Ch. 13 & 39 Flashcards by Destiny S

The left brachial pressure is 20mmHg lower than the right brachial pressure. What’s up?
A.Stenosis of the brachiocephalic artery
B.Stenosis of the subclavian artery
C.Stenosis of the brachial artery
D.Its a normal pressure gradient

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Buerger’s disease is an arterial disorder involving which of the following vessels?
A.Renal arteries
B.Coronary arteries
C.Pelvic arteries
D.Digital arteries

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What is cold or vibration induced digital vasospasm?
A.Marfan syndrome
B.Arteritis
C.Buerger’s disease
D.Raynaud’s disease

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Thoracic outlet syndrome is usually caused by extrinsic compression of the subclavian artery. true or false?
A.True
B.False

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Which of the following is the standard recovery time following a cold immersion test for raynauds?
A.2mins
B.5mins
C.7mins
D.10mins

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The innominate artery is also called the:
A.Brachiocephalic
B.Subclavian
C.Brachiobasilic
D.Axillary

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Which of the following is the manual test for palmar arch patency ?
A.Adson test
B.TOS test
C.Allen’s test
D.PPG

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In a vascular thoracic outlet test, which of the following is the most important arm test position?
A.Costoclavicular
B.Adson’s
C.Abduction-elevation to 180 degrees
D.Symptomatic

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Blood pressure cuffs should have a width ________________ the diameter of the limb.
a. 100% less than
b. equal to
c. 20% less than
d. 20% greater than

d. 20% greater than

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The characteristics of a normal Doppler signal obtained during lower-extremity arterial imaging include all of the following except:
a. sharp up slope.
b. triphasic and reverse flow component.
c. dicrotic notch.
d. low velocity forward flow in late diastole.

c. dicrotic notch.

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A normal pulse volume waveform contains a(n):
a. slow up slope.
b. dicrotic notch.
c. round peak during systole.
d. up slope and down slope with equal times

b. dicrotic notch.

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To obtain arterial Doppler signals during arterial color Doppler imaging, using a(n) ___________ imaging plane is best.
a. transverse
b. longitudinal
c. oblique
d. inverted

b. longitudinal

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During arterial duplex imaging, Doppler signals are obtained using a ___________ angle. a. zero-degree
b. 35-degree
c. 60-degree
d. direct

c. 60-degree

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Which one of the following statements best describes ultrasound compression therapy of pseudoaneurysms?
a. Is the most successful when the aneurysm is large
b. Is the most successful in patients who are receiving anticoagulated therapy
c. Takes minimal upper body strength
d. Usually requires 30 to 60 minutes to be successful

d. Usually requires 30 to 60 minutes to be successful

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Which one of the following is most likely to produce a palpable thrill?
a. Pseudoaneurysm
b. Common femoral occlusion
c. In situ bypass graft
d. Dialysis access graft

d. Dialysis access graft

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A difference in pressures greater than 20 mm Hg between arms usually indicates disease of which one of the following arteries?
a. Subclavian
b. Radial
c. Common carotid
d. Iliac

a. Subclavian

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Patients complaining of intermittent claudication will have an ankle-brachial index (ABI) of:
a. 1.
b. 0.45.
c. 0.59.
d. 0.35.

c. 0.59.

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Which one of the following imaging characteristics indicates a significant (greater than 50% diameter reduction) arterial narrowing during lower-extremity arterial imaging?
a. Spectral broadening
b. Increase of peak-systolic velocity of greater than 20% when compared with the
proximal adjacent area
c. Increase of peak-systolic velocity of greater than 100% when compared with the
proximal adjacent area
d. Loss of blood flow reversal in early diastole

c. Increase of peak-systolic velocity of greater than 100% when compared with the
proximal adjacent area

