Question 1

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

Accepted Answer

Running 5-0 or 6-0 nonabsorbable sutures are typically used for vascular anastomoses, including attaching a graft limb to an artery, because they provide a continuous, secure, and hemostatic suture line that is durable over time. Nonabsorbable sutures are preferred in vascular surgery to ensure the anastomosis remains intact long-term.

Question 2

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

Accepted Answer

The balloon dilator is typically inserted percutaneously via the femoral artery for coronary artery angioplasty.

Question 3

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

Accepted Answer

When a DVT from deep veins of the legs enters the cardiopulmonary system, it can travel to the lungs and cause a pulmonary embolus, which is a life-threatening condition. A pulmonary embolus can block blood flow to the lungs and cause serious complications such as shortness of breath, chest pain, and even death. The other options, aortic dissection, cardiac tamponade, and myocardial infarction, are not directly related to a DVT from deep veins of the legs entering the cardiopulmonary system.

Question 4

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

Accepted Answer

Vaginalis is not a part of the structure of an artery. The other tunicae, namely adventitia, media, and intima, make up the three-layered walls of an artery.

Question 5

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

Accepted Answer

Deep vein thrombosis (DVT) is a condition where a blood clot forms in a deep vein, usually in the legs. If the clot breaks free and travels to the lungs, it can cause a life-threatening condition called pulmonary embolism. While plaque and atherosclerosis can contribute to the development of DVT, they are not the primary cause. Carotid stenosis refers to narrowing of the carotid arteries in the neck, and claudication is a symptom of peripheral artery disease.

Question 6

What is another name for the innominate artery?

Accepted Answer

The innominate artery is also known as the brachiocephalic artery, as it is the first branch arising from the aortic arch and divides into the right subclavian and right common carotid arteries. Option A (aorta) is incorrect as it refers to the main artery that carries blood from the heart to the rest of the body. Options C (left subclavian) and D (left common carotid) are also incorrect as they refer to branches of the aortic arch other than the innominate artery.

Question 7

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

Accepted Answer

Angiography is considered the gold standard for evaluation of vascular disease because it provides high-resolution images of the blood vessels and can accurately detect any abnormalities or blockages. CT and PET scans may also be used to evaluate vascular disease, but they are not considered as reliable and accurate as angiography. Radiography is not typically used for vascular evaluation.

Question 8

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

Accepted Answer

Capillaries are responsible for the exchange of oxygen and metabolic waste due to their thin walls and close proximity to tissues. Oxygen diffuses from the capillaries into the tissues, while waste products like carbon dioxide diffuse from the tissues into the capillaries to be carried away. Arteries carry oxygenated blood away from the heart, while veins carry deoxygenated blood back to the heart. Venules are small veins that connect capillaries to larger veins.

Question 9

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

Accepted Answer

Arteriovenous fistula and shunt would be the best choice for a newly diagnosed patient in need of vascular access for long-term hemodialysis. It is a surgical connection of an artery and vein, which creates a larger and stronger blood vessel that can be used for multiple dialysis treatments. Embolectomy and endarterectomy refer to procedures to remove blockages in blood vessels and are not typically used for vascular access for hemodialysis. Inferior vena cava filter placement is used to prevent blood clots from traveling to the lungs and is not directly related to vascular access for hemodialysis.

Question 10

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

Accepted Answer

The serrations of DeBakey and Cooley vascular instruments are designed to be atraumatic, meaning they are meant to minimize tissue damage during surgery. These types of instruments are often used in delicate surgical procedures where minimal trauma is important, such as in cardiovascular or neurosurgery.

Question 11

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

Accepted Answer

Javid and Argyle are types of shunts used in vascular procedures to temporarily divert blood flow.

Question 12

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

Accepted Answer

The answer of How far beyond the atherosclerotic lesion should...

Question 13

Transient cerebral ischemic episodes are treated surgically by:

Accepted Answer

Carotid endarterectomy is the surgical treatment of choice for transient cerebral ischemic episodes caused by carotid artery stenosis. This procedure removes the plaque from the carotid artery, improving blood flow to the brain and reducing the risk of stroke. Angioplasty and stenting may be an alternative for some patients, but carotid endarterectomy is generally preferred. Coronary artery bypass surgery and atriovenous fistula and shunt are not appropriate treatments for transient cerebral ischemic episodes.

Question 14

Which is the largest artery in the body?

Accepted Answer

The aorta is the largest artery in the human body, originating from the left ventricle of the heart and extending down to the abdomen, where it branches off into smaller arteries. The carotid, renal, and subclavian arteries are all significant arteries in the body, but they are not as large as the aorta.

Question 15

What are urokinase and streptokinase used for in vascular pathology?

Accepted Answer

Urokinase and streptokinase are both fibrinolytic agents used for the lysis of embolus in vascular pathology. They help dissolve blood clots that have formed in blood vessels and can potentially lead to complications such as stroke, heart attack, or pulmonary embolism.

Question 16

Which of the following is found only in veins?

Accepted Answer

Valves are found only in veins and help to prevent backflow of blood. The tunica adventitia, tunica intima, and tunica media are all layers found in both arteries and veins.

Question 17

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

Accepted Answer

The Fogarty balloon embolectomy catheter is a frequently used catheter for the removal of emboli from blood vessels. The other options (Robinson, Groshong, and Foley) are types of catheters but are not specifically designed for embolectomy procedures.

Question 18

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

Accepted Answer

The tunica media is responsible for vasoconstriction and vasodilation through the contraction and relaxation of the smooth muscle cells located within it.

Question 19

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

Accepted Answer

A double-lumen Groshong catheter is routinely inserted into the right subclavian vein.

Question 20

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

Accepted Answer

The correct sequence for an arteriotomy for embolectomy or thrombectomy involves using a #11 blade to make the initial incision, followed by the use of Potts-Smith scissors for precise cutting or extension of the arteriotomy, and finally, the insertion of a Fogarty catheter to remove the embolus or thrombus.

Quiz 23: Peripheral Vascular Surgery