries are formed from the termination of which artery?
Which artery is located deep within the leg and descends along the medial aspect of the fibula?
Which artery is located deep within the leg and descends along the medial aspect of the fibula?
What is the origin of the metatarsal arteries in the foot?
What is the origin of the metatarsal arteries in the foot?
If a patient presents with suspected peripheral arterial disease, which of the following would be the LEAST relevant initial step in their diagnostic workup?
If a patient presents with suspected peripheral arterial disease, which of the following would be the LEAST relevant initial step in their diagnostic workup?
A patient describes experiencing pain in their calf muscles during exercise, which is relieved by rest. This symptom is most indicative of what condition?
A patient describes experiencing pain in their calf muscles during exercise, which is relieved by rest. This symptom is most indicative of what condition?
Which layer of the arterial wall is primarily responsible for regulating blood vessel diameter through contraction and relaxation?
Which layer of the arterial wall is primarily responsible for regulating blood vessel diameter through contraction and relaxation?
What is the primary function of the tunica adventitia, the outermost layer of an arterial wall?
What is the primary function of the tunica adventitia, the outermost layer of an arterial wall?
Arterioles play a critical role in regulating blood flow to capillary beds. How do they achieve this function?
Arterioles play a critical role in regulating blood flow to capillary beds. How do they achieve this function?
How do large arteries, such as the aorta, differ structurally from small and medium-sized arteries?
How do large arteries, such as the aorta, differ structurally from small and medium-sized arteries?
After originating from the left ventricle, what is the first section of the aorta that blood flows through?
After originating from the left ventricle, what is the first section of the aorta that blood flows through?
What is the correct order of layers that a surgeon would encounter when making an incision into an artery, starting from the outside?
What is the correct order of layers that a surgeon would encounter when making an incision into an artery, starting from the outside?
Which artery is the EIA a continuation of?
Which artery is the EIA a continuation of?
What are the two main branches of the popliteal artery?
What are the two main branches of the popliteal artery?
A patient experiences calf pain during exercise that subsides with rest. This is MOST likely indicative of:
A patient experiences calf pain during exercise that subsides with rest. This is MOST likely indicative of:
A patient with intermittent claudication reports experiencing pain in their thigh and buttocks during exercise. This symptom presentation MOST likely suggests:
A patient with intermittent claudication reports experiencing pain in their thigh and buttocks during exercise. This symptom presentation MOST likely suggests:
A patient's claudication symptoms consistently appear after walking a specific distance. This presentation suggests that:
A patient's claudication symptoms consistently appear after walking a specific distance. This presentation suggests that:
If a patient reports claudication primarily limited to the calf, which arterial segment is MOST likely affected?
If a patient reports claudication primarily limited to the calf, which arterial segment is MOST likely affected?
Which of the following is NOT a typical symptom associated with intermittent claudication?
Which of the following is NOT a typical symptom associated with intermittent claudication?
Buttock claudication is MOST often associated with disease in which of the following arteries?
Buttock claudication is MOST often associated with disease in which of the following arteries?
A patient reports experiencing calf pain during exercise that subsides with rest. According to the principles of claudication, where is the most likely location of the arterial disease causing these symptoms?
A patient reports experiencing calf pain during exercise that subsides with rest. According to the principles of claudication, where is the most likely location of the arterial disease causing these symptoms?
A patient presents with hair loss on the legs, thickened toenails, and shiny skin. What condition might these symptoms indicate?
A patient presents with hair loss on the legs, thickened toenails, and shiny skin. What condition might these symptoms indicate?
A patient has undergone a femoral-popliteal bypass graft. Which of the following is the MOST appropriate indication for a lower extremity arterial exam in this patient?
A patient has undergone a femoral-popliteal bypass graft. Which of the following is the MOST appropriate indication for a lower extremity arterial exam in this patient?
When adjusting ultrasound settings during a lower extremity arterial exam, what is the relationship between the scale and gain to optimize image quality?
When adjusting ultrasound settings during a lower extremity arterial exam, what is the relationship between the scale and gain to optimize image quality?
A patient complains of buttock pain on both sides that occurs with exercise. Where is the most likely location of the arterial disease?
A patient complains of buttock pain on both sides that occurs with exercise. Where is the most likely location of the arterial disease?
What is the primary indication for performing a lower extremity arterial (LEA) exam?
What is the primary indication for performing a lower extremity arterial (LEA) exam?
A patient who has had a percutaneous intervention such as angioplasty and stent placement now requires a follow-up lower extremity arterial (LEA) exam. What is the main goal of this exam?
A patient who has had a percutaneous intervention such as angioplasty and stent placement now requires a follow-up lower extremity arterial (LEA) exam. What is the main goal of this exam?
Which of the following symptoms is LEAST likely to be associated with the onset of peripheral arterial occlusive disease (PAOD)?
Which of the following symptoms is LEAST likely to be associated with the onset of peripheral arterial occlusive disease (PAOD)?
Flashcards
Aortic Arch Vessels
Aortic Arch Vessels
Three major vessels arise from the aortic arch: Brachiocephalic artery, Left common carotid artery, Left subclavian artery.
Common Iliac Arteries
Common Iliac Arteries
The aorta bifurcates into right and left common iliac arteries at the 4th lumbar vertebra.
External Iliac Artery
External Iliac Artery
Bifurcation of the common iliac artery that continues to become the common femoral artery.
