Peripheral Vascular Disease

Question 1

Why is diastolic flow important?

Answer 1

to maintain tissue perfusion

Question 2

An increase in blood velocity/flow occurs at stenosis

Answer 2

velocity

Question 3

At 75% stenosis, what happens to flow and pressure?

Answer 3

decrease

Question 4

What is the ankle brachial index?

Answer 4

ratio of pressure in ankle to pressure in arm –> degree of impairment due to PAD

Question 5

Why is flow monophasic during a severe stenosis?

Answer 5

normally a velocity flow diagram will demonstrate a positive deflection followed by a negative deflection (wave reflection) followed by a positive deflection (next heart beat) –> during stenosis, collaterals pick up the flow instead so there is no wave reflection AND the velocity of each beat is extremely high

Question 6

How does exercise compare to stenting in PAD?

Answer 6

exercise is best in claudication

Question 7

How does diastolic flow compare in the internal and external carotid arteries?

Answer 7

internal has greater diastolic flow because (except for opthalmic artery) is the direct supply to the brain which requires constant flow

Question 8

Hollenhorst plaque

Answer 8

cholesterol embolus that is seen in a blood vessel of the retina (often from internal carotid)

Question 9

What is subclavian steal syndrome?

Answer 9

dizziness/vertigo due to vertebro-basilar and posterior cerebral circulation ischemia + arm claudication and rest pain due to retrograde flow in vertebral artery b/c of subclavian blockage

Question 10

Clinical presentation of chronic mesenteric artery ischemia

Answer 10

1. postprandial abdominal pain
2. weight loss + food fear + malabsorption
3. nausea, vomiting, diarrhea, and constipation

Question 11

What do flow diagrams for DVT look like?

Answer 11

abnormal continuous flow instead of normal phasic flow