Test 2 lecture 6 Flashcards by luke allen

What is Peripheral Arterial Disease (PAD)?

Obstruction arteries of the legs

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Peripheral arterial disease result in what? and what does this mean?

Claudication

2. Pain weakness numbness or cramping in muscle due to decreased blood flow

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What is the prevalence of PAD?

approximately 8 to 12 million people in the US

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Direct medical cost in 2001 due to the impact of PAD

4.37 billion dollars

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What group of people does PAD impact?

older people, men , African Americans , people with diabetes

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What are the metabolic and neural effects of PAD

1 impaired energy utilization
2 impaired resynthesis of ATP and CP 
3 low concentration of ATP and CP
4 loss of muscle fibers
5 lower metabolic efficiency of muscle 
6 mitochondrial damage
7 damage to peripheral nerves

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what are the risk factors of PAD?

1 older age
2 smoking 
3 diabetes 
4 dyslipidemia 
5 hypertension 
6 high C-reactive protein 
7 High homocysteine 
8 high fibrinogen 
9 high blood viscosity 
10 family history for cardiovascular disease

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intermittent claudication happens to what percentage of PAD patients? It also progressively occurs during what?

1) 35-40 %

2) shorter activity bouts

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What are the common comorbidities associated with PAD?

1 Heart disease
2 stroke or cerebrovascular disease
3 pulmonary disease and
4. diabetes

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what diagnostic tests are used to identify pad

blood test for risk factors,
 ankle-brachial index, 
exercise test, 
Doppler ultrasound, 
reactive hyperemia, 
CT or MR angiogram

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What is the ratio used to find the ankle-brachial index or ABI?

SBP and Ankle / SBP in arm

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Post-exercise ABI may help identify what?

severe ischemia

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Prognosis for PAD is (worse / great) when intermittent claudication is present.

worse

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prognosis is poor /great with critical limb ischemia.

poor

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prognosis for PAD is (lower/greater) with low functional capacity.

lower

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What are some lifestyle modifications that should take place in the treatment of PAD?

smoking cessation, diet, physical activity

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What are the different forms of treatment for PAD?

lifestyle modification, medication revascularization, amputation

What are the two forms of revascularization used to treat PAD?

bypass grafting and angioplasty

What are some of the things exercise improves for PAD patients?

pain free walking time and distance
risk factor profile
functional capacity
quality of life

true or false claudication disappears with exercise for PAD patients

false

what are some of the adaptations to exercise for pad patients

improved oxidative metabolism in muscles improved walking biomechanics
reduced blood viscosity
greater collateral circulation
better endothelial function
greater pain tolerance
higher pain free walking distance and time

true or false PAD patients have 115% increase in distance after 6 month

true

What test is used to help identify severe ischemia in legs?

ABI

Functional testing may not be true Preak __ ,but should record ____ and _____

1) GXT
2) time and distant prior to onset pain
3) time and distance prior to maximal pain

What speed are test usually ran

2 miles per hour

What are the most common protocols for exercise testing in Pat patients?

ramping protocols

true or false discontinuous protocols may be used

true

What is the relative indication for termination of a test for a PAD patient

3 on a 4 point Pain Scale

what type of activities are usually prescribed to PAD patients?

large muscle activities and walking

what is the frequency initially prescribed for pad patients.

two to three times a week

What is the intensity prescribed to PAD patients? What is the percent VO2 Reserve or heart rate Reserve?

Moderate | 40-60%

what is the duration (for exercise) prescribed for pad patients and how long is the recovery?

intermittent; 2-5min exercise and 1-2 min recovery

true or false? for strength and flexibility training PAD patients follow General guidelines

true

true or false pad patients have a higher risk for cardiac and cerebrovascular events

true (5-7% per year)

what are some of the ways people prevent pad

early evaluation of risk factors | modification of risk factor profile (medication and life style modifications)

what are the two pain classification methods for PAD patients?

Fontaine stages and Rutherford

true or false arteriosclerosis likely begins with endothelial dysfunction due to oxidative stress

true

true or false arterial stenosis increases blood flow to musculature

false (lowers or decreases)

true or false mild PAD is always symptomatic

false (mild PAD can be asymptomatic)

What percent of PAD patients has intermittent claudication?

35-40%

critical limb ischemia can include the presence of ischemic rest pain, foot ulcers, and gangrene.What is the percent of PAD patients with critical limb ischemia?

1 - 2%

what are some signs and symptoms of PAD

``` intermittent claudication, critical limb ischemia, noticeable differences from unaffected limb, sores or ulcers slow to heal, gangrene, and other symptoms of atherosclerosis ```