Module 6 : Peripheral Arterial System Part 2

Question 1

what is a false aneurysm

Answer 1

• pulsating hematoma that originates from a leaking artery and confined by surrounding tissues not by arterial wall

Question 2

what is the most common cause of a flaw aneurysm

Answer 2

• arterial puncture

- violent trauma or infection

Question 3

what must there be in order to classify as a false aneurysm

Answer 3

• communicating channel between the main artery and pulsating mass

Question 4

what are 4 sonographic features of false aneurysms

Answer 4

• swirling of color and communication tract
• spectral trace within the tract will have high velocities and spectral broadening
• spectral trace within the hematoma will have turbulent flow
• 1-5cm

Question 5

what is the treatment of a false aneurysm

Answer 5

• size and location of channel important because can undergo compression treatment
• procedure is not fun and could result in arterial occlusions or venous thrombosis
• firmly compress with transducer for 10 minutes than rest then again
• can also inject thrombin into pseudo aneurysm

Question 6

what is arteritis and what are the vessels it typically effects

Answer 6

• inflammation arterial wall

- tibia Artemis and distal arterioles

Question 7

hat are the 3 types of arteritis

Answer 7

• takayasus
• temporal
• polyartierits

Question 8

what’s the most common type of arteritis

Answer 8

• burgers disease

- mainly in men < 40 with heavy smoking

Question 9

what is aortic coarctation

Answer 9

• congenital narrowing of the thoracic aorta may effect abd AO
• may result in LE ischemia

Question 10

what is vasoplastic disorders/ cold sensitivity

Answer 10

• intermittent ischemia in the fingers or toes in response to cold exposure or stress

Question 11

what is the cause of cold sensitivity

Answer 11

• idiopathic

- result of underlying disease

Question 12

what can color duplex help with in cold sensitivity

Answer 12

• color duplex helps rule out obstructive disease or emboli in larger vessels as cause of symptoms

Question 13

what are the 2 types of raynauds disease

Answer 13

• primary

- secondary

Question 14

what is primary raynauds disease also called

Answer 14

• idiopathic

- spastics raynauds disease

Question 15

what is primary raynauds disease

Answer 15

• intermittent digital ischemia caused by arterial spasm when exposed to cold temperatures

Question 16

in what population is primary raynauds most common in and is it bilateral or unilateral

Answer 16

• women

- bilateral

Question 17

what do the digits look like in primary raynauds

Answer 17

• digits go pale cyanotic blue then red as they warm up

Question 18

what is the progression of primary raynauds and the prognosis

Answer 18

• does not progress

- good prognosis

Question 19

what is another name for secondary raynauds

Answer 19

• obstructive

Question 20

what is the difference between secondary and primary raynauds

Answer 20

• reaction of tissue to cold is due to underlying obstructive systemic disease

Question 21

what is secondary raynauds disease

Answer 21

• chronic condition with ischemia

- can lead to ulceration, gangrene and amputation

Question 22

what are compression/entrapmetn syndromes caused by

Answer 22

• swelling within osteofascial compartments of the upper and lower extremities
• pressure increases and compromises blood flow to the tissue

Question 23

what is the treatment of compression/entrapment syndromes

Answer 23

• fasciotomy

Question 24

what is popliteal entrapment

Answer 24

• compression of the popliteal artery by gastrocnemius muscle
• repeated trauma to artery may cause aneurysm thrombi atherosclerosis and emboli

Question 25

which population is popliteal entrapment common in

Answer 25

- common in young adults and children

Question 26

what will patients with popliteal entrapment present with

Answer 26

- normal pressure pulses and waveform at rest - will decrease significantly with passive plantar flexion of foot - will have PAIN

Question 27

when is popliteal entrapment indicated

Answer 27

- when there is a decreased arterial diameter when patient points their foot downward resulting in visualized stenosis or loss of pulse

Question 28

what is adventitial cystic disease

Answer 28

- focal stenosis or occlusion of the popliteal artery | - seeing the arterial lumen compressed by cyst (bakers)

Question 29

what is thoracic outlet syndrome

Answer 29

- compression of subclavian artery/vein/ nerves as they emerge from thoracic outlet

Question 30

what does thoracic outlet syndrome lead t o

Answer 30

- hand and arm ischemia and pain or weakness

Question 31

what is a positive thoracic outlet test

Answer 31

- decrease in flow velocities or occlusion of flow in position of pain

Question 32

what can cause an AV fistula

Answer 32

- congenital l | - traumatic

Question 33

what is an AV fistula

Answer 33

- communication between and artier and an adjacent vein featuring + color bruit with high velocity, low resistance waveform at site

Question 34

what is the most common AV fistula

Answer 34

- CFA/CFV post catheterization

Question 35

what is blue toe syndrome

Answer 35

- toe ischemia due to micro emboli released from prox atherosclerotic lesions lodging in small arteries and arterioles

Question 36

what is the treatment of blue toe syndrome

Answer 36

- removal of emboli

Question 37

what can extrinsic compression be caused by

Answer 37

- tumors | - hematomas

Question 38

what can extrinsic compression result in

Answer 38

- stenosis or occlusion by applying pressure on arterial walls and compromising blood flow

Question 39

how do we asses tumors with color and power

Answer 39

- color = evaluate masses for vascularity | - power = detect low flow states