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RVT Review > Chapter 3 > Flashcards

Chapter 3 Flashcards

1
Q

T/F is it not important to keep a warm environment for arterial testing?

A

false

you want to keep it warm to permit peripheral dilation to occur

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2
Q

what are some some signs and symptoms of chronic occlusive disease?

A

a. claudication
b. ischemic rest pain
c. tissue loss

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3
Q

what is claudication?

A

pain in muscles usually occurring during exercise; symptoms subside with rest
discomfort is predictable and subsides min after exercise

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4
Q

why does claudication occur?

A

results from inadequate blood supply to the muscles

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5
Q

where is the level of disease for claudication?

A

level of disease usually proximal to location of symptoms

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6
Q

T/F pseudo- claudication mimics vascular symptoms

A

true

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7
Q

what are pseudo- claudication vascular symptoms really from?

A

they are neurogenic or orthopedic in origin

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8
Q

what is ischemic rest pain?

A

a more severe symptom of diminished blood flow

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9
Q

why does ischemic rest pain occur?

A

occurs when limb not dependent; BP decreased such as when sleeping

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10
Q

what is tissue loss?

A

necrosis or death of tissue

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11
Q

why does tissue loss occur?

A

due to deficient or absent blood supply

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12
Q

what are the six symptoms for acute arterial occlusion?

A

pain. pallor, pulslessness, paresthesia, paralysis, polar

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13
Q

what may acute arterial occlusion result from?

A

thrombus, embolism or trauma

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14
Q

T/F acute arterial occlusion is an emergency situation

A

true

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15
Q

why is acute arterial occlusion an emergency situation?

A

since the abrupt onset does not provide for the development of collateral channels

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16
Q

what is a vasospastic disorder?

A

raynauds

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17
Q

what is raynauds phenomenon?

A

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

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18
Q

what are the changes in skin color that occur with raynauds?

A

pallor (whiteness), cyanosis (bluish), or rubor (dark red)

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19
Q

what is primary raynauds?

A

ischemia due to digital arterial spasm

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20
Q

who is more prone for primary raynauds?

A

young females

may be hereditary, bilateral with 2 years of symptoms with no evidence of cause

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21
Q

T/F primary raynauds is a malignant condition with excellent prognosis

A

false

benign

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22
Q

what is another word for secondary raynauds?

A

obstructive raynauds syndrome

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23
Q

what is secondary raynauds?

A

normal vasoconstrictive responses of arterioles superimposed on a fixed artery obstruction. ischemia constantly present

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24
Q

what may be the first manifestation of buergers disease?

