Vascular Anatomy of the brain What is the basic normal vascular anatomy of the brain? Arterial The cerebral vasculature is supplied by 4 arterial vessels—the paired internal carotid arteries (ICA) and the vertebral arteries (VA)—and can be divided into anterior and posterior circulations. The anterior circulation consists of the bilateral internal carotid arteries, which bifurcate …
When are feeding G tubes not the tubes of choice? Patients may not be candidates for feeding G tubes because of anatomic or functional reasons. Anatomic contraindications include prior gastrectomy or gastric pull-through, presence of colon adherent to the stomach, and ascites. Patients with ascites are at high risk for constantly leaking fluid through the …
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What is the difference between a G tube G-J tube and J tube? A simple rule to follow in selecting an enteral access site is to use the stomach whenever possible. Direct gastrostomy (G) tubes are safe and easy to use. The stomach performs important digestive functions, and gastric access allows patients to receive bolus …
What factors should be considered when selecting the puncture site for percutaneous gastrostomy? The site of percutaneous gastrostomy should be subcostal and to the left of the midline. The outer third of the rectus abdominis muscle should be avoided because the inferior epigastric artery courses in this region. Fluoroscopy is performed so that the puncture …
Technical complications of esophageal stenting What technical complications are associated with esophageal stenting? Even with the most experienced operators, stents may be malpositioned or migrate. Because esophageal malignancies may be friable, stenting may occasionally result in esophageal perforation, a potentially life-threatening complication.
What are the indications for esophageal stenting? Esophageal stenting is most commonly performed in the treatment of dysphagia secondary to cancer ingrowth and bronchoesophageal fistula. Esophageal stents may also be used for treatment of refractory or recurrent esophageal strictures, tracheoesophageal fistulas, and esophageal perforation.
How does a ureteral stent work? A ureteral stent is hollow and has multiple side holes. It drains urine past obstructions from the collecting system into the urinary bladder. Some authorities believe that an element of capillary action augments this process. A ureteral stent also causes passive dilation of the ureter, which may or may …