movement term three Flashcards

1
Q

what is duplex scanning?

A

anothe name for an ultrasound scan

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2
Q

what is the best scan to do to view vasculature?

A

ultrasound

best resolution and you can see velocity and flow

nb however is operator dependent

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3
Q

why is CT angiography used more than MR angiography (MRA)?

A

MRA is less readily available (also not suitable for all patients)

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4
Q

what is the gold standard radiological test for looking at blood vessels?

why isn’t it used more?

A

contrast angiography

invasive procedure
- complication risk related to procedure + contrast

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5
Q

where do atherosclerotic plaques tend to form?

A

bifurcation points (where there is turbulence of flow)

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6
Q

what are the 4 stages of chronic limb ischaemia?

A

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

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7
Q

what are the three signs of critical ischaemia?

A
  • foot pain at rest
  • ulceration
  • gangrene
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8
Q

what is the difference between wet and dry gangrene?

A

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

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9
Q

acute limb ischaemia:

  • normal cause?
  • prognosis?
A

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!!

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10
Q

what are the 6 clinical signs of an acute ischaemic limb?

A

the 6 Ps

  • perishingly cold
  • pulseless
  • pale
  • painful
  • paralysis
  • paraesthesia
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11
Q

what are the 3 stages of acute limb ischaemia?

A

initially = white leg

6-12 hours = mottled leg

irreversible ischaemia = fixed blue staining

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12
Q

describe the path of the anterior tibial artery in the leg

A

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)

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13
Q

describe the path of the posterior tibial artery

A

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

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14
Q

what two arteries come of the profunda femoris artery?

what do they supply?

A

medial and lateral circumflex arteries

supply the hip

nb the profunda femoris (aka deep artery of the thigh) comes off the femoral artery

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15
Q

describe the DEEP veins of the lower limb

A

follow exactly the same path as the arteries and are named the same too

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16
Q

describe the path of the superficial veins of the lower limb

A

have a superficial dorsal venous arch (on dorsum of foot) which drains blood from the digits and it continues to form two vessels, one on medial side (great saphenous) and one on lateral side (small saphenous)

great saphenous vein travels up, ANTERIOR to MEDIAL malleolus, and it travels all the way up the anteromedial aspect of the leg and drains into the femoral vein in the femoral triangle

short saphenous vein travels up, POSTERIOR to LATERAL malleolus, and it travels up back of lower leg and then joins the popliteal artery in the popliteal fossa