Arterial Testing

Question 1

Chronic occlusive disease signs and symptoms of claudication

Answer 1

#Pain in muscles during exercise, subsides with rest.
#Results from inadequate blood supply to muscle.
#Discomfort is predictable and subsides within minutes after exercise.
#Disease usually prox to location of symptoms.
#Pseduo-claudication mimics vascular symptoms but neurogenic or orthopedic in origin.

Question 2

Chronic occlusive disease signs and symptoms of ischemic rest pain.

Answer 2

A more severe symptom of diminished blood flow.

Occurs when limb not dependent; BP decreased (when sleeping)

Question 3

chronic occlusive disease tissue loss signs and symptoms.

Answer 3

Necrosis or death of tissue.

Due to deficient or absent blood supply.

Question 4

6 P’s of acute arterial occlusion symptoms.

Answer 4

pain, pallor, pulselessness, paresthesia, paralysis, polar (cold)

Question 5

T or F, acute arterial occlusion may result from thrombus, embolism, or trauma?

Answer 5

True

Emergency situation since abrupt onset does not provide for development of collateral channels.

Question 6

A condition that exists when symptoms of intermittent digital ischemia occur in response to cold exposure or emotional stress?

Answer 6

Raynaud’s phenomenon

Question 7

What type of disorder is Raynaud’s? Symptoms?

Answer 7

Vasospastic

Changes in skin color include pallor (whiteness), cyanosis (bluish), or rubor (dark red)

Question 8

What is primary Raynaud’s?

Answer 8

#ischemia due to digital arterial spasm.
#common in young women; maybe hereditary, bilateral; history of symptoms for 2 years without progressive/evidence of cause.
#benign condition with excellent prognosis

Question 9

What is secondary Raynaud’s?

Answer 9

#AKA obstructive Raynaud's syndrome.
#Normal vasoconstrictive responses of arterioles superimposed on a fixed artery obstruction. Ischemia constantly present.
#May be manifestation of Buerger's disease.

Question 10

Skin color changes:

• Result of deficient blood supply; skin pale.
• Suggests dilated vessels or vessels dilated secondary to reactive hyperemia; skin reddened.
• A concentration of deoxygenated hemoglobin, causes bluish discoloration.

Answer 10

Pallor
Rubor
Cyanosis

Question 11

Physical examination of skin changes include:

Answer 11

Skin color
Temperature
Lesion: ulcers, deep, painful compared to venous, duration, gangrene
Capillary filling: increase in refill time is decreased perfusion
Elevation/dependency changes: pallor during elevation, red with dependency

Question 12

Grading scale of palpable pulse:

Answer 12

0 none to 4+ bounding

Aneurysms can be described as bounding.

Question 13

Palpable vibration or thrill over pulse site may indicate what?

Answer 13

fistula, post stenotic turbulence, or patient dialysis access site.

Question 14

palpable pulses include:

Answer 14

Aorta, femoral, popliteal, dorsalis pedis, posterior tibial>

Peroneals not palpable due to depth.

Question 15

Bruit auscultation is more often done with what exam?

Answer 15

Carotid

Question 16

What are the arterial risk factors of diabetes?

Answer 16

Atherosclerosis, higher incidence of disease, calcifications, neuropathy, higher incidence of gangrene

Question 17

Arterial risk factors of hypertension?

Answer 17

Unclear if high BP is a causative factor or if enhances atherosclerotic process. Systematic hypertension is associated with greater incidence of coronary atherosclerosis. Increased BP taxes the heart.

Question 18

Arterial risks of hyperlipidemia?

Answer 18

Elevated values closely associated with atherosclerosis.

Question 19

Smoking and other arterial disease risks?

Answer 19

smoking irritates the endothelial lining of the vessels, causing vasoconstriction. other uncontrollable risks are age, family history, male gender.

Question 20

What is the most common arterial pathology that involves thickening, hardening, loss of elasticity of the artery walls?

Answer 20

atherosclerosis (obliterans)

Question 21

Atherosclerosis changes occur in what layer of the vessel?

Answer 21

intima and media layer

Question 22

Major risk factors of atherosclerosis?

Answer 22

smoking, hyperlipidemia, and family history

Question 23

Most common sites of atherosclerosis?

Answer 23

carotid bifurcation, vessel origins, infra-renal aorto-iliac system, CFA bifurcation, SFA at the adductor canal level, and trifurcation region.

Question 24

Leriche syndrome is caused by obstruction of the aorta and occurs in males and is characterized by?

Answer 24

Fatigue in hips, thighs, or calves with exercise
Absence of femoral pulses
Impotence
Pallor and coldness of LE

Question 25

Obstruction of a vessel by foreign substance or blood clot. May be solid, liquid, or gaseous. May arise from the body or enter from outside.

Answer 25

Embolism

Question 26

Most frequent cause of an embolism?

Answer 26

Small plaque breaks loose and lodges in small vessel. An example is blue toe syndrome. Toe ischemia results

Question 27

Dilation of all three arterial wall layers?

Answer 27

true aneurysm

Question 28

most common site of a dissecting aneurysm?

Answer 28

thoracic aorta

Question 29

Most common location of a true aneurysm?

Answer 29

infrarenal aorta

other locations include thoracic, femoral, popliteal, and renal

Question 30

most frequent complications of an aneurysm?

Answer 30

rupture or embolization of the peripheral aneurysms

Question 31

Nonatherosclerotic lesions include?

Answer 31

Arteritis, coarctation of the aorta, dissection, vasospastic disorders, and entrapment syndrome

Question 32

Arteritis is associated with:

Answer 32

smoking, men

Question 33

can affect tibial and peroneal arteries ans smaller vessels, inflammation of wall leading to thrombosis, Buergers syndrome, and occlusion of distal arteries.

Answer 33

arteritis

Question 34

Congenital narrowing or stricture of thoracic aorta?

Answer 34

coarctation of aorta

Question 35

clinical findings of coarctation of the arota?

Answer 35

hypertension due to decreased kidney perfusion, manifestations of LE ischemia (decreased pulses)