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VABC section 4 already graded A+ 2024/2025
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VABC section 4 already graded A+ 2024/2025

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  • February 29, 2024
  • 18
  • 2023/2024
  • Exam (elaborations)
  • Questions & answers

Subjects

  • va bc
  • systemic circulation venous anstransports deoxy
  • pulmonary veins anstransport oxygenated blood to
  • tunica media venous ansmiddle layer composed of

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  • VA-BC
  • VA-BC

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VABC section 4

Systemic circulation venous - ANSTransports deoxygenated blood from tissue back to right side
of heart
Thinner wall 10% of diameter
Collapsible and distend able
Superficial and deep
Contains valves to prevent back flow of blood
Dark non pulsatilla blood
Flow rates relatively slow compared to arterial

Systemic circulation venous - ANSTransports deoxygenated blood from tissue back to right side
of heart
Thinner wall 10% of diameter
Collapsible and distendable
Superficial and deep
Contains valves to prevent back flow of blood
Dark non pulsatile blood
Flow rates relatively slow compared to arterial

Pulmonary veins - ANStransport oxygenated blood to left side of the heart

Pulmonary artery - ANStransport unoxygenated blood to pulmonary capillary bed for oxygen
and carbon dioxide exchange

Tunica Adventia venous - ANSOutermost layer
Connective tissue supportive layer

Tunica advenia arterial - ANSOutermost layer
Thicker layer of connective tissue compared with veins, to transport greater pressure from the
force of blood flow

Tunica media venous - ANSMiddle layer
Composed of smooth muscle and elastic tissues
Collapsible/distensible
Contains nerve fibers for vaconstriction and vasodilation
Change in temp or mechanical or chemical irritation may produce spasms

Tunica media arterial - ANSMiddle layer
Composed of more layers of smooth muscle and elastic tissues and more rigid when compared
to veins
Tend not to collapse

,Regulates blood flow
Vasoconstricts with pain and anxiety ,change in temp or by mechanical or chemical irritation
may produce spasms

Tunica intima venous (Endothelium) - ANSInnermost layer
Single layer of smooth flat endothelial cells lining all blood vessels, including veins, arteries,
heart and valves and capillaries
Non thrombogenic
Damage exposes underlying collagen layer and initiates activation of platelets to create a
platelet plug and activates clotting cascade to deposit fibrin in the platelet plug
Thrombus formation of larger deeper veins can lead to venous thrombosis

Tunica intima arterial (Endothelium) - ANSInnermost layer
Single layer of smooth flat endothelial cells lining all blood vessels
Non thrombogenic
Damage to this layer can cause thrombus formation
Loosening of a large thrombus can cause significant embroil events such as stroke (brain)
pulmonary embolus (lung) or other end organ or the the periphery (leg)

Venous valves - ANSFound in the larger veins of the extremities
Composed of endothelial leaflets
Function is to keep blood flowing toward of the heart
Occur at points of branching and often cause noticeable bulge in veins

Valves arterial - ANSNA

Digital veins: Anatomic route and clinical considerations - ANSAR: Along lateral distal portion of
fingers. CC: Fingers may require splinting and increased risk for infiltration.

Metacarpal veins: Anatomic route and clinical considerations - ANSAR: Dorsum of hand, formed
by the Union of the digital veins between the knuckles. CC: Easily accessible, lies flat on back of
the hand

Cephalic vein: Anatomic route - ANSSuperficial vein that arises from the radial side of the dorsal
side of the wrist (thumb side) and continues to the antecubical fossa. Above the elbow it
ascends superficially along the lateral border of the biceps muscle and the pectoral border of
the deltoid muscle and merges into the axillary vein. Occasionally connected with the EJ or
subclavian vein by a branch that passes upward in front of the clavicle

Cephalic vein: - ANSSmaller than the basilic vein and often smaller than the brachial vein
Often narrows as it descends up the arm
Often makes a sharp turn as it enters axillary vein causing diffulty with advancement with piccs
Higher risk with mechanical phlebitis with placement of piccs in Cephalic vein

, Ultrasound can access size of Cephalic vein along the route going up the arm for accuracy with
pic placement

Basilic vein - ANSSuperficial vein that arises from the ulnar (medial) aspect of the veins that
drain the hand and the lower arm. vein continues up the medial side of the arm across the
antecubical fossa, transversing up the medial side of the upper arm terminating where it joins
the brachial veins to become the axillary vein. Above the antecubital fossa the basilic vein is
deep traveling under the muscles

Basilic vein - ANSLarge vein in the upper arm
Vein of choice for the placement of piccs or midlines
Smooth direct route into the axillary vein and central circulation
Ultrasound guidance recommended to keep picc out of bend of elbow, decrease risk of
mechanical phlebitis , thrombus

Median cubical vein - ANSSuperficial vein , may be palpated and visualized in the antecubital
fossa
Vein joins either Cephalic or basilic vein

Median cubical vein - ANSSignificant variation of the presentation and route
Often used for venipuncture but not for picc placement

Brachial vein - ANSUsually appears as a pair of veins that drain the deep venous system of the
lower arm

Brachial veins - ANSOriginate in the anti cubical fossa transverse up the middle of the arm
along with brachial artery which travels in the opposite direction.the basilica and the brachial
veins join to form the auxiliary vein

Brachial vein clinical considerations - ANSDeep vein frequently used for placement of piccs
especially if basilic vein is not available. Requires use of ultrasound quidance , runs along inner
upper arm bundled with brachial artery and median nerve.

Brachial vein pediatric considerations - ANSUse in caution with use of brachial vein for pic
insertion in young or nonverbal patients due to their inability to verbalize symptoms of nerve
injury which includes pain or numbness

Axillary vein - ANSBegins at the junction of the basilic and brachial veins transverse through the
shoulder and terminates at the lateral border of the first rib, continuos with the subclavian vein.

Axillary vein clinical considerations - ANSEasy to access on the upper chest for cvad insertion
when using ultrasound guidance, avoids risk of pneumothorax or arterial pressure. These veins
should not be used for cvad insertion in patients with ckd or esrd unless cleared with
nephrologist

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