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Vascular Term 3 > Quiz 6 > Flashcards

Quiz 6 Flashcards

1
Q

what is PAD?

A

peripheral artery disease is a common circulatory problem in which narrowed arteries reduce blood flow to the limbs

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2
Q

what happens to the extremeties when one develops PAD?

A

extremeties do not recieve enough blood flow to keep up with demand

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3
Q

what causes intermittent claudication?

A

not enough blood flow is getting to the leg and the muscle cells are not getting the required oxygen when exercising

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4
Q

what is PAD also likely to be a sign of?

A

a more widespread accumulation of fatty deposits in other arteries as well as heart and carotids

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5
Q

what does PAD reduce?

A

blood flow to the heart and brain as well as the legs

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6
Q

what may be the cause of PAD?

A
  • blood vessel inflammation
  • injury to limbs
  • unusual anatomy of ligaments or muscles
  • radiation exposure
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7
Q

PAD with atherosclerosis has a risk of developing what?

A

critical limb ischemia

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8
Q

how does critical limb ischemia begin?

A

begins as open sores that dont heal, an injury, or an infection of your feet and legs

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9
Q

what may happen in the end with critical limb ischemia?

A

such injuries or infections progress and can cause tissue dealth (gangrene) and can cause amputation of the affected limb

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10
Q

fat deposits that build up in arteries supplying the heart and brain can cause what?

A

stroke or heart attack

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11
Q

what symptoms do most people with PAD have?

A

mild or no symptoms

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12
Q

what are intermittent claudication symtoms?

A

Muscle pain or cramping in the legs or arms that’s triggered by activity, such as walking, but disappears after a few minutes of rest

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13
Q

where is the location if claudication?

A

pain depends on the location of the clogged or narrowed artery

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14
Q

where is the most common location of cluaducation pain?

A

calf pain indication obstruction above this level in the popliteal or femoral artery

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15
Q

what are PAD symtoms?

A
  • Claudication/altered gait
  • Leg numbness or weakness
  • Coldness in the lower leg or foot, especially when compared with the other limb
  • Sores on the toes, feet or legs that won’t heal
  • A change in the color of the legs
  • Hair loss or slower hair growth on the feet and legs
  • Slower growth of the toenails
  • Shiny skin on the legs
  • No pulse or a weak pulse in the legs or feet
  • Erectile dysfunction in men
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16
Q

what does the physician look for signs of on a physical exam?

A
  • trauma
  • previous surgery
  • muscle wasting (asymmetry)
  • edema
  • erythema
  • hair abscent in PVD
  • skiny skin
  • haemosiderin deposits(brown pigment stain)
  • lipodermatosclerosis
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17
Q

where are arterial ulcers located?

A

arterial ulcers tend to be on the borders/sides of the foot

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18
Q

where are neuropathic ulcers located?

A

plantar surface of the foot

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19
Q

where are venous ulcers located?

A

venous ulcers tend to be on the medial aspect of the leg superior to the medial malleolus

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20
Q

what do doctors look for in palpation?

A
  • temperature (cool is poor circulation)

- pitting edema

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21
Q

ausculation

A

for femoral artery bruits, listening with a stethoscope in the groin area for wooshing sounds

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22
Q

where is the dorsalis pedis artery pulse?

A

on dorsal surface of the foot, running lateral to the tendon of the first toe

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23
Q

where is the posterior tibial artery pulse?

A

posterior and inferior to the medial malleolus

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24
Q

where is the popliteal artery pulse?

A

behind the knee, typically done with both hands

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25
Q

where is the femoral artery pulse?

A

in the femoral triangle/halfway between the ASIS and pubic tubercle

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26
Q

what do you ask your patient before starting the exam?

A
  • have you had any surgeries to your blood vessels
  • how far can you walk before pain starts (measure in blocks)
  • does the pain subside when you stop to rest
  • does it return when you resume walking
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27
Q

what does the sonographer visually assess for?

A

1-shiny skin
2-hairless especialy on toes
3-ulcers on the foot (diabetics)
4-asymmetry of limbs

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28
Q

what assesses peripheral vascular disease?

A

ankle-brachial pressure index (ABPI)

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29
Q

when may ABI be unreliable?

A

in patients with calcified arteries in the calf (often diabetic patients) or those with extensive edema

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30
Q

when ABI is unreliable, what should be used?

A

toe brachial pressure index (TBPI)

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31
Q

what is ischemic rest pain?

A

if peripheral artery disease progresses, pain may even occur when at rest or when lying down

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32
Q

rest pain may be intense enough to ___________

A

disrupt sleep

33
Q

what may temporarily relieve rest pain?

A

hanging legs over the edge of the bed or walking around the room

34
Q

what are risk factors for PAD and rest pain?

A
  • smoking
  • diabetes
  • obesity (BMI over 30)
  • high blood pressure (140/90)
  • high cholesterol (over 240)
  • increasing age (over 50)
  • family historyn PAD, heart disease or stroke
  • high levels of homocysteine
35
Q

what is homocysteine?

