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Vascular Sonography > Peripheral Arterial Disease Lecture 1 > Flashcards

Peripheral Arterial Disease Lecture 1 Flashcards

1
Q

three categories of PAD

A
  • aortoiliac
  • femoropopliteal
  • tibioperoneal
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2
Q

routinely, there must be a ____% diameter reduction before symptoms occur.

A

50

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3
Q

most common site of PAOD

A

aortoiliac

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4
Q

most common site for stenosis

A

bifurcation

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5
Q

Chronic occlusive disease …

A
  • claudication

- pain in muscle (progressive) w/exercise in calf, thigh or buttock, relieved by rest

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6
Q

disease is usually _____ to location of symptom

A

proximal

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7
Q

symptoms occurs _____ to disease

A

distal

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8
Q

during the periods of inadequate perfusion, a cramping or aching sensation occurs in the muscle

A

claudication

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9
Q

what is pseudoclaudication?

A

neurogenic: nerve compression; mot reproducible or musculoskeletal

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10
Q

occlusive disease reaches the point that there is reduced flow at rest

A

chronic occlusive disease

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11
Q

symptoms of end stage level of chronic occlusive disease

A

-rest pain or ischemic rest pain (forefoot, heel, and toes)

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12
Q

chronic symptoms usually occur when limb is ________, usually when sleeping, when bp is low and limb is elevated

A

not dependant

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13
Q

when supine BP is decreased by ____%

A

30

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14
Q

less than ____ mmHg = tissue loss, critical

A

60

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15
Q

most severe form of arterial disease

A

chronic

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16
Q

acute arterial disease is usually caused by …

A

embolus, thrombosis, or trauma

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17
Q

five P’s associated with acute arterial occlusion

A

pain, pallor, pulsessness, paresthesia, paralysis

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18
Q

6th P…

A

poikilothermia/polar (cold)

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19
Q

7th P…

A

purplish

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20
Q

vasospastic/cold sensitivity disorders

A

-Raynaud’s

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21
Q

diabetes is associated with what syndrome?

A

monkeburg’s

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22
Q

arterial sclerosis involving peripheral arteries especially in the legs (medial lay)

A

monkeburg’s syndrome

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23
Q

most common pathology condition, thickening, hardening, and loss of elasticity of the artery walls

A

atherosclerosis aka: arteriosclerosis

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24
Q
  • caused by obstruction of the terminal aorta
  • usually in males, characterized by fatigue in the hips, thighs, or calves on exercising
  • absence of pulsation in the femoral arteries, impotence, and often coldness/pallor of lower limbs
A

Leriche Syndrome***

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25
Q

most common site for embolism

A

-PTA and popliteal

26
Q

most common type of aneurysm

A

AAA and of AAA fusiform

27
Q

most common site for pseudoaneurysm

A

right common femoral artery

28
Q

___cm or less “neck” size, no thrombin injection

A

0.5

29
Q

____% of patients with PAD etiology is atherosclerosis

A

90

30
Q

Most common type of arteritis

A

buerger’s AKA thromboangiitis Obliterans

31
Q
  • media cells become infiltrated with white blood cells
  • muscular and elastic portions are eroded
  • fibrosis develops
  • blood vessel wall weakens and necrosis can occur
A

vascular arteritis

32
Q

symptoms of arteritis (similar to those seen in atherosclerosis)

A
  • claudication or rest pain
  • decreased and asymmetrical blood pressure
  • TIA/stroke symptoms
  • if in upper extremity; claudication symptoms
33
Q

types of arteritis

A
  • arteritis
  • Takayasu
  • temporal
  • polyarteritis
  • buerger’s (most common)
34
Q

Giant cell arteritis is also known as …

A

temporal arteritis

35
Q

inflammatory of the distal segment of the STA typically seen in elderly Caucasian women (70 years or greater)

A

Giant Cell Arteritis

36
Q

symptoms of Giant Cell Arteritis

A
  • asymmetric upper extremity bp
  • temporal headaches
  • tenderness over superficial temporal artery
  • decreased pulse
  • could also be: axillary/brachial/subclavian vessels
  • cord-like structure over superficial temporal artery
  • aching or stiffness in the neck
  • headaches
  • jaw claudication
37
Q
  • non-atherosclerotic
  • associated with heavy cigarette smokers (and chew tobacco)
  • occurs primarily in men < 45years old
  • prevalent in India
  • affects small and medium-sized arteries of upper and lower extremities
A

buerger’s disease AKA thromboangitis obliterans (TOA)

