Peripheral Circulation/ABI

Question 1

Systemic Arteries and layers

Answer 1

FUNCTION: bring blood to tissues

LAYERS:
-tunica externa: attaches vessel to surrounding connective tissue; dense
-tunica media: smooth muscle that provides support, changes diameter
-tunica intima: inner layer; squamous epithelium (lines blood vessel)

-more elastic than veins

Question 2

What is the overall function of the peripheral circulation?

Answer 2

-transport of blood in the body

-transport O2 to the tissues

-transport of O2 from the tissues to the lungs, to the atmosphere

Question 3

Veins

Answer 3

-transport blood from tissue to heart

-less smooth muscle and connective tissue
-veins can hold more blood –> 70% total volume at any given time

-valves in veins prevent the backflow of blood

Question 4

Circulation BRINGS and REMOVES what to/from exercise muscle?

Answer 4

BRINGS
-oxygen
-nutrients: glucose and FFA

REMOVES
-CO2, lactic acid
-leads to heat dissipation

Question 5

During exercise, what happens to body pH and termperature?

Answer 5

increase temp

decrease pH–> more acidic

decrease affinity of oxygen for hemoglobin–> more released into circulation

Question 6

How many ppl are affected by PAD?

Answer 6

12%–20% of Americans aged 65 years and older.

Question 7

Claudication Scale

Answer 7

1) Definite discomfort or pain, but only at initial or
modest levels (established, but minimal)

2) Moderate discomfort or pain from which the patient’s attention can be diverted (e.g., by conversation)

3) Intense pain (short of grade 4) from which the patient’s attention cannot be diverted

4) Excruciating and unbearable pain

** WANT PATIENT TO STOP AEROBIC EX AT 3/4 on claudication scale before taking a rest

Question 8

What is ABI and how is it measured?

Answer 8

ABI measures ability of blood to flow in arteries –> . A low ABI number can indicate narrowing or blockage of the arteries in the legs.

ABI- measured by placing the patient in a supine position for 5 min

SBP both arms (higher in denominator)

SBP in dorsalis pedis and posterior tibial arteries (cuff above ankle and doppler ultrasound transducer)

RIGHT ABI= highest pressure in R foot/ highest pressure of both arms

Question 9

What is a normal difference in the pressure in the UE versus the LE?

Answer 9

10 mmHg

Question 10

Normal and abnormal ABI values:

Answer 10

Normal: if 0.91+

Mild obstruction: 0.70-0.90

Moderate obstruction: 0.40-0.69

Severe obstruction if <0.40 (may have symptoms at rest)

< or equal to 0.25 -severe limb threatening PAD

Question 11

How to assess if vasculature is doing its job:

Answer 11

SIGNS:
-pulse
-skin color, nail, and hair growth
-venous engorgement
-ulceration
-ABI segmental blood pressure

SYMPTOMS:
-claudication
-lightheadedness

Question 12

What is a differential sign of vasculature function?

Answer 12

ABI