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The ABI on the left side is ________ mm Hg.
The following resting segmental pressure measurements (mm Hg) are taken:
Right/ Left
Upper arm 152/ 110
Upper thigh 180 /180
Lower thigh 100 /170
Calf 100/ 158
Ankle 100 /148
a. 0.50
b. 0.66
c. 1.35
d. 0.97

d. 0.97

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The ABI on the right side is ___________ mm Hg.
The following resting segmental pressure measurements (mm Hg) are taken:
Right /Left
Upper arm 152 /110
Upper thigh 180 /180
Lower thigh 100 /170
Calf 100 /158
Ankle 100/ 148
a. 0.50
b. 0.66
c. 0.91
d. 0.97

b. 0.66

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The lower limb pressures suggest disease of the ___________________ artery.
The following resting segmental pressure measurements (mm Hg) are taken:
Right /Left
Upper arm 152/ 110
Upper thigh 180 /180
Lower thigh 100 /170
Calf 100 /158
Ankle 100 /148
a. right common femoral
b. right superficial femoral
c. right popliteal
d. left popliteal

b. right superficial femoral

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The brachial pressure suggests disease of the _______________ artery.
The following resting segmental pressure measurements (mm Hg) are taken:
Right /Left
Upper arm 152 /110
Upper thigh 180/ 180
Lower thigh 100 /170
Calf 100 /158
Ankle 100 /148
a. innominate
b. right subclavian
c. left subclavian
d. right brachial

c. left subclavian

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Most patients describe claudication as which one of the following?
a. Pain in the toes
b. Pain at rest
c. Cramping of the leg muscles
d. Extreme leg pain when walking

c. Cramping of the leg muscles

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The profunda femoris artery lies __________ and __________ to the superficial femoral artery (SFA).
a. posterior; medial
b. posterior; lateral
c. anterior; medial
d. anterior; lateral

b. posterior; lateral

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The major branches of the popliteal artery are the _________ and _________ arteries. a. anterior tibial; peroneal b. sural; anterior tibial c. genicular; anterior tibial d. sural; genicular

d. sural; genicular

The second main branch of the aortic arch is which one of the following arteries? a. Innominate b. Right common carotid c. Left common carotid d. Left subclavian

c. Left common carotid

Segmental pressures of the lower extremity tend to ____________ the extent of the disease. a. overestimate b. underestimate c. equal d. underestimate or equal

b. underestimate

A toe pressure is considered normal if it is: a. 50 mm Hg. b. 45 mm Hg. c. less than 64% of brachial pressure. d. 50 mm Hg and less than 64% of brachial pressure.

a. 50 mm Hg.

The calf pulse volume waveform normally has greater amplitude than the thigh waveform because of which one of the following? a. Sequential changes b. Superficial femoral disease c. Cuff artifact d. Intermittent ischemia

C. Cuff artifact

Exercise testing of the lower-extremity arterial system is performed on a treadmill on a __________ grade. a. 5% to 10% b. 10% to 12% c. 12% to 15% d. 15% to 20%

b. 10% to 12%

Exercise testing of the lower-extremity arterial system is performed on a treadmill at a speed of ___________ mph. a. 1 to 2 b. 1.5 to 2 c. 2 to 2.5 d. 2.5 to 3

b. 1.5 to 2

Ankle pressures that fall after exercise and return to baseline in 5 minutes suggest which one of the following? a. Normal arterial system b. Multisegment arterial disease c. Single-segment occlusive disease d. Lower-extremity amputation

c. Single-segment occlusive disease

In nondiabetic patients, ischemic skin lesions are not likely to heal if ankle systolic pressure is below __________ mm Hg. a. 55 b. 45 c. 80 d. 30

a. 55

What is cold or vibration induced digital vasospasm

Raynaud's Syndrome

The deep and superficial arteries feeding the hands are called

Palmar Arch

Describe Buerger's Disease

-fixed disease -related to smoking -thrombosis of digital arteries

Describe Thoracic Outlet Syndrome

compression of the Sub V or Ax V by the first rib

Describe Raynaud's Phenomenon

(just symptoms) Fingers or toes turn white or purple, and have numbness or pain

Describe Raynaud's Disease

no underlying disease spasm brought on by random events

Describe Secondary Raynaud's

vasospasm with and underlying disease such as Rheumatoid Arteritis

4 signs/symptoms of thoracic outlet syndrome

-intermittent pain -numbness -weakness -cyanosis -painful digits

A palpable thrill indicates what probable abnormality

a fistula or dialysis graft (felt bc of high velocities)

Why would an Adson's Test be performed?

examination of TOS

What is the Allen's Test for?

palmar arch patency

What are symptoms of lower extremity occlusive aeterial disease?

claudication pain at rest

_______ is walking-induced muscular discomfort of the thigh, hip, or buttock due to ischemia.

claudication

How is claudication relieved?