A

a protein component that helps build and maintain tissue

36
Q

who has the greatest risk of developing periheral artery disease due to reduced blood flow?

A

people who smoke or have diabetes

37
Q

what are signs of PAD?

A
  • a weak or absent pulse below a narrowed area of the artery
  • whooshing sounds over the arteries
  • evidence of poor wound healing in the area where blood flow is restricted
  • decreased blood pressre in the affected limb
38
Q

what is a common test ti diagnose PAD?

A

ABI

39
Q

what is ABI?

A

compares the blood pressure in the ankle with the blood pressure in the arm

40
Q

how is an ABI done?

A

walking on a treadmill and have readings taken before and immediattely after exercising to capture the severity of the narrowed arteries during walking

41
Q

how are blood tests done for diagnosis of PAD?

A

a sample of the blood can be used to measure cholesterol and triglycerides and to check for diabetis

42
Q

what is angiography?

A

injecting a dye (contrast material) into the blood vessels, allows a specialoist to view blood flow through thr arteries as it happens

43
Q

how to you examine flow with angiography?

A

X-ray imaging, magnetic resonance angiography (MRA), or computerized tomography angiography (CTA)

44
Q

what is a more invasive angiography?

A

catherdar angiogrpahy involves guiding a cathedar through an artery in the groin to the affected area and injecting dye that way

45
Q

what does cathedar angiography allow for?

A

simultaneous diagnosis and treatment

46
Q

what does angiography do?

A

finding the narrowed area of a blood vessel and then widening it with an angioplasty procedure or administering medication to improve blood flow

47
Q

cholesterol - lowering medications?

A

a cholesterol lowering drug called a statin to reduce the risk factor of heart attack and stroke

48
Q

high blood pressure medications?

A

the goal of this is to reduce the systolic blood pressure to 140 millimeters of mercury or lower the diastolic blood pressure to 90 mm Hg or lower

49
Q

what is the target blood pressure for a diabetic patient?

A

under 130/80 mmHg

50
Q

what is important to control in a diabetic patient?

A

control blood sugar (glucose) levels

51
Q

why is it importnat to reduce risk of blood clots?

A

becuase peripheral artery disease is related to reduced blood flow to the limbs

52
Q

what can cause tissue dealth?

A

a blood clot ca completely block an already narrowed blood vessel

53
Q

what is a common drug to reduce risk of blood clots?

A

plavix

54
Q

what may necessary to treat peripheral artery disease thats causing intermittent claudication?

A

angioplasty or surgury

55
Q

how is an anioplasty preformed?

A

a small hollow tube (cathedar) is threaded through a blood vessel to the affected artery and a small balloon on the tip of the cathedar is inflated to reopen the artery and flatten the blockage to increase blood flow

56
Q

what may also be done with angioplasty?

A

a doctor may also insert a mesh stent in the artery to keep it open

57
Q

what is angioplasty the same procedure as?

A

same one doctors use to open heart surgeres

58
Q

how may a doctoe allow blood to flow around or bypass the blocked or narrowed artery?

A

the doctor may create a graft using a vessel from another part of your body or a blood vessel made of synthetic fabric

59
Q

what is thrombolytic therapy?

A

if there is a blood clot blocking an artery, the doctor may inject a clot dissolving drug into the artery at the point of the clot to break it up

60
Q

what is step 1 for arterial testing protocol?

A

bilateral ABI measurements

61
Q

ankle brachial indice

A

Ankle/Brachial systolic pressure

62
Q

BRA pressure use what?

A

use the highest systolic measurement of the Lt or Rt arm

63
Q

legs pressure use what?

A

highest of the PTA or dorsalis pedis A

64
Q

what will the ABI indicate?

A

how much disease you may encounter

65
Q

what ABI is indicative of little or no hemodynamically significant stenosis?

A

> 0.9

66
Q

ABI mild disease

A

0.8-0.89

67
Q

ABI moderate disease

A

0.5-0.79

68
Q

ABI severe disease

A

<0.5

69
Q

ABI ischemic rest pain

A

<0.3

70
Q

what is always preformed in step 2 of arterial testing protocol?

A

bilateral exam is always preformed

71
Q

how do we image the arteries in step 2?

A

image the arteries from the groin to the proximal PTA/PER A and ATA

72
Q

what do we sagital scan through?

A
  • CFA
  • PFA origon
  • FA prox, mid and distal through adductor (hunters) canal
  • pop artery form prox to distal
  • trifurcation-each branch
73
Q

why is color analyzed?

A

for aliasing

74
Q

where are ratio measurement taken?

A

sites of narrowing/aliasing

75
Q

how do we obtain the ratios?

A

PSV prox to stenotic zone and highest attainable PSV in the stenotic zone

76
Q

what must be used when obatining ratios?

A

angle correct of 60 degrees

77
Q

what may be history to a person with arterial diseae?

A
  • HBP
  • high cholesterol
  • smoking
  • heart disease
  • claudication
78
Q

what do we take note of when reporting arterial disease?

A

ulcers and gangrenous digits

Vascular Term 3 (8 decks)

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