A

secondary raynauds

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25
what is buergers diease?
inflammation and thrombolism in small / medium vessels associated with smoking can lead to gangrene
26
what is pallor and what is it caused from?
pale skin | result of deficient blood supply
27
what is rubor and what is it caused from ?
skin is reddened | suggest dilated vessels or vessels dilated secondary to reactive hyperemia
28
what is cyanosis and what is it caused from?
bluish discoloration | a concentration of deoxydenated hemoglobin
29
what will arterial lesions look like?
ulcerations located: tibial area, foot, toes deep and more regular in shape quite painful gangrene
30
what is gangrene?
death of tissue, due to deficient or absent blood supply
31
what does an increase in the capillary refill time denotes?
an decreased in arterial perfusion
32
what color does the foot turn with elevation?
pallor
33
what does rhythmic throbbing of artery in time with heartbeat signifies?
adequate circulatory status
34
what does diminished/ absent pulse suggest?
arterial insufficiency
35
what are the grading scale for palpations?
0-4+ 0=none 4+ Bounding
36
T/F aneurysms can be palpated and described as bounding
true
37
what may a palpable vibration or thrill over a pulse site indicate?
fistula, post-stenotic turbulence or a patent dialysis access site
38
what are some arteries that are palpable pulses?
aorta, femoral, pop. DPA, PTA
39
T/F peroneal artery is palpable
false
40
what is another word for bruit?
auscultation
41
T/F bruit ausculation is more often done with a carotid exam
true
42
what may you use to hear the bruit?
stethoscope
43
what are some risk factors for arterial testing?
``` diabetes hypertension hyperlipidemia (high cholesterol) smoking other (age, family history, male gender) ```
44
what does diabetes cause?
atherosclerosis: more common at a younger age
45
which areas have a higher incidence of disease with diabetics?
distal pop and tibial arteries
46
what are other characteristics of arterial disease with diabetics?
``` medial calcification develops in LE arteries poor sensation (neuropathy) may lead to increased injury higher incidence of gangrenous changes, amputations ```
47
what are some characteristics of arterial disease seen with hypertension?
systemic hypertension is associated with greater incidence of coronary atherosclerosis
48
what are some characteristics seen with hyperlipidemia?
elevated plasma lipids closely associated with development of atherosclerosis
49
what is a frequent cause of hyperlipidemia?
diet high in animal fat, metabolic problems associated with heredity
50
how does smoking play a role in arterial disease?
the chemical in cigarettes irritate the endothelial lining of the vessels causing vasoconstriction
51
what are some mechanisms of disease?
atherosclerosis embolism aneurysm non-atherosclerotic lesions
52
what is another name for atherosclerosis?
obliterans
53
what is atherosclerosis?
most common arterial pathology. | thickening, hardening, and loss of elasticity of the artery walls
54
what part of the vessel does atherosclerosis commonly affect?
intima and media layer
55
what are major risk factors for atherosclerosis?
smoking, hyperlipidema, and family history | less important factors: HTN, diabetes, sedentary lifestyle and arterial wall shear/ stress
56
what are common sites for atherosclerosis?
``` carotid bif vessel origins infra-renal aorto-iliac system CFA bif SFA at the adductor canal trifurcation region ```
57
what is Leriche syndrome?
caused by obstruction of the aorta
58
who is more at risk for Leriche syndrome?
males
59
what is Leriche syndrome characterized by?
fatigue in hips, thigh, or calves with exercise absence of femoral pulses impotence pallor or coldness of LE
60
what is an embolism?
obstruction of vessel by foreign substance or blood clot
61
T/F embolism may be solid, liquid, or gaseous
true | may arise from the body or enter from without
62
what is the most frequent cause of an embolism?
small plaque breaks loose | e.g atherosclerotic lesion, arteritis, or angiographic procedure and travels distally until lodges in small vessel
63
what can happen as a result of an embolism to a small vessel?
blue toe syndrome
64
what is blue toe syndrome?
toe ischemia | can improve and mainly from other small branches
65
what is an aneurysm?
true aneurysm is a dilation of all three arterial layers of the wall
66
what is fusiform aneurysm?
diffuse, circumferential dilation
67
what is saccular aneurysm?
localized out- pouching
68
what is a dissecting aneurysm?
occurs when a small tear of the inner wall allows blood to form cavity between two wall layers.
69
where do dissecting aneursyms most often happen?
thoracic aorta
70
what is a pseudo aneurysm?
results from a defect in the main artery wall | e.g post catheter insertion
71
what do pseudo aneurysm must have?
must be a channel communication from main artery to pulsatile structure outside vessel walls aka neck
72
where is the most common location for a true aneursym?
infrarenal aorta
73
what are other locations for a true aneursym?
thoracic aorta, femoral, pop, renal
74
T/F patients with one aneurysm do not have a higher chance for another aneurysm
false | they do have a higher chance
75
what are some causes of true aneursym?
poor nutrition, congenital defect, infection, or atherosclerosis
76
what is the most frequent complication for an aneurysm?
rupture | embolization of the peripheral aneursyms
77
what are some non-atherosclerotic lesions?
``` arteritis coarctation of the aorta dissection vasospastics disorders entrapment syndrome ```
78
which arteries can arteritis affect?
tibial and peroneal arteries as well as smaller distal arterioles and nutrient vessels
79
what is arteritis?
inflammation of arterial wall which can lead to thrombosis of the vessel
80
what is a type of arteritis?
buergers disease
81
what is another name for buergers disease?
thromboangiitis obliterans
82
T/F arteritis is associated with heaving smoking?
true
83
what is the age and gender group for arteritis?
men <40years old
84
what are some symptoms that patient presents with arteritis?
occlusions of the distal arteries rest pain ischemic ulceration present
85
what is coarctation of the aorta?
congenital narrowing or stricture of the thoracic aorta but may affect abdominal aorta as well
86
what is a congenital anomaly of the arterial system?
coarctation of the aorta
87
what are clinical findings for coarctation of the aorta?
HTN due to decreased kidney perfusion | manifestation of LE ischemia e.g decreased pulses and/or segmental presures
88
what is dissection?
media is weakened, intima develop tear through which blood leaks into media (false lumen)
89
what is a distinguishing ultrasound feature of dissection?
a think membrane diving the arterial lumen into 2 compartment
90
which arteries does dissection affect?
aorta and peripheral arteries
91
what are complications of dissection?
stenosis, occulsion or thrombosis
92
what can aortic dissections which extend to the iliacs lead to?
may occur consequent to HTN or severe chest trauma | can lead to death

RVT Review (30 decks)

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