Rest 2-5 mins

What does ischemic rest pain imply?

critical ischemia of distal limb when patient at rest

Physical signs of peripheral arterial disease

elevation in pallor and dependent rubor, ischemic ulcers, gangrene, bruits, and decreased peripheral pulses

The _____ supplies the pelvis.

internal iliac artery

The _____ continues distally to supply the lower extremity.

external iliac artery

The external iliac terminated at inguinal ligament, where it becomes the ______.

common femoral artery

The CFA terminates by dividing into the _____ and _____.

femoral and profunda femoris arteries

Profunda artery is _____ and ____ to the femoral artery.

posterior/ lateral

Where does the profunda artery begin and terminate?

begins and common femoral bifurcation and terminates in lower third of the thigh

What does the deep femoral supply?

muscles of the thigh and hip joint

The ______ artery travels the length of the thigh, through Hunter's canal, and terminates at the opening of the adductor Magnus muscle.

Femoral

The _____ artery begins at opening of adductor Magnus muscle and travels behind knee in popliteal fossa.

popliteal

What are the major branches of the popliteal artery?

Sural and genicular arteries

The popliteal artery terminates distally into the _____ and _____ trunk.

anterior tibial artery and tibial-peroneal trunk

_____ take off at popliteal and travel down lateral calf in the anterior compartment to the level of the ankle.

Anterior tibial arteries

What forms the palmar arch?

Arterial branches of the anterior tibial artery and posterior tibial artery

The ______ trunk takes off after the anterior tibial artery and bifurcated into posterior tibial artery and peroneal artery.

Tibial-peroneal

_______ artery travels down medial calf in posterior compartment and terminates between ankle and heel into medial and lateral plantar arteries.

posterior tibial artery *

______ artery is located deep within the calf and travels near the medial aspect of the fibula.

Peroneal artery

The subclavian artery originates at the inner border of scalenus anterior muscle and travels beneath clavicle to outer border of first rib, where it becomes the _______ artery.

axillary

What are the major branches of the subclavian artery?

Vertebral Thyrocervical trunk Costicervical trunk Internal mammary Dorsal scapular

The axillary artery is a continuation of the _____ artery.

subclavian

The _____ artery is continuation of axillary artery.

brachial

The ____ artery begins at the brachial bifurcation and travels down the forearm (thumb side) and terminates in the palm.

radial

The radial artery forms the ____ arch.

palmar

The ____ artery is slightly larger than the radial artery and travels down the forearm (small finger side) to the palm.

ulnar

The ulnar artery forms the _____.

superficial palmar arch

What supplies blood to the digital arteries?

both palmar arches

There should be a ____ minute rest period before the exam so the patient's BP can stablize.

T/F- You can place cuffs on the area of graft placement

false

What is a more accurate method of evaluating distal limb and foot perfusion in patients with falsely elevated segmental limb pressures?

toe pressures

Toe pressures can also be used to determine _____ involving the pedal arch and digital arteries.

obstructive disease

What measures changes in segmental limb volume with each cardiac cycle?

pulse volume recordings

Where are BP cuffs placed for pulse volume recordings?

arms, thighs, calves, ankles, and feet

Each cuff is inflated to preset pressure of ____ to maintain adequate contact between cuff bladder and limb.

65 mm Hg

What are pulse volume waveforms recorded on?

analogue chart recorder

In a normal individual without occlusive arterial disease, blood flow ____ with exercise because of a decrease in peripheral vascular resistance.

increase

Ischemic skin lesions are not likely to heal if ankle systolic pressure is below ____, toe pressure below ____, or foot pulse volume recording fails to demonstrate pulsatile perfusion.

55 mm Hg 30 mm Hg

Where might an aneurysm be located?

distal aorta, iliac, common femoral, or popliteal arteries

Why do pseudoaneurysms occur?

result of trauma, at vascular anastomoses, in angioaccess grafts, and at puncture sites

Describe the appearance of a pseudoaneurysm

unilocular/ multilocular; partially contain thrombus; variable sizes (size changes during cardiac cycle)

3 cm

What is the goal of the compression technique for a pseudoaneurysm?

stop blood flow into pseudoaneurysm by occluding the neck

Compression cycles of _____ minutes usually performed with progress evaluated between cycles.

15-20