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Vascular board > Doppler segmental LE and UE > Flashcards

Doppler segmental LE and UE Flashcards

1
Q

Calcified vessels (medical calcinosis) render falsely elevated doppler pressures
(diabetics)

A

Limitations

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2
Q

Artifactually elevated high thigh pressures when narrow cuff used on thigh.

A

Limitations

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3
Q

Difficult to interpret in presence of multi-level disease

A

Limitations

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4
Q

DVT, dialysis access, lymphedema, stent, bypass graft, patient who had mastectomy

A

Limitations (can’t do segmental limb pressures

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5
Q

How long should patient rest prior to exam, especially when vascular disease is present

A

20 minutes

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6
Q

What position should patient be in so that hydrostatic pressure cannot affect the BP measurements.

A

Supine

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7
Q

width of the cuff should be about what than the diameter of limb

A

20% greater

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8
Q

The size of the call cuffs except thigh

A

12 x 40 cm.

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9
Q

Thigh cuff size is

A

19 x 40 cm.

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10
Q

Four cuff method

A

brachial (arm)
High thigh
Above the knee (AK) low thigh
Below the knee (BK) (CALF)
Ankle

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11
Q

Three cuff method

A

Brachial (ARM)
High thigh
Blew knee (BK) (Calf)
Ankle

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12
Q

What size frequency probe should be used

A

8-10 MHz

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13
Q

Angle the CW doppler probe at what degrees to the skin

A

45-60

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14
Q

Due to vessel angulation, probe angle behind the knee may be closer to what

A

90 degree

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15
Q

Angle the probe so blood flow moves

A

Antegrade (towards the probe)

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16
Q

Brachial (upper arm) using brachial artery

A

done 1st to get systolic pressure

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17
Q

Ankle

A

Use PTA or DPA which one is ever the highest (Peroneal A only if neccessary

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18
Q

Calf BK

A

Use PTA or DPA which one was ever the highest

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19
Q

Above the knee (AK)

A

Same as calf (PTA or DPA) which one was the highest

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20
Q

High thigh (HT)

A

PTA or DPA which one was the highest

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21
Q

Start at the ______ and move proximally to eliminate the possible underestimation of the systolic pressure measurements

A

Ankle

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22
Q

The systolic pressure is recorded when?

A

First audible doppler arterial signal returns.

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23
Q

Sphygmomanometer

A

Manual

24
Q

calculated by dividing the ankle pressure by the higher of the two brachial pressures

A

Ankle/brachial index (ABI)

25
Q

Another term for ABI is

A

Ankle/arm pressure index (API)

26
Q

> 1.0

A

Normal

27
Q

> 0.9 - 1.0 (90-80%)

A

Maybe within normal limits

28
Q

0.8 - .9

A

Mild arterial disease

29
Q

0.5 - 0.8

A

Claudication (moderate disease)

30
Q

< 0.5

A

Rest pain (sever arterial disease)

31
Q

Falsely elevated and inaccurate pressures

A

Incompressible vessels (calcified)

32
Q

Considered incompressible/unreliable

A

ABI > 1.3-1.5

33
Q

ABI of ______ represents single segment disease

A

> .5

34
Q

ABI of ______ suggests multiple lesions

A

< .5

35
Q

Segmental pressure drops of 30 > mmHg two consecutive levels suggests

A

significant stenosis

36
Q

Horizontal difference of > 20 to 30 mmHg suggests

A

obstructive disease at or above the level in the leg with the lower pressure.

37
Q

The thigh high pressure is normally > 30 mmHg than highest brachial pressure

A

4 cuff method

38
Q

The AK and BK pressure should be at least the same as the highest brachial

A

4 cuff method

39
Q

Thigh pressure is similar to the highest brachial pressure thigh=brachial

A

3 cuff method

40
Q

Does not allow for differentiation of high thigh to AK (above knee) pressures

A

3 cuff method

41
Q

Toe pressure maybe more reliable in a _____ patient

A

diabetic

42
Q

Immediately (normal = Increase ABI post exercise)
Abnormally, ABI decreases minimally or to a severe amount
With drop after exercise, pressures obtained every two minutes until pre-exercise pressures are attained

A

Post - exercise ABI’s are obtained

43
Q

Shortness of breath, severe hypertension, significant cardiac problems, stroke, walking problems.

A

Contraindications for not doing exercise

44
Q

Takes 2-6 minutes for the ABI’s to increase back to resting levels after they dropped to low or unrecordable levels after exercise

A

Single level disease

45
Q

Takes from 6-12 minutes for the ABI’s to increase back to resting levels after they remained low or at unrecordable levels after exercise

A

Multi-level disease

46
Q

To evaluate patency of the palmar arch: asses for adequate perfusion to the hand if radial artery harvested or used for dialysis access

A

Allen Test

47
Q

Reappearance of the normal color to indicate the ulnar artery is providing flow to the palmar arch

PPG documents pulsations during compression

A

Normal

48
Q

Color does not reappear to indicate; an ulnar artery occlusion or palmar arch obstruction

PPG documents loss of pulsations during compression

A

Abnormal
Cannot harvest radial artery

49
Q

15-20 mmHg difference from one brachial pressure to the other Suggests

A

50% stenosis of subclavian artery and or the vessel under the cuff

50
Q

A difference of > 20 mm Hg between radial and ulnar pressures suggests

A

obstruction in vessel with lower P

51
Q

An alternate method stressing the peripheral circulation. Used when patients: have PVOD in contralateral leg, use a cane or walker have pulmonary problems, poor cardiac status, or other situations

A

Reactive hyperemia

52
Q

Bilateral thigh cuffs (19x40) inflated to suprasystolic pressure levels (usually 20-30 mmHg above the higher brachial BP) maintaining the pressure 3 to 5 minutes

A

Reactive Hyperemia

53
Q

Produces ischemia and vasodilation distal to the occluding cuffs

A

Reactive hyperemia

54
Q

The ______ testing is the preferable test because it produces physiologic stresses that reproduces a patient’s ischemia symptoms

A

Treadmill

55
Q

< 50% in ankle pressure with reactive hyperemia

A

Single level disease

56
Q

> 50% ankle pressure drop is seen (reactive hyperemia)

A

Multi-level disease

Vascular board (10 decks)

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