Chapter 3: Arterial Testing Flashcards
Claudication
pain in muscles occurring during exercise, subsides with rest
Claudication results from
inadequate blood supply to muscle
With claudication the level of the disease is usually
proximal to the location of symptoms
pseudo-claudication
mimics vascular symptoms but is neuogenic or orthopedic
ischemic rest pain
more severe symptom of dimished blood flow
occurs when limb is not dependent (sleeping)
decreasses BP
ischemic rest pain can effect
forefoot, heel, toes
tissue loss
necrosis or death of tissue
due to deficient of absent blood supply
acute arterial occlusion symptoms (6 P’s)
pallor pain pulselessness polar parsthesia paralysis
acute arterial occlusion is an emergency because
collaterals do not have time to form –> no blood flow
Raynaud’s Phenomenon
vasopastic disorder
intermittent digital ischemia due to cold or emotional stress
Primary Raynaud’s
ischemis due to digital arterial spasms common in young women can be hereditary hx of symptoms x2 years without worsening benign
Secondary Raynaud’s aka Obstructive Raynauds
normal vasoconstrictive responses of arterioles superimposed on fixed artery occlusion
ischemia is constantly present
Secondary Raynaud’s may be the first manifestation of
Buerger’s Diseas
Pallor
pale skin
result of deficient blood supply
Rubor
redness
dialated vessels secondary to reactive hyperemia
Cyanosis
Blue discoloration
concentration of deoxygenated hemoglobin
what to look for on physical exam for arterial exams
skin color changes temperature lesions (ulcers) capillary filling time elevation/dependency color changes
increased capillary filling time suggests
decreased arterial perfusion
diminished or absent pulses suggest
arterial insufficiency
Grading pulses
0(none)- to 4(bounding)
aneurysms are a 4
palpable thrill may indicate
fistula
post stenotic turbulence
dialysis access site
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
