Arterial Insufficiency Ulcer CAT

Question 1

What causes an arterial insufficiency ulcer?

Answer 1

Inadequate perfusion of oxygenated blood in the affected tissue means the metabolic demands of the tissue are no longer met and cell death follows

Question 2

The ulcer is usually secondary to what probllem?

Answer 2

An underlying pathology like progressive atherosclerosis or arterial embolism

Question 3

Superficial ulceration

Answer 3

Damage to epidermis

Question 4

Partial thickness ulceration

Answer 4

Damage through epidermis and into (not through) dermis

Question 5

Full thickness ulceration

Answer 5

Damate through epidermis and dermis and into deeper layers

Question 6

Contributing factors to arterial insufficiency ulcers

Answer 6

Peripheral artery disease (risk factors include atherosclerosis, hypertension, obesity, DM, and smoking)

Question 7

Clinical presentation for arterial insufficiency ulcers

Answer 7

• Distal 1/3 of LE
• Dorsum of foot, lateral malleolus, toes
• Wound edges slightly irregular initially, progress to CHARACTERISTIC smooth and defined appearance
• Minimal bleeding, clean wound bed (pinkish w/ gray undertone)
• Discoloration in nails/nailbed and surrounding skin
• Intact surrounding skin may be cool to the touch, thin, shiny, and hairless
• Distal pulses usually absent

Question 8

Pain complaints with arterial insufficiency ulcers

Answer 8

• Significant pain
• Limbs usually in a elevated position (non-dependent)

Question 9

Labs or imaging w/ arterial insufficiency ulcer

Answer 9

• Duplex ultrasonography
• Angiogram
• ABI 0.79 or less

Question 10

Physical therapy management for arterial insufficiency ulcer

Answer 10

• Wound care and skin protection
• Cleansing agents and/or debridement
• Packing depending on wound depth

Question 11

Healing of arterial insufficiency ulcer

Answer 11

Secondary intention w/ adequate blood supply