Arterial testing chapter 3 Flashcards
Pain in muscles usually occurring during exercise (activity); Subsides with rest.
Claudication (intermittent)
Level of disease usually proximal to location of symptoms
Claudication (intermittent)
Chronic Occlusive disease
Claudication or Ischemic Rest pain, Tissue loss
Sever symptom of reduced blood flow (loss of perfusion)
Ischemic rest pain
Necrosis or death of tissue
Tissue loss
Symptoms include the 6 p’s: Pain, pallor, pulselessness, paresthesia, paralysis, polar (cold)
Acute arterial occlusion
Emergency situation since no time for development of collateral channels - No collaterals
Acute arterial occlusion
Symptoms of intermittent digital ischemia occur due to cold exposure or emotional stress.
Raynaud’s Phenomenon
Changes I skin color may include pallor, cyanosis, or rubor (color change in fingers)
Raynaud’s Phenomenon
Ischemia due to digital arterial spasm (healthy)
Common in young women; may be hereditary, bilateral
Benign condition- (does not lead to gangrene)
Primary Raynaud’s
Underlying disease
Normal vasoconstriction of arterioles present with a fixed artery obstruction. Ischemia constantly present
Secondary Raynaud’s
May be the first manifestation of Buerger’s disease
Secondary Raynaud’s
swelling of blood vessels (smoking/tobacco use inflammation, can clot ischemic
Buerger’s disease
A concentration of deoxygenated hemoglobin, causes bluish discoloration
Cyanosis
Result of deficient blood supply; skin pale
Pallor
Suggests dilated vessels or vessels dilated secondary to reactive hyperemia; skin is reddened
Rubor
Normal capillary refill time is
less 3 seconds
An increase in the capillary refill time denotes
decrease in arterial perfusion
Press on the skin to see how long color comes back
Capillary filling
Ulcerations location
Tibial area, foot toes.
Cadaveric pallor during elevation with ruborous red discoloration with dependency (dependent rubor)
Elevation/dependency changes
When the hangs down
hydrostatic pressure
Dependent rubor
Enlarged
Aneurysms can be palpated and described as
Bounding in palpation
Rhythmic pulsation of artery
signifies adequate circulatory status.
Grading pulses on scale of
0 (none) - 4+
Palpable thrill over pulse site may indicate
Fistula, a patent dialysis access site or post-stenotic turbulence.
Aorta, femoral, popliteal, dorsalis pedis (DPA), posterior tibial (PTA)
Palpable pulse
The peroneal artery is not
Palpable
Bruit auscultation is more often done with
Carotid examination
Diabetes, Hypertension, Hyperlipidemia, Smoking, Other
Risk factors
Atherosclerosis, Higher incidence of disease, Medial calcification develops in LE arteries, Poor sensation (neuropathy), Higher incidence of gangrenous change
Diabetes
More common in; occurs in at a younger age
Atherosclerosis
Higher incidence of disease
Distal pop, and tibial arteries
This is associated with increased risked for cardiovascular events; death usually related to heart disease
Medial calcification develops in LE arteries
May lead to increased injury
Neuropathy
Atherosclerosis (obliterans)
99%
Thickening, hardening, loss of elasticity of the artery walls (less of kinetic energy)
Most common arterial pathology
Changes occur in what layers of the vessel
Intima and medial layer
Carotid bifurcation
Aorto-iliac system
CFA bifurcation
SFA-Distal-abductor canal
Most common sites
what syndrome that is caused by obstruction of the aorta occurs in males
Leriche syndrome
Symptoms of\_\_\_\_\_\_\_ Fatigue in hips, thighs, or calves with exercise Absence of femoral pulses Impotence Often times, pallor and coldness of LE
Leriche Syndrome
Obstruction of vessel by foreign substance or blood clot
Embolism
Dilatation of all three arterial wall layers
True aneurysm
Diffuse, circumferential dilatation
Fusiform
Localized “sac-like”
Saccular
small tear of the inner wall allows blood to form cavity between two walls layers (occurs more often in thoracic aorta
Dissecting aneurysm
Results from a defect in the main artery wall (post catherization)
Pseudoaneurysm
The most common location of a true aneurysm
Infrarenal aorta
To pulsatile structure outside vessel walls pulsatile hematoma :to and fro flow”
Pseudoaneurysm
Patients with one aneurysm have incidence of ____
2
More often in a pseudo of the _____ or _____ as opposed to elsewhere.
CFA or Popliteal A.
Rupture of the aortic aneurysm; emobolization of the peripheral aneurysms “blue toe”
Most frequent complication of pseudoaneurysm
Inflammation of small vessels - finger and toes
Arteritis
Types of arteritis is
Buerger’s disease (thromboangiitis obliterans)
Narrowing of the Aorta
Coarctation of the aorta
One of the several congenital anomalies of arterial system
Narrowing of the aorta
Coarctation of the aorta usually occurs in the _____ but also can occur in the ______
Thoracic aorta, abdominal aorta
clinical findings of coarctation:
due to decreased kidney perfusion
Ischemia e.g., reduced pulses
Hypertension
Symptoms of LE
Flow velocities differ in each lumen
Dissection
No dilation 2 compartments 2 different flows
Dissection
If a aorta ruptures it can cause _____
Death
