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Vascular > Test 5 > Flashcards

Test 5 Flashcards

1
Q

why do women have a higher risk for DVT’s?

A

high levels of estrogen

may promote clotting and the large uterus can press against vessels and slow blood flow

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2
Q

where does pressure increase the pressure?

A

veins in pelvis and legs

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3
Q

how long does the risk for blood clots in women continue in pregnant women?

A

up to 6 weeks after you have the baby

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4
Q

why does your blood clot more easily when you pregnant?

A

body’s way of preventing too much blood loss during childbirth

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5
Q

what contains the female hormone estrogen?

A
  • combined contraceptive pill

- HRT

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6
Q

what does estrogen do to your blood?

A

causes blood to clot more easily

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7
Q

is there a increased risk for progesterone only?

A

no

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8
Q

what can be a significant risk factor for DVT’s?

A

travel

-sluggish blood flow in the bent and stationary legs

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9
Q

how does surgery increase for blood clots?

A
  • injury to your veins or surgery can slow blood flow

- general anesthetics can make them wider which can increase blood pooling then clotting

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10
Q

how does a cast increase risk for DVT’s?

A

injury to the vein during injury

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11
Q

why do cancer patients have a higher risk for DVT’s?

A

higher number of platelets and clotting factors in their blood (because cancer cells produce and release chemicals that stimulate the body to make platelets)

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12
Q

what are platlets?

A

blood cells that play an important role in helping your blood to clot

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13
Q

why may cancer patients under treatment have an increased risk?

A

when chemotherapy kills cancer cells, the cells can release substances that cause an increase in blood clotting. (coagulation)

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14
Q

what cancer treatment drug increases blood clots?

A

tamoxifen

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15
Q

what disease increases the disease of IBD?

A

IBD

-ulcerative colitis

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16
Q

what hospital stay may increase DVT?

A

having an operation for an inflammatory or abdominal condition such as appendicitis

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17
Q

cellulitis

A

bacterial infection if the deep layer of skin (dermis)

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18
Q

lymphedema

A

swelling in an arm or leg

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19
Q

tennis leg

A

term describing pain in leg caused by a tear in the inner head of gastrocnemius and plantaris muscle

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20
Q

muscle tear appeaerance

A

well localized hypo echoic interposed between medial head of the gastrocnemius and the soleus muscle, typical of a tear

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21
Q

bakers cyst

A

longitudinal image of the calf

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22
Q

what is seen posterior to knee joint in ruptured baker’s cyst?

A

hypo echoic effusion

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23
Q

what is the path of the ruptures bakers cyst?

A

superficially to medial head of gastrocnemius and dissects between the gastrocnemius and the soleus towards the ankle joint

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24
Q

where does the bakers cyst extend?

A

proximal to the formation of the schilles tendon by the soleus and gastrocnemius

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25
Q

what are vascular diagnostic procedures?

A
  • duplex imaging
  • ABI measurements
  • segmental pressures
  • exercise testing
  • reactive hyperemia
  • plethysmography, pneumo and photo
  • digital pressures
  • cold stress
  • penile
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26
Q

ankle-brachial index

A

comparison of ankle blood pressure to brachial blood pressure

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27
Q

what does ankle-brachial index effecient for?

A

documenting the presence of lower extremity arterial disease

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28
Q

ABI less than what has a sensitivity of 90% and specificity of 98% for detecting a stenosis over 50%

A

less than 0.9

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29
Q

where are blood pressure cuffs placed?

A

both arms and ankles

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30
Q

what pressure do you use for ABI?

A

highest brachial pressure and the highest of the 2 ankle pressures

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31
Q

how do you calculate ABI?

A
  1. brachial is taken on BOTH arms
  2. highest brachial systolic number is used
  3. posterior tibial and dorsalis pedis pressures are obtained
  4. highest systloic of 2 pressures is used in ratio

ankle/brachial

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32
Q

dorsalis pedis artery?

A

distal anterior tibial artery

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33
Q

what is a normal result in a ABI ratio?

A

greater than 0.9

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34
Q

what ABI indicates PAD?

A

under 0.9

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35
Q

the lower the ABI __________

A

the more severe the disease will be

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36
Q

what arteries can be assessed with doppler?

A

common femoral
femoral
popliteal
calf

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37
Q

what ratio indicates atleast 50% stenosis-using PSV?

A

a ratio of 2 or more between normal and stenosed segment

38
Q

what are used to measure BP in legs?

A

doppler ultrasound

blood pressure cuffs

39
Q

when are segmental pressures taken?

A

when there is intermittent claudication

40
Q

intermittent clauducation

A

pain subsides when walking ceases and resumes when walking resumes

41
Q

what is the BP in legs similar to?

A

BP in arms

42
Q

when there are lower pressure in legs, what does this mean?

A

plaque

43
Q

who are segmental pressures usually done on?

A

diabetics-prone to small vessel disease

44
Q

what is an indicator of severity of PAD with exercising?