38
Q

buergers disease is always ________

A

bilateral, with one side worse than the other

39
Q
  • occlusions of the distal arteries
  • rest pain and ischemic ulceration
  • can cause superficial thrombophlebitis and numbness and tingling in the hands and feet
  • can consist of ischemic digital ulcers
A

buerger’s disease/ thromboangitis obliterans (TOA)

40
Q
  • rare complication of radiation therapy for cancer
  • results in perivascular fibrosis, inflammation, and acceleration of atherosclerosis
  • may be difficult to distinguish from atherosclerosis
  • pt often presents with claudication several months after ration treatment
A

radiation-induced arteritis

41
Q
  • congenital narrowing of the ascending or thoracic aorta (can effect abdominal)
  • causes bilateral decrease pluses and segmental pressures
  • LE ischemia
  • on RVT think “youth”
A

coarctation of aorta

42
Q

media is weakened; intima develops tear through wich blood leaks into the media (false lumen)

A

dissection (aorta) trama

43
Q

John Ritter’s cause of death

A

aortic dissection

44
Q
  • primary and secondary
  • commonly affecting young women
  • intermittent digital ischemia caused by digital arterial spasm from exposure to cold / emotional stress
  • bilateral
A

Raynaud’s phenomenon

45
Q

primary Raynaud’s syndrome

A

intermittent vasospasm, symptoms unassociated with any other disease process/idiopathic
caused by cold or emotional stress

46
Q

secondary Raynaud’s syndrome

A
  • connective tissue disorders
  • arterial occlusive disease one or more digits
  • TOS
  • trauma
  • blood disorders
  • disease that blocks the arteries
47
Q

compression of an artery between two muscles

A

entrapment syndrome

48
Q

the two types of entrapment syndrome

A

-popliteal and thoracic outlet syndrome

49
Q
  • compression of pop. artery by the medial head of gastrocnemius muscle or fibrous bands
  • found in young men
  • bilateral in a third of cases
  • symptomatic arterial occlusion or intermittent claudication
A

popliteal entrapment syndrome

50
Q

normotensive

A

normal bp

51
Q
  • inflammation of the periosteum where the muscle fibers are attached
  • pain in the shin area
  • treatment: rest, ice, low-impact exercise
A

shin splints

52
Q
  • rare condition affects the shoulder and UE in young and middle-aged adults
  • abnormality w/neurovascular bundle compression by the shoulder structures, usually occurs only in certain positions
  • symptoms due to neurogenic compression of the brachial plexus (97%)
  • ** non-threatening
A

Thoracic Outlet Syndrome

53
Q

TOS is the area where the _______ artery and ________ leave the chest and pass between the anterior and middle scalene muscle over the 1st rib and underneath the clavicle.
This is a compact anatomical area.
seen in muscular people.

A

subclavian, brachial plexus

54
Q

symptoms of TOS

A
  • aching discomfort of shoulder, radiates down the forearm
  • cold, painful, numbness, that varies with position
  • parasthesia, due to compression of nerves
  • arm claudication
  • 90% are neurogenic
55
Q

new non-invasive assessment of TOS

A

White Hand Sign**

56
Q

how is TOS diagnosised

A
  • PPG and or Doppler waveforms utilized to monitor any changes
  • attach PPG to index finger or CW Doppler to radial artery
  • resting waveforms are obtained, place arm in various positions
  • abnormal changes with waveform with movement of arm
57
Q

what position is used to diagnose TOS

A

Adison position

58
Q

treatment for TOS

A

surgical removal of cervical rib and division of fibrous band to relieve compression

59
Q

livedo reticularis***

A

purple patches on skin

60
Q

what are the skin changes in TOS

A
  • pallor: deficient in blood supply
  • rubor: hyperemia, blood pooling in the arterioles; dark red
  • cyanosis: deoxygenated blood
61
Q

what are the temperature changes with TOS

A
  • symmetrical coolness = vasoconstriction

- asymmetrical coolness = arterial insufficiency

Vascular Sonography (8 decks)

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