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Vascular Sonography > Peripheral Arterial Disease- Lecture 3 > Flashcards

Peripheral Arterial Disease- Lecture 3 Flashcards

1
Q

capabilities of laser doppler

A
  • determine the healing potential of ulcer, would or amputation
  • can be utilized in calcified arteries, edema and check pedal flow in patients with diabetes
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2
Q

laser doppler

A
  • measures the characteristics of the microvascular blood volume in capillary beds of the skin***
  • uses optical light waves
  • skin perfusion pressure (SPP)
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3
Q

SPP laser doppler of _________ is good healilng
________ is marginal healing
________ less likely ulcers will heal

A

greater than 40mmHg
30-40 mmHg
less than 30 mmHg

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4
Q

vasculogenic impotence affects as many as ________ american men
_____ men have a varying degree of erectile dysfunction

A

one million, 30 million

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5
Q

causes of of vasculogenic impotence

A

hormonal imbalance
psychological neurogenic dysfunction
cavernosal venous leak
arterial insufficiency

-organic or psychogenic impotence***

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6
Q

what size cuff is used for PBI (penile Brachial Index)

A

2.5 cm x 9.0 cm

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7
Q

calcified plaque of the tunica

A

Peyronie’s disease***

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8
Q

non-imaging interpretation - PBI
Normal…
marginal…
abnormal…

A

normal PBI - greater than 0.75-1.0
marginal - 0.65-0.74
abnormal - less than 0.65

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9
Q

what PBI is consistent with vascular impotence?

reduced pressure highly suggestive of more proximal arterial disease

A

less than 0.65

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10
Q

penile flow should go from _____ resistance to ____ post injection

A

high, low

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11
Q

when testing for impotence, dorsal veins should _____ increase, which could suggest venous leak
normal EDV is less than _____ cm/sec
abnormal is greater than _____ cm/sec

A

not
5
6

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12
Q
  • little flow in cavernosa
  • arterioles in the corpora covernosa are constricted
  • high resistance flow
A

flaccid state

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13
Q

blood flow begins in _________ to __________ to________ (which is the main arterial supply to rectile tissue) to dorsal arterty

A

hypogastric, internal pudenal, cavernosal

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14
Q

physiology of erection

A
  • relaxation of vasoconstriction within cavernosal arteriole
  • blood flow increases into the corpora as resistance decreases (low)
  • increase in arterial inflow, decrease in venous outflow
  • blood is trapped, inflow and outflow temporarily ceases
  • tumescence occurs
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15
Q

in impotnece testing, the ________ arteries are assessed by PSV and EDV
after ____ min, repeat measurements in _____ min increments

A

cavenous
1-2
5

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16
Q

normal diameter of cavernous arteries should _______ post-injection
normal range greater than _____ cm/sec
marginal _____ cm/sec
reduced less than _____ cm/sec

A

increase
30-35
25-29
25

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17
Q

is PPG a true plethysmography?

A

NO

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18
Q

is PVR a true plethysmography?

A

yes

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19
Q

___ is most often used to evaluate the digits and penile vasculature

A

PPG

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20
Q

plethysmography is an _______ assessment and can’t discriminate between major arteries and collaterals

A

indirect

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21
Q

PVR:
VPR:
PCR:

A

pulse volume recording
volume pulse recording
pulse contour recording

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22
Q
  • records a volume change in a limb or organ related to pulsatile arterial flows
  • overall volume of flow coming into the limb segment with each heart beat (difference between arterial inflow and venous outflow)
  • PVR waveform analysis is accomplished by a combination of QUALITATIVE and QUANTITATIVE assessment
A

pulse volume recordings (PVR)

23
Q

biggest limitation of PVR

A

cannot distinguish stenosis from total occlusion**

24
Q

PVR troubleshooting

A

*** AC mode, calibration is required, very sensitive to pt conditions (ie: tremors)

25
Q

concave is _______ while convex wavforms are _______

A

normal, abnormal

26
Q

-transducer, amplifier and strip-chart recorder (toes/fingers)
-detects cutaneous blood flow changes and records pulsations NOT volume
-not true plethysmography
-in AC mode
sends infared light into the tissue w/light-emitting diode cutaneous blood flow is determined

