Arterial Insufficiency and Leg Ulcers

Question 1

Angiopathy

Answer 1

poor perfusion of blood supply, nutrients, and oxygen for wound healing

Question 2

2 types of angiopathy

Answer 2

• macroangiopathy

- microangiopathy

Question 3

Macroangiopathy

Answer 3

• large vessel disease

- typically affects bilateral lower extremities

Question 4

Microangiopathy

Answer 4

small vessel disease with possible sclerosis

Question 5

Why is smoking such an important risk factor for wound care?

Answer 5

it causes vasoconstriction for 30 min to 1 hr

Question 6

Risk factors for ischemic/arterial ulcers

Answer 6

• arteriosclerosis
• diabetes
• hyperlipidemia
• thrombosis
• smoking
• males >50 yo

Question 7

Which 2 fingers should I use to check for a pulse?

Answer 7

3rd and 4th

Question 8

Where to check for a pulse

Answer 8

dorsalis pedis and posterior tibialis

Question 9

Pulse scale

Answer 9

0 no pulse
1+ barely felt
2+ diminished
3+ normal pulse
4+ bounding

Question 10

ABI stands for

Answer 10

Ankle Brachial Index

Question 11

Which of the arterial tests and measures is not always reliable in diabetics?

Answer 11

ABI

Question 12

How to perform an ABI

Answer 12

• pt in supine with pillow
• place cuff around ankle
• find post tib with doppler and inflate cuff until pulse disappears
• deflate cuff, record number that pulse audible
• repeat using brachial artery (repeat on contralateral extremity using higher value to calculate ABI)

Question 13

Segmental pressures are usually performed where?

Answer 13

in vascular lab

Question 14

Ischemic tissues

Answer 14

• lack of oxygen to tissues

- allow and protect for dry demarcation

Question 15

In ischemic tissues, a lack of oxygen results in

Answer 15

mummification and dry gangrene

Question 16

Potential medical complications of ichemic/arterial ulcers

Answer 16

• amputation

- infection

Question 17

Arterial ulcer plan of care

Answer 17

• improve blood flow to wound
• exercise or walking program
• conservative wound care
• avoid compression and debridement

Question 18

Regarding arterial ulcer plan of care, how does the PT improve blood flow to a wound?

Answer 18

with systemic or local treatment

Question 19

Regarding arterial ulcer plan of care, how long should the PT avoid compression and debridement?

Answer 19

until circulation improved

Question 20

Arterial ulcer treatment options

Answer 20

• surgical interventions
• medical interventions
• others if arterial supply inadequate

Question 21

Surgical interventions for arterial ulcer treatment

Answer 21

revascularization procedures

Question 22

Medical interventions for arterial ulcer treatment

Answer 22

drugs

Question 23

. . . eschar

Answer 23

• circulation
• pressure redistribution
• nutrition

Question 24

Thromboangiitis Obliterans aka

Answer 24

Buerger’s Disease

Question 25

Buerger’s Disease aka

Answer 25

Thromboangiitis Obliterans