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Vascular > Ch. 3 Arterial Testing > Flashcards

Ch. 3 Arterial Testing Flashcards

1
Q

Chronic occlusive disease (3)

A

Claudication,
Ischemic rest pain
Tissue loss

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2
Q

Claudication

A

Pain in muscles usually occurring during exercise (activity); subsides with rest.

Results from inadequate blood supple to muscle.

Discomfort is predictable and subsides within minutes after exercise (activity).

Level of disease usually proximal to location of symptoms

Pseudo-claudication mimics vascular symptoms but is neurogenic or orthopedic in origin.

Side note: pt history may state 4 block claudication. This means the pt c/o pain after walking 4 blocks.

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3
Q

Ischemic rest pain

A

Severe symptom of reduced blood flow

Occurs when limb not dependent; BP decreased (such as when sleeping). Affects forefoot, heel, toes.

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4
Q

Tissue loss

A

Necrosis or death of tissue

Due to deficient or no blood supply

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5
Q

Acute arterial occlusion.

State symptoms, causes, and emergency or not?

A

Symptoms = 6 P’s: pain, pallor, pulselessness, paresthesia, paralysis, polar

Possible causes = thrombus, emboli, trauma

Emergency situation since no time for development of collateral channels.

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6
Q

Vasospastic Disorders

Raynaud’s phenomenon- what are the symptoms and changes in skin color?

A

Symptoms of intermittent digital ischemia occur due to cold exposure or emotional stress.

Changes in skin color may include pallor, cyanosis, or rubor

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7
Q

Primary Raynaud’s 3 characteristics.

A

Ischemia due to digital arterial spasm

Common in young women; may be hereditary, bilateral

Benign condition

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8
Q

Secondary Raynaud’s 3 characteristics

A

Also known as obstructive Raynaud’s syndrome

Normal vasoconstriction of arterioles present with a fixed artery obstruction. Ischemia constantly present.

May be the first manifestation of Buerger’s disease

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9
Q

Skin changes - Color

A

Pallor- Result of deficient blood supply; skin pale

Cyanosis- concentration of deoxygenated hemoglobin, causes bluish discoloration

Rubor- Suggests dilated vessels or vessels dilated secondary to reactive hyperemia; skin is reddened

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10
Q

Lesions (arterial)

A

Ulcerations located: tibial area, foot, toes

Deep and more regular in shape

Quite painful

Gangrene: tissue death due to lack of blood supply

Duration of ulceration (e.g. days?)

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11
Q

What should capillary filling be like?

A

An increase in cap refill time denotes decreased art perfusion.
Normal cap refill time is < 3 sec

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12
Q

What does a palpable “thrill” indicate?

A

It may indicate a fistula, a patent dialysis access site or post stenotic turbulence.

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13
Q

What are the palpable pulses?

A

AO, fem, pop, dorsalis pedis (DPA), PTA

Pero art is NOT palpable

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14
Q

What are the risk factors for arterial disease

A 
Diabetes
HTN
Hyperlipidemia
Smoking 
Other
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15
Q

How is diabetes a risk factor?

A

A. Atherosclerosis: more common;occurs at a younger age
B. Higher incidence of disease: distal pop and tib arts
C. Medial calcification develops in LE arteries; this is associated with increased risk for cardiovascular evens; death usually related to heart disease.
D. Poor sensation (neuropathy) may lead to increased injury.
E. Higher incidence of gangrenous change, amputations.

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16
Q

How is HTN a risk factor?

A

Two opinions: May cause or enhance the development of atherosclerotic process.

17
Q

How is hyperlipidemia a risk factor

A

A. Elevated plasma lipids assoc. with atherosclerosis development.
B. Frequent cause: Diet high in animal fat; metabolic issues based on heredity.

18
Q

How is smoking a risk factor?

A

Studies suggest chemicals in cigarettes irritate the artery’s intimal lining causing vasoconstriction

19
Q

What are other risk factors?

A

non controllable factors like age and family history

20
Q

What is the most common arterial pathology?

A

Atherosclerosis (obliterans) - thickening , hardening , loss of elasticity of artery walls.

These changes occur in the intima and media layer of vessel

21
Q

Risk factors of atherosclerosis

A

smoking, hyperlipidemia, family history. Less important factors- HTN, diabetes, sedentary lifestyle, and arterial wall shear/stress.

22
Q

Most common sites of atherosclerosis

A

Carotid bifurcation
Aorto-iliac system
CFA bifurcation
SFA distal

23
Q

What is Leriche Syndrome?

What is it caused by?

A

Example of atherosclerosis caused by obstruction of the AO; occurs in males and is characterized by:

fatigue in hips, thighs, or calves with exercise
absence of femoral pulses
impotence
often times, pallor and coldness of LE

24
Q

What is an embolism? what form may they come in and what are the most frequent causes?

A

It is an obstuction of vessel by forein substance or blood clot.

Emboli may be solid, liquid or gaseous

Most frequent causes: small plaque breaks loos (e.g. atherosclerotic lesion, arteritis, or angiographic procedure); travels distally until it lodges in smallest vessel
Example: Blue toe syndrome (trash foot). Toe ischemia results; often improves, mainly from collateralized branches.

25
Q

What is a true aneurysm and what are two examples

A

dialation of all three arterial wall layers

Ex:
fusiform - diffuse, circumferential dilatation
Saccular: localized “sac-like”

26
Q

What is a dissecting aneurysm

A

This happens when a small tear of the inner wall allows blood to form cavity between two wall layers. Often occurs in thoracic aorta.

27
Q

Describe a pseudoaneurysm

A

This results from a defect in main artery wall (e.g. post catheter insertion). Must have a communication from main artery to pulsatile structure outside vessel wall

28
Q

What is the most common location of a true aneurysm and what are other locations?

A 
Most common - infrarenal aorta. 
Other locations- 
throacic ao
femoral
pop
renal
29
Q

True/ False

Pt’s with one aneurysm have a higher incidence of 2

More often of the CFA or Pop A as opposed to elsewhere

Cause unknown; (e.g. ? poor nutrition, infection, or atherosclerosis)

A

All true

30
Q

What is the most frequent complication of an aneurysm?

A

Rupture of AO aneurysm; embolization of the peripheral aneurysms

Both types can accumulate thrombus inside

31
Q

What are some non-atherosclerotic lesions?

A 
Arteritis
Coarctation of the AO
Dissection
Vasospastic disorders
Entrapment syndrome
32
Q

What is arteritis, what can it affect, types, and charateristics?

A

Can affect tibial, pero arts, or smaller more distal arterioles.

Inflammation of arterial wall can lead to thrombosis.

Type: Buerger’s disease (thromboangiitis obliterans)

Occurs primarily in men < 40 yr old who smoke heavily

Pts present with occlusions of distal arteries

Rest pain and ischemic ulceration present.

Vascular (3 decks)

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