PPG, Toe Pressures Flashcards
True or False: Not all obstructions in the LE are due to atherosclerosis.
True.
True or False: Not all obstructions in the LE are due to atherosclerosis.
True.
What are the other LE vascular diseases?
- Buerger’s disease
- Acute embolism
What does arteritis mean?
It means the inflammation of your arteries.
What is Beurger disease?
It is the most common form of arteritis. It affects the upper but mostly lower extremity digits. May lead to tissue death and amputation.
What is another name for Beurgers disease?
Thromboangiitis Obliterans.
What is beurger disease associated with?
Heavy smoking.
Who does beurgers disease primarily affect?
It occurs primarily in young men <40 years of age.
What are the early symptoms of beurgers disease?
Rest pain and ischemic ulceration’s.
What is the most clinical presenation of beugers disease?
Gangrene.
What is acute arterial occlusion?
Sudden loss of blood flow to an area.
What can an acute arterial occlusion be caused by?
Embolism, trauma, thrombus, inflammation.
What type of situation is an arterial occlusion?
It is an emergency occlusion.
What is an indicator of an emergency arterial occlusion?
Patient with sudden pain and many of the 6 ‘P’s’.
What are the 6 “P’s” in an acute arterial occlusion?
- Pain (severe pain)
- Pallor (pale)
- Parathesia (feeling of pins and needles)
- Pulselessness (no pulse)
- Paralysis (can’t move toes)
- Poikilothermia (ice cold)
What is the 7th “P” that is occasionally used?
Purplish.
What is blue toe syndrome?
Microemboli that becomes stuck in the digit vessel and may yield purple or blue digits.
What are the symptoms of blue toe syndrome?
- Sudden appearence
- Painful
- Slow capillary refill.
Why are toe pressures important?
- They are important when a foot or toe symptoms are not explained by a low ABI (which would indicate a proximal obstruction).
- Helps determine potential for healing.
When do you use toe pressures?
when ankle pressures can not be obtained due to:
- Calcification
- Distal bypass
- Ulceration
What are some toe pressure techniques?
- Photoplethysmography (PPG)
- Doppler
- Strain guage
What does PPG measure?
It measures changes in light reflection due to volume of blood in skin under the device.
What size cuff do you want to use for the digit toe pressure?
Use a 2.5 cm digit cuff.
What happens when you use a smaller cuff?
It results in a higher pressure due to cuff artifact.
What is a normal toe waveform?
PPG waveform normally with dicrotic notch or downslope bowing toward baseline.
What is an abnormal toe waveform?
Very low amplitude and blunted, digits differ, flat.
What are PPG tracings very susceptible to?
Temp., caffeine, and smoking.
