Chapter 5 - Doppler segmental pressure lower extremity

Question 1

Average blood pressure cuff bladder dimension

Answer 1

12 x 40 cm

Question 2

Doppler frequency for segmental pressures

Answer 2

8-10 MHz

Question 3

Location of the four cuff technique

Answer 3

1) high thigh
2) low thigh
3) below knee
4) ankle

Question 4

Principle on the width of the bladder used

Answer 4

20% greater (1.2x) diameter of limb

too narrow = falsely elevated
too wide = falsely low

Question 5

Location of the three cuff technique

Answer 5

1) high thigh
2) below knee
3) ankle

Question 6

Order of sequential pressure measurement

Answer 6

Start distal, move to more proximal

Question 7

Amount of pressure drop between segments to suggest significant disease

Answer 7

> 20-30 mmHg drop

Question 8

Interpretation of thigh:brachial pressure indices

Answer 8

> 1.2 = normal
0.8-1.2 = AIOD
< 0.8 = proximal occlusion

Question 9

Pressures needed for foot ulcer healing

Answer 9

> 30 mmHg

Question 10

Technique for treadmill test

Answer 10

1) resting values obtained
2) walk < 12% elevation at 1.5 miles/hr for 5 min or until symptom onset
3) measure pressure again (start with most symptomatic leg)
4) measure every 2 min until pre-exercise pressures obtained

Question 11

Interpretation of pressure drop duration after exercise and correlation with level(s) of disease

Answer 11

2-6 min before return = single level

> 6 min = multi level obstruction

Question 12

Reactive hyperemia techniques

Answer 12

1) thigh cuff (19x40 cm) inflated to 20-30mmHg above brachial pressure for 3-5 min
2) Release cuff
3) < 50% drop = single level disease
4) > 50% drop = multilevel disease

Question 13

Difference in reactive hyperemia vs treadmill test in the normal limb

Answer 13

Pressure only drops in the normal limb after reactive hyperemia (17-34%)