Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Vascular > Peripheral Arterial Evaluation > Flashcards

Peripheral Arterial Evaluation Flashcards

0
Q

Arterial is more _______ not pain like in venous

A

cramping

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
1
Q

Peripherial arterial evaluation is because of a ________ disease

A

progressive

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

peripheral arteries develop ________

A

plaque

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Why would you need an arterial study?

A

chronic atherosclerosis

acute occlusion

aneurysm

pseudoaneurysm

arteriovenous fistula

follow of bypass grafts

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are some reasons for noninvasive arterial testing?

A

pulsatile masses

suspected arterial trauma

angioplasty/stent placement

post op f/u including bypass graft surveillance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What do you need to see when looking at arterial circulation?

A

reduction of blood flow

condition of artery

collateral branches

changes with exercise

single or multiple level disease - where on the leg is the disease?

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is PAD?

A

peripheral arterial disease

aka: poor circulation

atherosclerosis

effects 8-12 million in USA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

If you don’t treat PAD what may occur?

A

worsening claudication

leg bypass surgery

leg amputation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what is claudication?

A

may include:

pain

numbness

aching

heaviness

may also affect:

buttocks, thighs, calves and feet

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are the risk factors for arterial?

A

age

family history

male

HTN

Diabetes 4x more likely

elevated cholesterol

hyperlipidmia

smoking

atheroscerosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is the treatment for arterial disease?

A

lifestyle modification

dietary changes

exercise

smoking cessation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

How can you fix arterial circulation problems if lifestyle doesn’t work?

A

grafts,

angioplasty,

stent

medication

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What needs to be determined for arterial fixing?

A

restriction of flow

where

how severe

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are the symptoms of PAD?

A

mild - asymptomatic

moderate - claudication (cramping) (asymptomatic at rest) **most common symptom

severe - night pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are some adjectives that might describe claudication?

A

cramping

tightness

heaviness

tired

fatigued

charlie horse

sharp

dull ache

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

The ______of disease is _______to the location of the symptoms

A

level

proximal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

if you have thigh pain, where is the arterial disease?

A

aortoiliac disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

if you have calf pain where is your arterial disease?

A

femoral or popliteal disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is claudication?

A

walking induced muscular discomfort - cramping

relieved by rest

not severe pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is the next level of pain after claudication?

A

ischemic rest pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is ischemic rest pain?

A

pain in horizontal position ( at night)

relieved by standing or dangling the foot in a dependent postion

decreased peripheral pulses

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Blockages can occur in _______than one vessel

A

more

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

if you have a blockage what happens to the muscle?

A

below the blockage begins to die

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Describe advanced lower extremity disease

A

ischemic

elevation = pallor (white

dependent (hanging down) = rubor (red)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What happens beyond ischemic rest?

A

tissue loss

gangrene and necrosis

insufficient blood supply

ulceration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What is the order of disease?

A

claudication

ischemic rest

gangrene

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

what is pulse palpating?

A

doctor determines the pulse force grading by touch

0 - absent

1 - weak, thready

2 - normal

3+ - bounding

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What are the 7 P’s of acute arterial occlusion

A

pain

pallor

pulselessness

paresthesia (numbness)

paralysis (weak)

polar

purplish

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What are the arteries for a peripheral artery study up to the knee?

A

aorta

common iliac arteries

IIA and EIA

CFA

SFA

profunda femoris artery (DFA)

popliteal artery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

What are the arteries of the lower leg?

A 
popliteal
anterior tib
post tib
dorsalis pedis
plantar arch
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What are branches off of the aorta?

A

from left to right:

rt: INNOMINATE (brachiocephalic) (branches into rt subclavian, rt CCA)

LCCA
Lt SUBCLAVIAN

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

what are the arteries of the arm?

A

axillary artery

brachial artery

radial

ulnar

palmer arches

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

What is the standard of care for arterial flow?

A

arteriography

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

how will you get the patient ready in order to do an arterial study?

A

keep room warm to allow for peripheral dilation

supine

performed at rest

cuff placement is key

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Where do you put the cuffs?

A

PVR - pulse volume recording (plethysmography)

at high thigh

low thigh

below knee

ankle

toe measurements are recommended

35
Q

What do the cuffs do?

A

segmental systolic pressures at the different levels

assess both limbs

gives a wave (PVR)

not doppler* just a wave form by a different machine

36
Q

Do you scan when you do a PVR? Is it doppler?

A

no and no

37
Q

What does the PVR indicate?

A

changes in segmental limb volume with cardiac cycle

38
Q

draw the wave forms for normal to mild PAD

A

normal - high peaks

severe - little lumps

see slide 47 for picture

39
Q

Calf recordings may have a _______ artifact which produces a ________amplitude than that in the thigh

A

cuff

higher

40
Q

if amplitude of calf is ______ or _______than the thigh SFA disease is suspected

A

equal

smaller

41
Q

What two things are measured for PAD?

A

pressure

pulsed volume record

42
Q

why should legs be at the same level as the heart?

A

because this position avoids hydrostatic pressure artifact

43
Q

What is the rest period for an arterial study?