A

fall in ankle systolic pressure after exercise

45
Q

describe exercise testing

A

Pressures are recorded at rest,then the patient is placed on treadmill for 3 minutes or as long as they can withstand the pain=claudication

46
Q

the higher the fall in pressure=____________

A

the more severe the PAD will be

47
Q

what is an alternative test for patients with heart conditions or shortness of breath?

A

reactive hyperemia test

48
Q

describe reactive hyperemia test

A
  1. thigh cuffs are inflated for 3-5 minutes than deflated
  2. ankle cuffs are inflated immediately and briefly, than deflated slowly
  3. using doppler, BP’s are taken at both ankles
49
Q

using reactive hyperemia test, what indicates PAD?

A

over 50% or more decrease in ankle pressure

50
Q

Plethysmography

A

pulse volume reading

measures blood flow within the arteries

51
Q

when may Plethysmography be used?

A
  • PAD
  • arm artery disease
  • thoracic outlet syndrome
  • Raynauds disease
52
Q

how many cuffs are used in Plethysmography?

A

3-4 blood pressure cuffs on thighs, calves, and ankles

53
Q

what is Plethysmography used in conjunction with?

A

segmental pressures

54
Q

Pneumoplethysmography (PPG)

A

ABI is measured first

55
Q

PPG toe pressure

A

uses an infrared PPG to determine small vessel vasculature distal to ankle

56
Q

what are toe pressure studies useful to determine?

A

ulcer healing potential in the diabetic foot

57
Q

PPG-venous reflux testing

A

measures effciency of musculovenous calf pump

58
Q

what does PPG-venous reflux testing measure?

A

changes in skin blood volume using a small light probe places on skin above ankle

59
Q

describe how venous reflux is determined?

A
  1. After exercising the calf by moving the foot up and down at the ankle, the patient rests
  2. The rate at which the blood returns to the skin is measured
  3. Poor emptying of the skin = venous reflux
60
Q

why is the assessment and diagnosis of lower limb peripheral arterial occlusive disease (PAD) is important?

A

it can lead progressively to disabling claudication, ischaemic rest pain and gangrene

61
Q

Pulse contours can be used to obtain the same information obtained from ___________

A

digital arteries

62
Q

what do pressure measurements of the toe allow us to predict?

A

the healing potential of foot lesion

63
Q

over 90% of foot lesions heal when toe pressure exceeds _________

A

30 mmHg

64
Q

what toe pressure are consistent with rest pain?

A

under 20 mmHg

65
Q

where are toe pressures especially useful in?

A

diabetic patients with in compressible calcific ankle arteries

66
Q

Photoplethysmography PPG

A

provides more reliable results and offers the you to view a waveform of blood flow from the tip of the toe

67
Q

In diabetic patients, what would ABI readings above 1.3 indicate?

A

hardening of the leg arteries

68
Q

why do hardening of leg arteries produce high ABI?

A

because arteries require more pressure to compress and toe arteries are used as an alternative

69
Q

when should diabetics take the ABI/toe test??

A

annually

70
Q

where are digital pressures placed?

A

pneumatic toe cuffs on big toe, ankle, and arm

71
Q

what does digital pressures predict?

A

outcome of future amputation due to PAD of small vessels in foot

72
Q

TBI

A

toe brachial index

73
Q

TBI over 0.8

A

no significant PAD

74
Q

TBI 0.2-0.5

A

claudication

75
Q

TBI less than 0.2

A

rest pain

76
Q

what is the cold stress test?

A

assesses the change in circulation of the digits in response to induced vasospasm

77
Q

what is used in a cold stress test?

A
  • PPG
  • PVR
  • digital thermisters
  • doppler and segmental pressures
78
Q

describe cold stress test

A
  1. waveforms are all recorded prior to cold water bath
  2. waveforms are recorded post cold water bath immediately and at several intervals until temperatures return to normal
  3. waveforms are analyzed and compared for change
79
Q

when is a penile doppler used?

A

presence of impotence-ED

80
Q

what may penile doppler be the result of?

A

nervous, arterial, venous and sinusoidal factors

81
Q

what are taken with doppler of the cavernosal artery?

A

baseline PSV and EDV

82
Q

what is used before doing a penile doppler?

A

60 mg of papavarine is injected intercavernosally to induce erection

83
Q

when is PSV and EDV measures in penile doppler?

A

5, 10, 15 & 20 minutes

84
Q

PSV penile doppler

A

indicator for arterial dysfunction

85
Q

EDV penile doppler

A

indicator for venous dysfunction

86
Q

what is MRI used for?

A

image arterial blood vessels for stenoses, occlusions, and aneurysms

87
Q

what does MRI display?

A

blood flowing through the vessel

88
Q

duplex imaging

A
  • safe
  • inexpensive
  • non-invasive
  • reliable
89
Q

what does duplex imaging help screen?

A

PAD

venous disease

90
Q

what is the drawback of duplex imaging?

A

accuracy however is operator dependant

Vascular (10 decks)

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