Chapter 3: Arterial Testing Flashcards by corrie Vancour

Claudication

pain in muscles occurring during exercise, subsides with rest

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Claudication results from

inadequate blood supply to muscle

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With claudication the level of the disease is usually

proximal to the location of symptoms

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pseudo-claudication

mimics vascular symptoms but is neuogenic or orthopedic

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ischemic rest pain

more severe symptom of dimished blood flow
occurs when limb is not dependent (sleeping)
decreasses BP

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ischemic rest pain can effect

forefoot, heel, toes

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tissue loss

necrosis or death of tissue

due to deficient of absent blood supply

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acute arterial occlusion symptoms (6 P’s)

pallor
pain
pulselessness
polar
parsthesia
paralysis

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acute arterial occlusion is an emergency because

collaterals do not have time to form –> no blood flow

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Raynaud’s Phenomenon

vasopastic disorder

intermittent digital ischemia due to cold or emotional stress

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Primary Raynaud’s

ischemis due to digital arterial spasms
common in young women
can be hereditary
hx of symptoms x2 years without worsening
benign

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Secondary Raynaud’s aka Obstructive Raynauds

normal vasoconstrictive responses of arterioles superimposed on fixed artery occlusion
ischemia is constantly present

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Secondary Raynaud’s may be the first manifestation of

Buerger’s Diseas

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Pallor

pale skin

result of deficient blood supply

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Rubor

redness

dialated vessels secondary to reactive hyperemia

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Cyanosis

Blue discoloration

concentration of deoxygenated hemoglobin

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what to look for on physical exam for arterial exams

skin color changes
temperature
lesions (ulcers)
capillary filling time
elevation/dependency color changes

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increased capillary filling time suggests

decreased arterial perfusion

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diminished or absent pulses suggest

arterial insufficiency

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Grading pulses

0(none)- to 4(bounding)

aneurysms are a 4

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palpable thrill may indicate

fistula
post stenotic turbulence
dialysis access site

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palpable pulses

aorta
femoral
popliteal
dorsalis pedis (DPA)
posterior tibial

what arteries can not be palpated

peroneal arteries

risk factors for arterial disease

diabetes
hypertension
hyperlipidemia
smoking
other (fam hx, age)

Arterial disease with diabetes

``` atherosclerosis distal pop and tibial arteries mostly effected medial calcification develop in LE poor sensation higher incidence of gangrenous change amputations ```

systemic hypertension mostly leads to

coronary atherosclerosis

Hyperlipidemia and arterial disease

leads to atherosclerosis

causes of hyperlipidemia

diet high in animal fat | metabolic problems

smoking and arterial disease

chemical in cigs irritate endothelial lining of vessel, causing vasoconstriction

what is the most common arterial pathology

atherosclerosis (obliterans)

what happens to arterial walls with atherosclerosis

thickening hardening loss of elasticity of walls

where do changes occur with atherosclerosis

intima and media layers

risk factors for atherosclerosis

``` smoking hyperlipidemia fam history hypertension diabetes sedentary lifestyle ```

most common sites of atherosclerosis

``` carotid bifurcations vessel origins infra renal aorta cfa bifurcation SFA at adductor canal trifurcation ```

Leriche Syndrome

occurs in males | obstruction of the aorta

Leriche Syndrome is characterized by

fatigue in hips, thighs calves with exercise absense of femoral pulses impotence pallor and coldness of LE

arterial embolism

obstruction from solid, liquid, or gaseous foreign substance

Blue toe syndrome

related to embolism | toe ischemia

Aneursym

dilation of all three walls

fusiform aneurysm

circumferential dilation

saccular aneursym

out pouching

dissecting aneursym

tear in inner layer allowing blood to flow between two layers happens in thoracic aorta

pseudoanyersm

all three walls are not involved | results from defect in main artery wall

patients with one aneursym have a higher incidence of

2 anerusyms | most likely of CFA or pop artery

most frequent complication of an aneursym is

rupture of aortic aneurysm with emobolization of peripheral aneursyms

arteritis is

inflammation of the arterial wall leading to thrombosis of the vessel

arteritis can affect

tibial and peroneal arteries

Buerger's Disease

is arteritis (thomboangititis obliterans)

Buerger's Disease is associated with

heavy cigarette smoking | occurs primarily in men <40 yrs olf

Buerger's Disease patients present with

rest pain, ulcers | occlusion of distal arteries

coarctation of the aorta

common in thoracic aorta | congenital narrowing or a vessel

clinical findings of coarctation

hypertension due to decreased kidney perfusion | LE ischemis

Aortic Dissection

may occur consequent to hypertension or severe trauama | affects aorta and peripheral arteries

ultrasound findings of a dissection

thin membrane dividing the arterial lumen into 2 compartments flow velocities differ in each lumen