Peripheral Vascular

Question 1

What is AAA

Answer 1

may become manifest as aneurysmal dilation, the abdominal aorta is frequently affected. >5 cm width will have 20% chance of rupture.

Question 2

What is microvascular dx?

Answer 2

occurs with pts with diabetes. Changes in small arterioles in the skin or nerves. Responsible for development of peripheral neuropathy

Question 3

How to inspect?

Answer 3

Look for symmetry of the extremities, if extremity is cool, means arterial insufficiency

Question 4

How to assess abdominal aorta?

Answer 4

palpate deeply but gently into the mid- abdomen. Presence of a mass with laterally expansive pulsation suggests AAA. (normal width is 2-3 cm)

Question 5

How to rule out abdominal bruit?

Answer 5

Listen to abdomen, about 5 cm above the umbilicus (aortic bruit). Listen to abdomen about 5 cm above umbilicus and 1-2 inches laterally to either side (renal bruit). Can be found in normal individuals and those with hypertension

Question 6

How to grade pulses?

Answer 6

0= absent
\+1= diminised
\+2= normal
\+3 = increased
\+4 = bounding

Question 7

What is lymphangitis?

Answer 7

Inflammation of the lymphatic channels due to infection, can manifest as red streaks to the skin. Pt will report fever, chills, malaise, headache, decreased appetite and muscle aches

Question 8

What is lymphedema?

Answer 8

Obstruction to the lymphatic flow, can be indistinguishable from other types of edema

Question 9

What is the ankle brachial index?

Answer 9

Quick non invasive test
ratio of the blood pressure in the lower legs to the blood pressure in the arms
lower BP in the legs suggests peripheral vascular disease
ABI = ankle systolic/brachial systolic

Question 10

what is claudication?

Answer 10

pain in the lower extremities with activity and relieved by rest = intermittent claudication
site of pain is always distal to the site of occlusion
as the dx progresses, pain at rest occurs
aggravated by cool temperatures and elevations

Question 11

what is chronic arterial insufficiency?

Answer 11

Extremity is cool and pale

Question 12

What is chronic venous insufficiency?

Answer 12

extremity is warmer than normal, common for erosions to result. Edema in dependent areas

Question 13

How do you get an ulceration?

Answer 13

Persistent ischemia of the limb is associated with ischemic ulceration and gangrene

Question 14

Describe an arterial wound?

Answer 14

appear punched out and as a result of injury. Common to toes and heel, and is very painful

Question 15

Describe a venous ulcers

Answer 15

venous ulcer are stasis ulcers, tend to be painless and occur around the ankle or lower leg

Question 16

What are the signs of acute arterial occlusion?

Answer 16

Pain, pillow, pulselessness, paresthesia and paralysis

Question 17

what is necrobiosis lipoidica and diabeticorum?

Answer 17

The cutaneous hallmark of diabetes. Waxy, yellow or reddish brown, sharply demarcated, plaque like lesions. Typically found on anterior lower legs. Lesions have a tendency to ulcerate

Question 18

What is deep vein thrombosis?

Answer 18

Characterized by unilateral marked swelling, venous distention, erythema, pain and increased warmth and tenderness. Often resistance to dorsiflexion of the ankle. Calf swelling is common in femoral or popliteal involvement. Thigh swelling occurs with iliofemoral thrombosis

Question 19

What is Homan’s sign?

Answer 19

pain with gentle dorsiflexion of the ankle. Not very sensitive and seen with DVT

Question 20

What is Raynaud dx?

Answer 20

Is primary or idiopathic. causes the blood vessels in the fingers or toes to constrict

Question 21

What is Raynaud phenomenon

Answer 21

normally secondary ( following an illness like an autoimmune dx)