Peripheral Arterial Disease- Lecture 2 Flashcards
CW doppler has ____ crystals and angle of insonation is _____degrees
2, 45-60
-estimates the frequencies
-displayed on strip chart recorder
-not as common as spectral analysis
-zero-crossing frequency meter
can adjust the gain*
Analog
- displays individual frequencies using FFT method
- time is on horizontal axis, velocity or frequency shifts is on vertical axis
spectral waveform
peak systolic pressure is ______ as the pulse wave progresses down the lower limb
amplified
they systolic pressure measured at the ankle is normally ______ than that in the upper arm
higher
smaller vessels = ________ in resistance and ______ in diastolic flow component
increase, decrease
most reliable pressure parameter for diagnosis of arterial narrowing
peak systolic pressure/velocity
is CW qualitative or quantitative?
qualitative
first change seen with disease is ….
loss of reverse component
Monophasic can be found ______ and _____ to an occlusion
proximal, distal
vasodilation of the distal vessels often occur with _____ obstruction, reducing the pulsatility, causing the signals to have lower resistant (steady) flow quality
proximal
analog not capable of detecting velocities less than ____cm/sec
6
doppler typically used in lower extremities
CW
what should you adjust to get rid of noise
increase the filter and reduce the gain
quantitative interpretation
- pulsatility index
- acceleration time
- inverse damping factor
- transit time
Pulsatility Index
peak 1 to peak 2 divided by mean frequency
normal CFA and pop. PI
75.5 and 8
aortoiliac occlusive disease has an API of ….
less than 5
time of onset of systole to point of maximum peak velocity
decrease is normal
acceleration time
increased or prolonged amount of acceleration time indicates disease is present ______ to site of interrogation
proximal
greater than _____ msec in CFA/EIA suggests significant iliac disease
133
- ratio of distal PI to the proximal PI of a segment in an artery
- ratio of proximal SFA to distal
Inverse Damping Factor - IDF
normal Inverse Damping Factor (IDF)
0.9-1.1
Popliteal IDF of 0.9 or less suggests…
SFA occlusion or stenosis
- systole should be simultaneously evident at a specific site bilaterally
- a delay on one side may indicate a more proximal occlusive process
transit time
transit time is an ________ assessment
bilateral
cuffs for ABI should have width of _____% greater or ____ diameter of the limb
20, 1.2
the diastolic and mean pressure gradually ______ as the pulse wave moves distally
decreases
smaller vessels = _______ in resistance and ________ in diastolic flow component
increase, decrease
Obtain pressures starting at the _______, moving ____ the leg.
otherwise pressures would be falsely _______
ankle, up
lower
any reduction in distal ABI pressure should be less than _____mm Hg between adjacent segments
20-30
______ of thigh cuff changes interpretation
width
foot and toe ulcers will fail to heal if the toe pressure is less than _____ mmHg
30
concave is _______ downstroke whereas, convex is ________ downstroke
normal, abnormal
for exercise testing the treadmill should be at a less than _____% elevation at _____ mph for a maximum of ____ min or until pt must stop
12, 1-2, 5
what’s a common anatomical variant in the upper arm?
radial artery originates in the mid to upper arm
upper extremity arterial disease accounts for only ____% of all extremity ischemia
5
normal subclavian artery velocity is ….
80-120 cm/sec
most likely area in the upper extremity to have PAOD…
subclavian and proximal axillary arteries
a greater than ______ mmHg difference in brachial systolic pressure indicates a presence of greater than 50% diameter reduction of the subclavian artery (or under cuff artery)
a greater than _____ mmHg difference between adjacent segments indicates disease as well
20, 20
- evaluates patency of the palmer arch
- optional test that can be performed in conjunction with the upper extremity arterial doppler examination
Allen’s Test
