VABC Vascular Anatomy 5 — Questions and Answers
Question 1: Which deep vein thrombosis location carries the highest risk of pulmonary embolism due to clot size and proximity to central circulation?
- Tibial veins
- Popliteal vein
- Superficial femoral vein
- Iliofemoral segment (Correct answer)
Correct answer: Iliofemoral segment
Iliofemoral DVT carries the highest risk of pulmonary embolism because clots in this proximal, large-diameter segment can dislodge and travel to the pulmonary circulation.
Question 2: The azygos vein drains into which central venous structure at approximately the level of T4?
- Inferior vena cava
- Left brachiocephalic vein
- Superior vena cava (Correct answer)
- Right atrium directly
Correct answer: Superior vena cava
The azygos vein arches over the right main bronchus at the T4 level and empties into the posterior aspect of the superior vena cava.
Question 3: Which valve is located at the junction of the subclavian and internal jugular veins and is clinically significant for preventing retrograde flow into the arm?
- Subclavian valve
- Brachiocephalic valve
- Jugulo-subclavian valve (Correct answer)
- Venous angle valve
Correct answer: Jugulo-subclavian valve
The jugulo-subclavian valve (also called the subclavian-jugular junction valve) prevents retrograde flow and can affect catheter advancement during PICC insertion.
Question 4: The right lymphatic duct drains lymph from which quadrant of the body into the venous system?
- Entire right side of the body
- Right lower extremity and abdomen
- Right upper quadrant: right head, neck, arm, and right thorax (Correct answer)
- Bilateral lower extremities and pelvis
Correct answer: Right upper quadrant: right head, neck, arm, and right thorax
The right lymphatic duct drains only the right upper quadrant (right head, neck, upper extremity, and right side of thorax) into the right subclavian vein.
Question 5: During tunneled catheter placement, the subcutaneous tunnel is created between the venous entry site and which exit location for a chest port?
- Upper arm near the deltoid
- Anterior chest wall below the clavicle (Correct answer)
- Lateral neck above the clavicle
- Infraclavicular fossa at the third rib level
Correct answer: Anterior chest wall below the clavicle
For a chest port, the subcutaneous tunnel connects the venous entry site (typically the subclavian or internal jugular) to the port pocket on the anterior chest wall below the clavicle.
Question 6: What is the approximate diameter difference between a vein and its accompanying artery in the upper extremity?
- Veins and arteries are nearly equal in diameter
- Veins are typically 1.5–2 times larger in diameter than arteries (Correct answer)
- Arteries are typically twice as large in diameter as veins
- Veins are always smaller because they are compressible
Correct answer: Veins are typically 1.5–2 times larger in diameter than arteries
Veins are typically 1.5–2 times larger in diameter than their corresponding arteries due to their thinner walls and lower-pressure system design.
Question 7: A PICC placed in the cephalic vein has a higher malposition rate due to which anatomical challenge?
- The cephalic vein has more valves than the basilic vein
- The cephalic vein makes a sharp angle entering the axillary vein at the deltopectoral groove (Correct answer)
- The cephalic vein is too small to accommodate a PICC catheter
- The cephalic vein drains into the external jugular rather than the subclavian
Correct answer: The cephalic vein makes a sharp angle entering the axillary vein at the deltopectoral groove
The cephalic vein makes a near-90-degree turn as it passes through the deltopectoral groove to enter the axillary vein, making catheter advancement and correct positioning more difficult.
VABC Vascular Anatomy 5
Which deep vein thrombosis location carries the highest risk of pulmonary embolism due to clot size and proximity to central circulation?