Popliteal Artery
Popliteal Artery
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Dorsalis Pedis Artery
Dorsalis Pedis Artery
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External iliac arteries
External iliac arteries
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Common femoral artery
Common femoral artery
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Profunda femoris artery
Profunda femoris artery
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Superficial femoral artery (SFA)
Superficial femoral artery (SFA)
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LEA Exam Indications
LEA Exam Indications
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LEA Exam Symptoms
LEA Exam Symptoms
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Tunica Intima
Tunica Intima
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Tunica Media
Tunica Media
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Tunica Adventitia
Tunica Adventitia
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Arterioles
Arterioles
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Aorta
Aorta
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Types of Arteries
Types of Arteries
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Anterior tibial artery
Anterior tibial artery
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Posterior tibial artery
Posterior tibial artery
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Peroneal artery
Peroneal artery
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Medial plantar artery
Medial plantar artery
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Lateral plantar artery
Lateral plantar artery
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Metatarsal arteries
Metatarsal arteries
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Digital arteries
Digital arteries
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Coldness in lower leg
Coldness in lower leg
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Claudication
Claudication
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Weak pulse in legs
Weak pulse in legs
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Skin changes in PAOD
Skin changes in PAOD
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Sores that won’t heal
Sores that won’t heal
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Erectile dysfunction
Erectile dysfunction
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Hair loss on legs
Hair loss on legs
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Popliteal Artery Branches
Popliteal Artery Branches
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Intermittent Claudication
Intermittent Claudication
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Distal Symptoms of PAD
Distal Symptoms of PAD
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Superficial Femoral Artery Disease
Superficial Femoral Artery Disease
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Common Femoral Artery Disease
Common Femoral Artery Disease
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Iliac Artery Disease
Iliac Artery Disease
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Symptoms Progression
Symptoms Progression
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Study Notes
Chapter 4: LEA Anatomy
- The chapter focuses on the anatomy of the lower arterial vascular system, specifically the arteries.
- The exam objectives include listing indications and symptoms, defining components, describing vessel arrangements, and identifying vessels using ultrasound images.
- The arterial walls consist of three layers: tunica intima, tunica media, and tunica adventitia.
- The tunica intima is the innermost layer, consisting of endothelial cells and connective tissue.
- The tunica media is the thickest layer, primarily composed of smooth muscle, elastic fibers, and collagen.
- The tunica adventitia is the outermost layer, composed of connective tissue, nerve fibers, and small capillaries, in contact with surrounding tissues.
Arterial Anatomy
- The aorta, the main artery, arises from the left ventricle.
- It's shaped like an umbrella handle.
- The ascending aorta curves into the aortic arch.
- Branches from the aortic arch include the brachiocephalic (innominate) artery, left common carotid artery, and left subclavian artery.
- The descending aorta passes through the diaphragm, becoming the abdominal aorta.
- Branches from the abdominal aorta supply the intestines and abdominal viscera.
- The aorta bifurcates into the common iliac arteries.
- The common iliac arteries further branch into external and internal iliac arteries.
- The external iliac arteries supply the lower extremities, becoming the common femoral artery at the inguinal ligament.
Lower Extremity Arteries
- The common femoral artery divides into superficial femoral artery (SFA) and profunda femoris artery (DFA).
- The SFA courses distally, passing through the adductor canal, becoming the popliteal artery.
- The popliteal artery continues behind the knee in the popliteal fossa.
- Branches of the popliteal artery include sural and genicular arteries.
- Branches of the popliteal artery include sural and genicular arteries.
- Branches of the popliteal artery are the anterior tibial, posterior tibial, and peroneal arteries
- Anterior tibial artery passes through the interosseous membrane, runs distally in the anterior compartment of the leg, and becomes the dorsalis pedis artery.
- The posterior tibial artery courses medially and runs behind the medial malleolus, dividing into lateral and medial plantar arteries.
- The peroneal artery is a deep artery that runs down the leg, connecting to the posterior and anterior tibial arteries.
- Arteries of the foot include the medial and lateral plantar arteries branching off plantar arches, and digital arteries arising from metatarsal arteries.
Lower Extremity Protocol Video
- The Lower Extremity Arterial Protocol outlines the steps to evaluate the arteries using ultrasound.
- Each specific artery segment will have four separate views performed, including a grey scale, long grey scale, long color, and long color Doppler view.
TGC
- Too many artifacts require better optimization techniques for accurate imaging and diagnosis.
- Optimize image quality and visualization of the vessel intima without artifacts.
Techniques
- Important to use the correct scale and gain settings.
- Adapt scale and gain in small increments.
- Techniques like "rocking" or "heel-toe" the probe can improve imaging quality.
- Ensure the color box and ultrasound beam meet an acute angle of 60 degrees or less (rather than angled up) when viewing the vessel.
- Review the appropriate sweep speeds of the waveform.
Arterial Symptoms
- Claudication, a common symptom of PAOD, refers to leg pain or cramping caused by activity, which improves with rest.
- Other symptoms may include coldness in the affected leg, numbness or weakness, absence or reduced pulse, painful cramping after activity, scaly skin, and skin color changes.
Indications for LEA Exam
- Diagnosing stenosis or occlusion.
- Monitoring intervention sites.
- Following up after interventions.
- Evaluating arterial integrity in cases of trauma.
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Description
Questions covering the arterial supply of the lower limb, including the common femoral, deep femoral, and superficial femoral arteries. Also covers blood flow from the aortic arch to the dorsalis pedis artery.
