movement term three Flashcards
what is duplex scanning?
anothe name for an ultrasound scan
what is the best scan to do to view vasculature?
ultrasound
best resolution and you can see velocity and flow
nb however is operator dependent
why is CT angiography used more than MR angiography (MRA)?
MRA is less readily available (also not suitable for all patients)
what is the gold standard radiological test for looking at blood vessels?
why isn’t it used more?
contrast angiography
invasive procedure
- complication risk related to procedure + contrast
where do atherosclerotic plaques tend to form?
bifurcation points (where there is turbulence of flow)
what are the 4 stages of chronic limb ischaemia?
1) asymptomatic
2) intermittent claudication
3) ischaemic rest pain
4) ulceration/gangrene
nb the larger the artery, the longer the asymptomatic period
nb intermittent claudication is a bit like stable angina but in the leg (pain on exercise, goes away with rest)
nb in chronic limb ischaemia, there is time for collaterals to develop
what are the three signs of critical ischaemia?
- foot pain at rest
- ulceration
- gangrene
what is the difference between wet and dry gangrene?
dry:
- tissue necrosis
- black, dry and shrunken
wet:
- tissue necrosis PLUS infection
- black, soft + putrid
nb wet gangrene occurs because lack of blood flow means immune cells can’t get to area so infection can easily set in
acute limb ischaemia:
- normal cause?
- prognosis?
often caused by an embolus from an atherosclerotic plaque -> sudden decrease in limb perfusion
(often from AF)
acutely ischaemic limb must be revascularised within hours if function is to be reserved
- significant morbidity + mortality
surgical emergency!!
what are the 6 clinical signs of an acute ischaemic limb?
the 6 Ps
- perishingly cold
- pulseless
- pale
- painful
- paralysis
- paraesthesia
what are the 3 stages of acute limb ischaemia?
initially = white leg
6-12 hours = mottled leg
irreversible ischaemia = fixed blue staining
describe the path of the anterior tibial artery in the leg
comes of the posterior tibial artery then goes through a proximal aperture in the interosseous membrane to enter the anterior compartment of the leg then travels down and, as it crosses the ankle joint, becomes the dorsalis pedis artery.
as dorsalis pedis goies into dorsal surface of foot it curves around, parallel to end of foot, this is called the ARCUATE artery (and then gives rise to digital and metatarsal arteries)
describe the path of the posterior tibial artery
main continuation of the popliteal artery
- gives rise to the anterior tibial and fibular arteries
goes down posterior of leg and then travels BEHIND the MEDIAL malleolus
then goes underneath foot to form medial and lateral plantar arteries which then form the deep plantar arch
nb this is why peopple bleed a lot when tread on sharp things
what two arteries come of the profunda femoris artery?
what do they supply?
medial and lateral circumflex arteries
supply the hip
nb the profunda femoris (aka deep artery of the thigh) comes off the femoral artery
describe the DEEP veins of the lower limb
follow exactly the same path as the arteries and are named the same too