Interpretation of UE Pressures Flashcards
capabilities of UE segmental pressures
3
assess presence /severity of arterial disease
locate via segment
combined with doppler velocity or PVR
limitations of UE segmental pressures
cannot discriminate between stenosis / occlusion
calcified vessels - (falsely elevated Pa)
CHF (decreased ABI)
wrong cuff size
multilevel disease –better dx with duplex
what conditions preculde taking segmental limb pressure
6
DVT dialysis access lymphedema stent bypass graft masectiomy
what will wrong cuff size do to segmental pressre
2
too large = BP falsely lower
too small = BP falsely higher
how many cuffs for upper extremities
`2
what size cuff
12 x 40cm upper arm
10 x 40 cm lower arm
what artery is upper arm BP
brachial
what artery is forearm pressuree
ulnar
radial
Allen test is used to
assess for AVF – patency of palmar arch
if radial artery is harvested
what is the primary source for hand perfusion
ulnar artery
how long is manual compression which artery while pt clenches fist
1 min
radial artery
what is the modified verison of the ALLEN test
PPG on index finger before and during manual compression of the radial artery
describe normal / abnormal results of allen test ‘s both qualitative and quantitative
NORM: reappearance of normal color indicates the ulnar artery is providing flow to palmar arch
PPG doc pulsations during compression
ABNORM: color DOES NOT reappear – indicates ulnar artery occlusion
PPG documents loss of pulsations during compression
LImitations to UE segmental pressures
excessive dorsiflexion of wrist = compress radial / ulnar arteries = false positive
opening hand too wide false pallor do to cmpression of small vessels
Interpretation of UE segmental pressure:
15-20 mmHg difference from one brachial pressure to the other suggests _______ stenosis of subclav a
and / or the vessel under the cuff.
50%