A

15-20 min

44
Q

What should the pressure cuff width be?

A

20% greater than the diameter of the limb

45
Q

how far do you inflate the cuff?

A

20-30mmHg above systolic pressure

46
Q

The part of the cuff that gets the air?

A

the bladder

47
Q

What are the advantages of the arterial study?

A

simple to perform

short test time

objective data

instrumentation cheaper than imaging

48
Q

What is PPG?

A

photoplethysmography

for digit arteries

uses infrared light to respond to blood circulation

49
Q

What are the limitations for arterial testing with pressure cuffs?

A

casts or bandages

CHF

temperature changes

doppler angle

50
Q

Why would you do toe pressure?

A

evaluate distal limb and foot perfusion

51
Q

if the ankle pressure is below 55mmHg what happens?

A

possible amputation

ischemic lesion will not heal

52
Q

What do you assess if you doppler the arteries?

A

CW doppler

CFA, SFA, PA, ATA, and PTA

assess on both limbs

53
Q

be able to tell the difference between the doppler wave form and the PVR

A

slide 62 has picture

54
Q

For CW doppler what is is the angle needed?

A

45-60 degrees

55
Q

How do you figure out the ankle-brachial pressure (ABI)?

A

take the ankle pressure on the selected side

divide by the highest arm pressure (which ever arm is the highest)

used to diagnose arterial disease the systolic number (top)

56
Q

what is the ABI numbers from normal to tissue loss?

A

normal > 1.00

claudication 0.50 - 0.90

rest pain 0.30 - 0.50

tissue loss < 0.30

57
Q

if there is a difference of ________mmHg between the arm pressure and the leg there is a problem

A

20 mmHg

58
Q

What kind of flow do you find in peripheral arteries?

A

triphasic

59
Q

What is the Pulsatility index?

A

PSV - PDV / MEAN VELOCITY

inverse relationship with arterial disease

PI high = no arterial disease

PI low = disease

60
Q

What would a triphasic waveform indicate?

A

normal artery

61
Q

what would a biphasic waveform indicate?

A

increased velocity through mild stenosis

62
Q

How does a monophasic waveform appear?

A

greatly increased velocity through tight stenosis

63
Q

femoral artery waveform picture

A

triphasic - see slide 89

recognize the picture waveform different from aorta

64
Q

What do you adjust for arterial studies?

A

red is assigned to arterial flow

color scale (PRF)

color gain

color box

65
Q

What is the PRF when you see the baseline??

A

the numbers along the side

66
Q

How should the PRF (scale) (sampling rate) be adjusted for venous vs arterial studies?

A

Venous Arterial

low PRF High PRF

67
Q

What determines the PRF?

A

the depth

68
Q

If you cant get a good waveform what should you check?

A

see if the PRF needs to be adjusted

Up for arterial (fast flow)

down for venous

down for slow flow (ovary, testicle, thyroid)

69
Q

What is the wall filter?

A

Filters out low frequency and slow moving

aka: high pass filter, wall-thump filter

helps reduce movement when set high (echocardiogram - eliminates movement from the thumping of the heart)

for GENERAL - we want a low wall filter

70
Q

If you have a 50-99% diameter reduction stenosis what does it produce on the spectral waveform?

A

monophasic waveform

extensive spectral broadening

PSV of more then 100% relative to the proximal adjacent area

71
Q

What are some complications of the upper extremity arterial system?

A

arterial embolization from the heart

thoracic outlet syndrome

Raynaud’s

72
Q

What is thoracic outlet syndrome?

A

(affects the arms and causes them to go numb because the vessels are compressed for some reason)

impingement of the vessels - compression

Tests:
segmental pressure and PVR and CW

Subclavian artery stenosis with duplex

73
Q

What is Raynaud’s phenomenon?

A

fingers become white due to lack of blood flow

then blue as vessels dilate to keep blood in tissues

finally red as blood flow returns

74
Q

Arterial obstruction might cause what condition in the hands?

A

Raynaud’s

intermittent pallor in response to cold

75
Q

What is primary Raynaud’s?

A

no underlying disease - transient

76
Q

What is secondary Raynaud’s?

A

vasospasm

secondary to disease

77
Q

What do you test with indirect arterial testing?

A

brachial pressures should be obtained in both arms

78
Q

What is reactive hyperemia?

A

purposely increasing the pressure in the cuff to determine blood flow

79
Q

What is Takayasu’s Arteritis?

A

Pulseless disease

diminished pulses

Artery issue throughout the body - non atherosclerotic

80
Q

How does a dampened monophasic waveform appear?

A

with reduced velocity

see slide 83 to learn from the pictures

81
Q

What is a subclavian steal?

A

stenosis of the subclavian artery

subclavian artery steals blood from the contralateral vertebral

produces reversed vertebral flow

82
Q

What arteries can you get aneurysms in?

A

aorta

iliac

CFA

Popliteal Artery

83
Q

What is a pseudoaneurysm?

A

perivascular collection

neck collection

results to trauma

84
Q

What are the different kinds of grafts?

A

aorto-bifemoral (bypass diseased aorta or iliacs)

femoral to femoral - jump graft

Vascular (6 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions