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VASCULAR URR > Physiologic Exams > Flashcards

Physiologic Exams Flashcards

1
Q

How should you prepare the patient to start the examination used to assess the venous refill time using photoplethysmography

A

seated at the edge of the table with lower legs dangling, sensor placed at medial malleolus

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2
Q

What are the average treadmill settings utilized in exercise testing

A

2mph at 12% grade

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3
Q

Where is the recommended placement for the pneumatic cuff when using a rapid cuff inflator to evaluate the distal femoral vein and GSV

A

upper calf

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4
Q

A patient presents with a history of recurrent upper extremity DVT due to paget schroetter syndrome. The referring physician ordered a PVR exam of the upper extremities instead of a venous doppler exam of the upper extremities. Why

A

to rule out thoracic outlet syndrome

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5
Q

The upslope of a waveform is called-
The downslope is called-

A

anacrotic, catacrotic

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6
Q

You are preparing for a lower extremity segmental pressure exam on a patient with leg pain. She was admitted to the hospital 2 days ago due to extensive lower extremity DVT. How will you proceed

A

obtain doppler waveforms and toe-brachial indices

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7
Q

You are evaluating a patient with suspected Raynaud disease using PPG. After obtaining a baseline tracing, you place the hand in cold water for 2 minutes. Once the hand is removed, PPG sensors are reapplied to the fingertips. Which of the following correctly describes normal results for this exam

A

waveforms return to baseline within 5 minutes after removing the hand from the cold water

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8
Q

What is the normal change in flow velocity in response to releasing the cuff during reactive hyperemia

A

increase to more than double the resting flow velocity

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9
Q

Lower extremity arterial segmental pressure exam resulting in a post exercise basal pressure recovery time of ________ suggests single level disease. Longer than 6 minutes is

A

2-6 minutes, multi level disease

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10
Q

Lower extremity arterial segmental pressure exam results in a post exercise basal pressure recovery time of 2 to 6 minutes which suggests

A

single level stenosis

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11
Q

When performing a lower extremity venous doppler for insufficiency, a minimum of ___________ between augmentation maneuvers is recommended

A

30 secs

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12
Q

A normal lower extremity arterial response to reactive hyperemia is

A

<35% drop in ankle pressures that return to normal within 1 minute

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13
Q

What setting on the photoplethysmography system should remain constant during an extremity arterial evaluation and if it is adjusted it must be documented on the tracing

A

size control

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14
Q

What patient would benefit from an exercise segmental pressure exam

A

patient with claudication and a resting ABI of 0.95

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15
Q

What technique can be used to assess the presence and timing of reflux in multiple vessels simultaneously

A

color doppler

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16
Q

Patients experiencing claudication typically have an ABI of

A

0.5-0.9

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17
Q

The Adson maneuver is helpful in the diagnosis of what vascular disorder

A

thoracic outlet syndrome

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18
Q

An abnormal penile/brachial index will be

A

<0.65

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19
Q

When evaluating suspected thoracic outlet syndrome, a PPG exam can be performed with the sensor placed on the ______ or a doppler exam can be performed with the transducer placed _________

A

2nd digit, on the radial artery

20
Q

An arterial duplex exam demonstrates monophasic flow in the popliteal and calf arteries. The bilateral ABI calculations are over 1.0. What type of testing can be used to better evaluate the pressures in the lower extremities in this patient

A

digit plethysmography

21
Q

What is a normal response from the capillary beds of the feet and ankles after 5 minutes of vigorous exercise

A

vasodilation

22
Q

Which extremity arterial evaluation technique can be describes as the placement of multiple cuffs around the extremity that measures the volume changes beneath them

A

pulse volume recording

23
Q

The normal pressure in the lower extremity digits is normally at least _______ of the brachial pressures

A

60%

24
Q

If the systolic brachial pressure is 116mmHg, the toe pressure would be considered normal if it is _______ or greater

A

70mmHg

25
Q

If the VRT returns to a level above 20 seconds, this indicates the insufficiency is in the

A

superficial system

26
Q

If the VRT remains abnormal with the superficial system “cut off” by the tourniquet, this indicates

A

deep venous system insufficiency

27
Q

Venous PPG tracings are obtained. The right side demonstrates a venous refill time of 14 seconds. The left side demonstrates a refill time of 23 seconds. What describes the next step in evaluation

A

a tourniquet will be applied to the right leg at the thigh level and the VRT assessment will be repeated

28
Q

When the patient exercises, the leg muscles require more blood flow for proper operation. The resistance will __________ at the ankle to allow the increased flow in diastole

A

drop

29
Q

When a patient performs exercise on a treadmill what will be the normal change in arterial flow in the legs

A

increased antegrade flow in diastole

30
Q

Photoplethsymography uses _______ to detect changes in venous volume in the leg

A

light

31
Q

What is a reason to perform exercise with a segmental pressure exam

A

to differentiate true claudication from pseudoclaudication

32
Q

Subcutaneous blood supply to the digits can be evaluated using which non-invasive plethysmography technique

A

photoplethysmography

33
Q

__________ uses photocells to detect the changes in blood cell volume in subcutaneous tissue during the cardiac cycle

A

photoplethysmography

34
Q

When using the 4 cuff method to obtain segmental pressures in the legs, the blood pressure in the proximal thigh normally exceeds the brachial systolic pressure by ________mmHg

A

30-40

35
Q

If the flow velocity in a lower extremity arterial bypass graft falls below ______, graft failure is suspected

A

40cm/s

36
Q

The patient is experiencing rest pain which is found in patients with an ABI

A

less than 0.5

37
Q

A patient presents with left lower extremity pain that awakens him at night. The pain is relieved by sitting at the side of the bed for a few minutes. What would the predicted ABI value be for the left leg

A

0.4

38
Q

When performing a treadmill test for PAD, exercise is normally performed ______. When performing a reactive hyperemia exam for PAD, the cuffs are inflated ________.

A

for up to 5 minutes, for up to 5 minutes

39
Q

The double peaked PPG tracing is indicative of ________ seen with _________

A

vasospasm, raynaud syndrome

40
Q

A double peaked waveform obtained during PPG evaluation of the digits of the left hand is indicative of

A

raynaud syndrome

41
Q

Rest pain is associated with ankle pressures less than _______ and toe pressures less than _______ will be associated with a non-healing wound

A

50mmHg, 30mmHg

42
Q

Abnormal results for an arterial segmental pressure evaluation with exercise will include

A

25% or greater decrease in ankle pressure post-exercise with basal pressure recovery time >3min

43
Q

Why should a segmental pressure exam be performed with the patient supine

A

to eliminate the influence of hydrostatic pressure on the ankle pressures

44
Q

Venous insufficiency is assessed by placing the sensor on the

A

distal calf

45
Q

Arterial disease is assessed by placing the sensor on the

A

pads of the toes

46
Q

Abnormal results for a penile doppler evaluation that suggest impotence include _______ peak systolic flow velocity and a peak pressure ________

A

<30cm/s, <60mmHg

47
Q

The lower extremity segmental pressure exam is most commonly performed with a/an _________ to obtain the doppler signal for the pressure measurements at the ankle

A

8-10MHz CW doppler probe

VASCULAR URR (6 decks)

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