Discussion Questions and Notes (Quiz 1) Flashcards
what are the proximal lower extremity arteries? (6)
- common iliac
- internal iliac
- external iliac
- common femoral
- superficial femoral
- deep (profunda) femoral
what are the distal lower extremity arteries? (6)
- popliteal
- anterior tibial
- tibioperoneal trunk
- posterior tibial
- peroneal
- digital arteries and plantar arches
how long is the external iliac?
about 5cm
how long is the internal iliac?
3-4cm
5 purposes for arterial physiologic testing
- evidence for arterial occlusive disease
- responsible for patient’s symptoms?
- Is it arterial disease or neurospinal compression
- how severe
- assess limb profusion during follow up exams
waveforms are obtained from (5)
CFA SFA popliteal PTA DPA
normal doppler signals in leg are ________
triphasic
ankle to brachial pressure should be
equal
what is claudication?
pain in muscle distal to blockage
what is ischemic rest pain?
pain in clotted limb when elevated because gravity can’t push blood down
what does plethysmography do?
senses for volume changes in limb with each heart beat and gives a waveform
lower resistance=
higher flow rate
higher resistance=
lower flow rate
velocity and pressure are ______ related
inversely
as the vessel radius decreases, resistance _____
increases
to maintain volume flow as the vessel size decreases velocity must ______, these principles are demonstrated in _______
increase
poiseuille’s law
a critical, hemodynamically significant stenosis causes a major reduction in ______ and ______
volume flow
pressure
a stenosis usually becomes hemodynamically significant when:
the cross-sectional area of the arterial lumen is reduced 75%
what happens to velocities when flow is going through the stenosis profile?
- velocities dampened prox to stenosis
- as flow passes through there is an increase in doppler shift
- poststenotic turbulence seen at exit from stenosis
maintain a doppler probe angle of _______ when insonating arteries for segmental pressure studies
45-60 degrees
which of the 2 arteries would be used to obtain the remainder of the segmental pressures after the ankle pressure is obtained with each?
higher of the two pressures
if the cuff bladder is too wide for the extremity, the BP will be artifactually ____
low
when utilizing the four-cuff technique, what type of artifact are you expecting to see at the level of the high thigh?
higher blood pressure (20-30 mmHg)
what 2 arteries are insonated on each leg when performing a full segmental limb pressure study?
PTA and DPA
*calculate right and left ABIs and severity of disease Right brachial: 120 mmHg Left brachial: 115 mmHg Right ankle PT: 100 mmHg Right ankle DP: 110 mmHg Left ankle PT: 96 mmHg Left ankle DP: 75 mmHg
right: .917 mmHg–asymptomatic obstructive disease
left: .8 mmHg–claudication
if the right above-knee pressure was 140 mmHg and the right below-knee pressure was 125 mmHg, what would be the interpretation of those findings?
normal
an ABI of _______ is consistent with incompressible/calcified arteries. what risk factor is associated with this finding?
> 1.3-1.5
diabetes
if a patient felt pain in their right thigh after walking 3 blocks, but subsided with rest, where would you say the arterial disease is located, if present?
suggests distal external iliac/common femoral disease
what are the five P’s and what do they indicate?
acute arterial occlusion symptoms
pain, pallor, pulselessness, paresthesia, paralysis
list 3 of the most common locations for atherosclerosis to occur in the body
- carotid bifurcation
- common femoral bifurcation
- popliteal trifurcation
