Click the buttons in front of each correct answer. Click the CHECK button to compare your responses with those we consider correct.

1. In which direction is the blood flowing?

   ?    towards the left   ?    to right and then to left   ?    towards the right

   
    

2. What's going on here? (sorry this is a bit blurry)

   ?    Angiography injection intra-operatively   ?    Carotid sinus nerve anesthetic block   ?    Irrigation   ?    Stump pressure measurement

   
    

3. In what manner might vital signs suddenly change during manipulation of the carotid bifurcation area?

   1. Hypotension
   2. Bradycardia
   3. Tachycardia
   4. Malignant hypertension
   5. Asystolic arrest
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4. Click on optional techniques for carotid endarterectomy

   1. Intra-op Anticoagulation
   2. Shunt
   3. Patch
   4. Neurolept anesthetic
   5. Absorbable sutures for arteriotomy closure
   6. Intra-op EEG
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5. What is the yellow arrow pointing to?

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6. Which artery is indicated by the yellow arrow?

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7. What artery is indicated by the yellow arrow?

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8. To what instrument is the white pointer pointing?

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9. What is the orange device indicated by the white pointer?

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10. What is this structure called?

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11. Retractors are in place and the anatomy is therefore a little different. What structures are indicated by the other yellow arrows?

    jugular vein transverse cervical nerve vagus nerve thyroid artery phrenic nerve Check

12. What instrument is under the artery?

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13. What instruments are indicated by the yellow arrows?

    Potts scissors microscissors kilner suction yankauer suction McKissock's scissors Metzenbaum scissors Check

    
     

14. Something very important lies here between the carotid and the jugular. What is is?

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15. Which of these are normal clamp times for carotid endarterectomy?

    1. 5 minutes
    2. 15 minutes
    3. 10 minutes
    4. 20 minutes
    5. 30 minutes
    6. 40 minutes
    7. 60 minutes
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16. What coagulation affecting meds are often circulating during a carotid endarterectomy? (& do you know how they work?)

    1. heparin
    2. protamine
    3. aspirin
    4. clopidogrel
    5. coumadin
    6. warfarin
    7. aggrenox
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17. Which nerves might be seen during cartid endarterectomy?

    1. vagus
    2. hypoglossal
    3. phrenic
    4. ansa cervicalis
    5. mandibular trigeminal
    6. superior thyroid
    7. posterior auricular
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18. What might cause stridor just after extubation following carotid endarterectomy?

    1. vocal cord palsy
    2. laryngospasm
    3. hematoma displacing the trachea
    4. ansa cervicalis trauma
    5. occluded jugular vein
    6. aspiration
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19. What skills should an assistant bring to carotid endarterectomy?

    1. microdissection
    2. follow as running sutures placed
    3. bipolar cautery skill
    4. atraumatic suction
    5. stamina for retraction
    6. speed and precision with suturing
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20. For approximately how many years have cartid endarterectomies been done?

    1.   ?    25
    2.   ?    50
    3.   ?    75
    4.   ?    150