Chapter·AnatomySurface anatomy

Pulse points and vascular accessDownloads

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1

A 47-year-old woman comes to the emergency department after coughing up 2 cups of bright red blood. A CT angiogram of the chest shows active extravasation from the right bronchial artery. A coil embolization is planned to stop the bleeding. During this procedure, a catheter is first inserted into the right femoral artery. Which of the following represents the correct subsequent order of the catheter route?

AThoracic aorta, right superior epigastric artery, right bronchial artery

BThoracic aorta, right bronchial artery

CThoracic aorta, left ventricle, left atrium, pulmonary artery, right bronchial artery

DThoracic aorta, brachiocephalic trunk, right subclavian artery, right internal thoracic artery, right bronchial artery

EThoracic aorta, right subclavian artery, right internal thoracic artery, right bronchial artery

2

A 14-year-old boy is brought to the emergency department because of acute left-sided chest pain and dyspnea following a motor vehicle accident. His pulse is 122/min and blood pressure is 85/45 mm Hg. Physical examination shows distended neck veins and tracheal displacement to the right side. The left chest is hyperresonant to percussion and there are decreased breath sounds. This patient would most benefit from needle insertion at which of the following anatomical sites?

A5th left intercostal space along the midclavicular line

B8th left intercostal space along the posterior axillary line

C2nd left intercostal space along the midclavicular line

DSubxiphoid space in the left sternocostal margin

E5th left intercostal space along the midaxillary line

3

A 41-year-old man with a history of hypertension and hyperlipidemia is brought to the emergency department by his wife for difficulty breathing after choking on food at dinner. He is unconscious and pulseless on arrival. Despite appropriate life-saving measures, he dies. Examination of the heart shows a necrotic, pale yellow plaque in the left circumflex artery. Similar lesions are most likely to be found in which of the following locations?

AThoracic aorta

BSuperficial temporal artery

CInternal carotid artery

DAbdominal aorta

EPulmonary artery

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