Discussion Questions and Notes (Quiz 1)

Question 1

what are the proximal lower extremity arteries? (6)

Answer 1

1. common iliac
2. internal iliac
3. external iliac
4. common femoral
5. superficial femoral
6. deep (profunda) femoral

Question 2

what are the distal lower extremity arteries? (6)

Answer 2

1. popliteal
2. anterior tibial
3. tibioperoneal trunk
4. posterior tibial
5. peroneal
6. digital arteries and plantar arches

Question 3

how long is the external iliac?

Answer 3

about 5cm

Question 4

how long is the internal iliac?

Answer 4

3-4cm

Question 5

5 purposes for arterial physiologic testing

Answer 5

1. evidence for arterial occlusive disease
2. responsible for patient’s symptoms?
3. Is it arterial disease or neurospinal compression
4. how severe
5. assess limb profusion during follow up exams

Question 6

waveforms are obtained from (5)

Answer 6

CFA
SFA
popliteal
PTA
DPA

Question 7

normal doppler signals in leg are ________

Answer 7

triphasic

Question 8

ankle to brachial pressure should be

Answer 8

equal

Question 9

what is claudication?

Answer 9

pain in muscle distal to blockage

Question 10

what is ischemic rest pain?

Answer 10

pain in clotted limb when elevated because gravity can’t push blood down

Question 11

what does plethysmography do?

Answer 11

senses for volume changes in limb with each heart beat and gives a waveform

Question 12

lower resistance=

Answer 12

higher flow rate

Question 13

higher resistance=

Answer 13

lower flow rate

Question 14

velocity and pressure are ______ related

Answer 14

inversely

Question 15

as the vessel radius decreases, resistance _____

Answer 15

increases

Question 16

to maintain volume flow as the vessel size decreases velocity must ______, these principles are demonstrated in _______

Answer 16

increase

poiseuille’s law

Question 17

a critical, hemodynamically significant stenosis causes a major reduction in ______ and ______

Answer 17

volume flow

pressure

Question 18

a stenosis usually becomes hemodynamically significant when:

Answer 18

the cross-sectional area of the arterial lumen is reduced 75%

Question 19

what happens to velocities when flow is going through the stenosis profile?

Answer 19

• velocities dampened prox to stenosis
• as flow passes through there is an increase in doppler shift
• poststenotic turbulence seen at exit from stenosis

Question 20

maintain a doppler probe angle of _______ when insonating arteries for segmental pressure studies

Answer 20

45-60 degrees

Question 21

which of the 2 arteries would be used to obtain the remainder of the segmental pressures after the ankle pressure is obtained with each?

Answer 21

higher of the two pressures

Question 22

if the cuff bladder is too wide for the extremity, the BP will be artifactually ____

Answer 22

low

Question 23

when utilizing the four-cuff technique, what type of artifact are you expecting to see at the level of the high thigh?

Answer 23

higher blood pressure (20-30 mmHg)

Question 24

what 2 arteries are insonated on each leg when performing a full segmental limb pressure study?

Answer 24

PTA and DPA

Question 25

*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

Answer 25

right: .917 mmHg–asymptomatic obstructive disease
left: .8 mmHg–claudication

Question 26

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?

Answer 26

normal

Question 27

an ABI of _______ is consistent with incompressible/calcified arteries. what risk factor is associated with this finding?

Answer 27

> 1.3-1.5

diabetes

Question 28

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?

Answer 28

suggests distal external iliac/common femoral disease

Question 29

what are the five P’s and what do they indicate?

Answer 29

acute arterial occlusion symptoms

pain, pallor, pulselessness, paresthesia, paralysis

Question 30

list 3 of the most common locations for atherosclerosis to occur in the body

Answer 30

1. carotid bifurcation
2. common femoral bifurcation
3. popliteal trifurcation