Vascular Test 3 Sangeeta

Front 1

List the arterial insufficency signs and symptoms from most to least serious

Back 1

Most Severe -
Necrosis --> ulceration / gangrene/ amputation
Rest Pain --> Pain @ rest, relieved with gravity, moderate disease
Claudication --> pain while walking/exercising but subsides @ rest, mild disease
Asymptomatic --> possible disease but no symptoms. May or may not have normal ABIs

Front 2

Plethsmography is also known as ______ and records changes in ______

Back 2

Plethsmography is aka PVR. this is used to record changes in volume amplitude

Front 3

List 3 methods of Plethysmography

Back 3

Air cuff
Strain gauge
Photoplehysmography PPG

Front 4

Describe/ellaborate on the air cuff method of plethysmography

Back 4

Air cuffs are inflated 65 mmHg and you are looking for volume changes that create pressure changes

Front 5

Describe/ellaborate on the strain gauge method of plethysmography

Back 5

A mercury filled tube 1-3 cm shorter than the limb is used. Any changes in the length of the tube results in waveform changes

Front 6

Describe/ellaborate on the photoplethysmography PPG method of plethysmography

Back 6

A photo cell sends infrared light into the tissue and receives reflection

Front 7

PPG sends infrared light into the tissue with a light emitting diode and the photocell receives the backscattered infrared light and measures its reflection. As the blood flow increases the_________ ________

Back 7

The reflection increases and the waveform increases

Front 8

PVR: Amplitude of waveforms in the thigh or ankle should exceed ____ mm

Back 8

Thigh or ankle should exceed 15 mm

Front 9

PVR Amplictue of wavefroms in the calf should exceed ____ mm

Back 9

Calf should exceed 20 mm

Front 10

The pressure within the PVR cuff should be at least ___ mmHg

Back 10

the cuff should be at least 65 mmHg

Front 11

True or false. PVR can discriminate between occlusion and tight stenosis

Back 11

False. PVR cannot discriminate between occlusion and tight stenosis

Front 12

True or false. Diabetic patients or athlerosclerosis can cause incompressibility of the artery.

Back 12

True.

Front 13

Who is treadmill testing performed on?

Back 13

Patients with symptoms of claudication. may have normal or borderline ABIs

Front 14

during treadmill testing, what speed does the patient walk at?

Back 14

1.5 to 2 mph

Front 15

During treadmill testing, what incline is the ramp elevated to?

Back 15

10-12%

Front 16

During treadmill testing, how long does the patient walk for?

Back 16

5 min or until symptoms appear

Front 17

What is a normal result for treadmill testing?

Back 17

The ABI should remain the same @ normal levels or increase slightly

Front 18

During treadmill testing, if the pressure decreases, how often is the ABI taken?

Back 18

It is initially taken @ 2 min and then every 5 min for 20 minutes or until it returns to normal levels

Front 19

For treadmill testing, what is the result for single level of disease?

Back 19

Ankle pressure decreases but recovers in 2-6 min

Front 20

For treadmill testing, what is the result of multiple level disease?

Back 20

Ankle pressure decreased and stays low for 10-12 minutes

Front 21

If a patient cannot under go treadmill testing, how else can they be assessed?

Back 21

Reactive hypermia test aka post exclusive reactive hyperemia

Front 22

Describe reactive hyperemia.

Back 22

- perform DSP/PVR
- Inflate cuff 20-30 mmHg and occlude the vessel for 3-5 min
- deflate cuff and take ABI, repeat in 1-2 min intervals

Front 23

What are normal results for reactive hyperemita

Back 23

The pressure should drop <20 % in ABI

Front 24

What are the abnormal results for reactive hypermia

Back 24

The pressure will drop > 20 % in ABI

Front 25

What is popliteal artery entrapment?

Back 25

- See in athletes bilaterally
- Abnormal insertion of the gastroskemus muslce compressing on the pop A resulting in lack of blood flow to the calf
- patient will have symptoms of pain in the calf

Front 26

_____ artery after crossing the inguinal ligament becomes ______

Back 26

The External Iliac Artery becomes the Common Femoral Artery

Front 27

Define adductor canal

Back 27

See @ distal SFA in the lower thigh. AKA adductor hiatus or AKA hunters canal

Front 28

Define collaterals

Back 28

alternate routes or natural grafts
1) dont develop in acute conditions. Seen only in chronic conditions
2) development of collaterals is variable
3) if collaterals are present, symptoms WILL NOT be present

Front 29

Define acceleration Time

Back 29

Time from the onset of systole to the point of max peak velocity.
Seen in damp signal post stenosis

Front 30

Define Tardus Pardus waveform

Back 30

Seen @ post stenosis
Tardus = prolonged Acceleration Time
Pardus = decreased amplitude

Front 31

Buerger's disease AKA

Back 31

Thromboangitis Obliterans TAO
Inflammation of the arteries and veins preventing blood flow
- Seen in males and heavy smokers
- starts distally and progresses proximally (hands/feet are cold and sx of rest pain)
- Collaterals will NOT be seen in TAO
- Secondary Raynaulds phenomenon is associated with TAO

Front 32

Define altherosclerosis obliterans

Back 32

- Plaque build up on intima leading to hardening of the vessels
- AKA ASO
- Increased blood pressure
- Aneurysms are 90% of the time caused by plaque buildup

Front 33

List the signs and symptoms of chronic arterial disease

Back 33

- loss of ahir on lower extremity
- Thickening and color changes on skin and nails
- Decreased pulsatility
- Change in skin texture (shiny and tight)
- Pins and needles sensation
- Redness in foot
- Bruit
- Arterial ulcers

Front 34

List the signs and symptoms of acute arterial disease

Back 34

5 P's
Pallor
Pain
Pulselessness (pins & needles)
Parasthesis (numbness & tingling)
Pariesis (paralysis)

Front 35

An ABI result of > 0.96 is ____

Back 35

Normal

Front 36

An ABI result of 0.5 - 0.95 is ______

Back 36

Mild - single segment disease

Front 37

An ABI result of 0.21 to 0.49 is ____

Back 37

Moderate - multiple segment disease

Front 38

An ABI result of < 0.20 is ____

Back 38

Severe - Necrosis

Front 39

The diseased area is found where in relation to the segment with the low reading?

Back 39

Disease is @ or above the cuff. (proximal)

Front 40

What is the normal score for a TBI?

Back 40

> 0.75

Front 41

In Duplex arterial scan what type of transducer should be used?

Back 41

5-7 Mhz Linear or 3-5 Mhz curvilinear for obese people

Front 42

The segmental pressure exam ABI is based on what theory?

Back 42

Bernolli ... Blood pressure drops post stenosis. Disease is @ and proximal to the lowest BP site.

Front 43

For ABI, the thigh should be more than ____ mmHg than the highest Brachial A

Back 43

Thigh > 30 mmHg

Front 44

For ABI, each adjacent segment should be less than ___ mmHg

Back 44

Each segment < 20 mmHg

Front 45

For ABI, segments at the same lelve should be less than ___ mmHg

Back 45

Segments at the same level < 20 mmHg

Front 46

Describe how to perform and evaluate an ABI

Back 46

1) take bilateral brachial blood pressures ---> choose highest
2) Take ankle BP @ DPA and PTA
3) Calculate ABI Ankle divided by brachial
4) repeat on other ankle
5) Compare:
Brachial should be > 30 mmHg than thigh
Each segment below should be < 20 mmHg