Chapter 5 Doppler Segmenal Pressures (lower extremity) Flashcards
How long should a patient rest prior to the exam
20 minutes
If the cuff is too large for a limb segment and happens to the BP
It is falsely lower
If the cuff pressure is too narrow for a limb segment what happens to the BP
It is falsely higher
Width of cuff should be about _______% greater than diameter of limb
20%
What frequency probe should be used
8-10 MHz
The angle of the CW Doppler probe should be how many degrees to the skin
45-60
Angle the probe so blood flow moves
A) antegrade
B) retrograde
A) antegrade
You must start at the ______ and move _____ to eliminate the possibility of underestimating the systolic pressure measurement
Ankle, proximally
If pressure measurements must be repeated the cuff should be fully deflated for about how many minutes prior to repeat inflation
1 minute
Inflate the cuff _____ mmHg higher than the highest brachial pressure
20-30 mmHg
What does ABI stand for
Ankle/pressure index
How are ABIs calculated
Dividing the ankle pressure by the higher of the 2 brachial pressure
What is another term for ABI
Ankle/arm pressure (API)
An brachial index of what is considered normal
> 1.0
A brachial index of what is considered an asymptomatic disease or mild arterial disease
> 0.9-1.0
A brachial index of what is claudication (moderate disease)
0.5-0.9
A brachial index of what is rest pain and is considered severe arterial disease
<0.5
An ABI of _______ is considered incompressible
> 1.3-1.5
Stradness work suggest that an ABI of ____ represents single disease
> .5
Strandness work suggest an ABI of ______ suggest multiple lesions
<.5
Segmental pressure drops of ______ mmHg between 2 consecutive levels suggest significant obstruction
> 30 mmHg
A horizontal difference of ______ mmHg suggests obstructive disease at or above the level in the leg with lower pressure
20-30 mmHg
Thigh pressure is normally >30 mmHg than highest brachial pressure and the AK and BK pressures should be at least the same as the highest brachial describes what cuff technique
4 cuff technique
Thigh pressure is similar to the highest brachial pressure and does not allow for differentiation of HT to AK pressures describes what cuff technique
3 cuff technique
Toe pressure of _______ mmHg are evident in foot and toe ulcers that failed to heal
<30
Name 5 contraindications of exercise
1) shortness of breath
2) hypertension
3) cardiac problems
4) stroke
5) walking problems
What level of disease takes 2-6 minutes for the ABIs to increase back to resting levels after they dropped to low or unrecordable levels after exercise
Single level disease
What level of disease takes 6-12 minutes for the ABIs to increase back to resting levels after they remained low or at unrecordable levels after exercise
Multi level disease
________ _________ produces ischemia and vasodilation distal to the occluding cuffs
Reactive hyperemia
What level of disease has a <50% drop in ankle pressures with reactive hyperemia
Single level
What level of disease has a >50% ankle pressure drop
Multi level disease
What type of testing is the preferable test because it produced a physiologic stress that reproduces a patients ischemic symptoms
Treadmill
High thigh pressure should be _______ mmHg or highest brachial pressure
30
Patients with rest pain usually have ABIs between
0.25 and 0.5
