Upper venous from HW 2 Multiple choice

What is the main reason that venous thrombosis in the upper extremities has become more common?

a. a more sedentary lifestyle

b. increased injury to vein walls

c. an increase in hypercoagulable disease states

d. decreased rates of prophylactic anticoagulation

b. increased injury to vein walls

Unlike the lower extremities, what do the upper extremities NOT have that may allow spontaneous thrombus formation?

a. deep veins

b. superficial veins

c. soleal sinuses

d. respiratory phasic flow dynamics

c. soleal sinuses

What is venous thrombosis secondary to compression of the subclavian vein at the thoracic inlet?

a. paget-schroetter syndrome

b. May-Thurner syndrome

c. Raynaud's syndrome

d. phlegmasia

a. paget-schroetter syndrome

A patient presents to the vascular lab for upper extremity venous evaluation with face swelling and prominent veins on the chest and neck. What do these findings suggest?

a. subclavian vein thrombosis

b. cephalic vein thrombosis

c. internal jugular vein thrombosis

d. superior vena cava thrombosis

d. superior vena cava thrombosis

Transducer compressions are limited over several veins in the upper extremity because of limited access from bony structures. What are the most common veins that are NOT able to be compressed?

a. brachiocephalic and subclavian veins

b. subclavian and axillary veins

c. cephalic and basilic veins

d. brachial and radial veins

a. brachiocephalic and subclavian veins

What is the most appropriate transducer for mapping of the upper extremity superficial venous system?

a. 5 to 10 MHz straight linear array

b. 5 to 10 MHz curved linear array

c. 10 to 18 MHz straight linear array

d. 3.5 to 5 MHz curved linear or sector array

c. 10 to 18 MHz straight linear array

Why are the subclavian and jugular veins assessed with the patient lying flat?

a. to reduce hydrostatic pressure

b. to reduce compression from the clavicle

c. to reduce heart pulsatility

d. to reduce respiration

a. to reduce hydrostatic pressure

How does the external jugular vein lie in relation to the internal jugular vein?

a. anterior

b. superior

c. deep

d. posterior

d. posterior

With which vein does the brachial vein become the axillary vein at the confluence?

a. cephalic vein

b. radial vein

c. basilic vein

d. median cubital vein

c. basilic vein

During an upper extremity venous examination, the technologist has made the patient take in a quick, deep breath through pursed lips while viewing the subclavian vein. What is the purpose of this action?

a. dilate the subclavian vein

b. increase color filling of the vein

c. collapse/coapt the subclavian vein

d. show pulsatile flow in the vein

c. collapse/coapt the subclavian vein

In the upper extremity, in general, which venous system is larger?

a. deep system

b. superficial system

c. deep and superficial of equal size

d. perforating system

b. superficial system

During an upper extremity venous duplex examination, the technologist notes significant pulsatility in the spectral doppler waveform from the internal jugular vein. What does this finding suggest?

a. proximal venous obsruction

b. distal venous obstruction

c. normal findings for the IJV

d. superficial venous obstruction

c. normal findings for the IJV

Which vessel may NOT be routinely evaluated in a UE venous duplex examination but is often added in the event of significant thrombosis?

a. internal jugular vein

b. subclavian vein

c. basilic vein

d. external jugular vein

d. external jugular vein

Because of the location of the brachiocephalic veins, documentation of patency of these vessels is usually performed with which of the following?

a. grayscale image with additional color-flow and spectral doppler images

b. grayscale imaging alone

c. grayscale image with and without transducer compression

d. color-flow imaging alone

a. grayscale image with additional color-flow and spectral doppler images

Which vessel connects the basilic and cephalic veins?

a. radial veins

b. anterior jugular vein

c. medial cubital vein

d. interosseous vein

c. medial cubital vein

Which forearm vessels are NOT routinely evaluated during upper extremity venous duplex testing

a. basilic and cephalic veins

b. basilic and ulnar veins

c. cephalic and radial veins

d. radial and ulnar veins

d. radial and ulnar veins

A 34-year-old female presents to the vascular lab with a 1 day history of arm swelling and redness. The patient has recently had a PICC line inserted. During the duplex evaluation, the axillary and subclavian veins are incompressible with hypo echoic echoes noted within their lumens. What do these findings suggest?

a. chronic venous thrombosis

b. acute venous thrombosis

c. acute venous insufficiency

d. normal findings in these vessels

b. acute venous thrombosis

A 78 year old male presents to the vascular lab with right arm swelling for the past several days. The patient notes that he is currently being treated for cancer. During the upper extremity duplex examination, decreased pulsatility is noted in the right internal jugular and subclavian veins as well as rouleaux (slow) flow formation. What do these findings suggest?

a. normal upper extremity duplex examination

b. a more distal obstruction, likely in the brachial and cephalic veins

c. a more proximal obstruction, likely in the brachiocephalic vein or superior vena cava

d. congestive heart failure

c. a more proximal obstruction, likely in the brachiocephalic vein or superior vena cava

During an upper extremity venous duplex evaluation, color flow is noted filling the axillary vein. However, in a transverse view, the axillary vein is noted be only partially compressible. Which of the following could explain these findings?

a. color priority set too low and color gain too high

b. color scale too high and color gain too low

c. color priority and scale too high

d. color packet size and gain too low

a. color priority set too low and color gain too high

A 22 year old male patient presents to the vascular lab with a 3 day history of left arm swelling with no apparent injury or risk factors. Upon further questioning, the patient does state that he has recently begun weight training. What do the vascular technologist suspect in this patient?

a. effort thrombosis

b. superficial venous thrombosis

c. superior vena cava syndrome

d. lymphedema

a. effort thrombosis