Digit Plethysmography And Pressures

Question 1

Other than detecting the presence of arterial disease, what else does digit PPG an pressures help with

Answer 1

Differentiates fixed arterial obstruction from vasospasms

Question 2

For toe evaluation, patients should be supine with…….

And finger evaluation, patients should be sitting with………

Answer 2

TOE= supine with some elevation of the head
FINGER= sitting with arms on pillow placed on patients lap

Question 3

Cuff size of toe exam should be atleast ____ times that of the toe

Answer 3

1.2 times (2.5-3 cm)

Question 4

TOE technique

• digit cuff placed at BASE of _____
• use double stick tape or Velcro to attach _____ to plantar side of toe
• pulses recorded w/ paper speed SLOWED to ___ mm/sec
• cuff is inflated to 20 to 30 mmHg above _________ (hint: not a number)

Answer 4

• base of GREAT TOE
• attach PHOTOCELL to plantar side of toe
• paper slowed to 5mm/sec
• 20 to 30 mmHg above HIGHEST BRACHIAL PULSE

Question 5

Finger cuff usually use what size

Answer 5

2-2.5cm

Question 6

Digit pressures can be performed with or without cold stress for cases that…..

Answer 6

Incase the symptoms occur due to cold sensitivity

Question 7

For finger “cold stress” tests, hands get immersed in ice cold water for ____ minutes if possible and immediately get waveforms/pressures, then again _____ minutes after

Answer 7

Immerse for 3 minutes

Doppler again 5 minutes after

Question 8

An abnormally PEAKED waveform quality will look like what?

*common with vasospastic process

Answer 8

• slow upslope
• the reflected wave (notch) will be located HIGH on the DOWNSLOPE
• as qualities of both normal and obstructive waveforms

Question 9

Three types of waveform observations can be described as:

• abnormal Doppler arterial signals, systolic pressures and PPG tracings
• normal Doppler signals and pressures, and/or PPG tracings, but abnormal after cold stress
• pulse is unique to the waveform contours of patients with Raynaud’s phenomena

** match descriptions with: organic (fixed), Functional (intermittent), peaked

Answer 9

ORGANIC (fixed) = abnormal Doppler arterial signals, systolic pressures and PPG tracings
FUNCTIONAL (intermittent) = normal Doppler signals and pressures, and/or PPG tracings, but abnormal after cold stress
PEAKED = pulse is unique to the waveform contours of patients with Raynaud’s phenomena

Question 10

Normal UE digit measurements are finger/brachial indices of?

Answer 10

0.8-0.9

Question 11

Normal LE digit pressures for toe/brachial index (TBI) range from __ to __ % of brachial pressure

Answer 11

60-80%

*toe/ankle pressures CANNOT be relied upon with artifactually high ankle pressures