A

PPG plethysmography

27
Q

toe cuffs at least ____ times that of the toe; usually _______ size

A
  1. 2

2. 5-3 cm

28
Q

anacrotic notch is consistent with …

A

vasospasms and Raynaud’s

amplitude of the waveform is greater in the fingers than in the toes

29
Q

following cold immersion, abnormal cold sensitivity is likely if the amplitude fails to return to baseline levels within ______ min

A

5-10

30
Q

_____ MHz transducer is used for UE

A

5-7

31
Q

proximal to stenosis: velocities are usually _______

A

dampened

32
Q

at the entrance, through, and end of stenosis:

A

increase in velocity with spectral broadening, flow becomes disorganized

33
Q

at the exit of a stenosis:

A

post stenotic turbulence characterized by flow reversals, flow separation, vortices, and eddy currents

34
Q

with pulsed doppler, _____ degrees is optimal angle

______ is acceptable in peripheral studies and ______ degrees is not doppler shift

A

0, 45-60, 90

35
Q

what should be evaluated in a dialysis access graft?

A
  • inflow artery
  • arterial anastomosis***
  • scan through the graft
  • observe for aneurysm, puncture sites, perigraft fluid
  • venous anatomsis**
  • outflow vein
36
Q

low PSV obtained throughout the access graft could suggest

A

an arterial inflow problem

37
Q

in dialysis access grafts, _________ and ________ are the most common site for stenosis

A

venous anastomosis, outflow vein***

38
Q

in dialysis access grafts there is increased ________ in the vein.
-intimal hyperplasia

A

arterial pressure

39
Q

early graft failure is from

A

intimal hyperplasia

40
Q

complications of dialysis grafts…

A
  • intimal hyperplasia
  • increase of IVC and hepatic veins
  • pt develop anemia in lower extremities and CHF
  • ‘steal syndrome’ distal arterial flow is reversed causing pain, pallor, and coolness
41
Q

a major pitfall of stenosis profile is ….

A

calcified vessels

42
Q

aneurysm is present if the diameter of a vessel is _____% times greater than the adjacent, more proximal segment

A

50

43
Q

Focal velocity greater than 100% suggests

A

a greater than or equal to 50% stenosis

44
Q

a stenotic PSV ra of greater than 400 cm/sec suggests

A

greater than or equal to 75% stenosis

45
Q

most common site for arteriovenous fistulae

A

CFA and CFV

-in-situ grafts most common complication

46
Q

considered the gold standard for diagnosis of arterial stenosis

A

contrast arteriography

47
Q

limitations of contrast arteriography

A
  • fails to visualize outflow and inflow in very low-flow situations
  • delays prompt treatment
  • misses thrombosed popliteal aneurysms
48
Q

used to vasodilate in extreme disease, not commonly used

A

sympathectomy

49
Q

a catheter with rotational device cuts and pulverizes the plaque

A

atherectomy

50
Q
  • a balloon-tiped catheter is used to dilate the vessel by pushing the plaque against the vessel wall
  • used for focal lesions in large vessels such as iliac artery, femoral and popliteal artery
A

angioplasty

51
Q

with renal transplants evaluate for increase kidney size and a RI of greater than _____ may suggest rejection

A

0.75

52
Q

renal-aorta ratio
less than ___ = less than 60% stenosis
greater than ___ = greater than 60% stenosis

A

3.5, 3.5

53
Q

synthetic grafts are used for ____ the knee

below the knee native veins are used (long term duration)

A

above

54
Q

preoperative arterial mapping

-radial artery evaluate for:

A
  • calcified wall
  • stenosis
  • diameter of vessel
  • measure peak systolic velocities proximal and distal

Vascular Sonography (8 decks)

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