Testing considerations, patient history, mechanisms od disease, and physical examination Flashcards
What website contains resources to assist physicians in making a determination in a diagnostic study?
www.svu.net
Society for vascular ultrasound
What website includes common indications, contraindications, and limitations?
www.svu.net
Society for vascular ultrasound
What website has guidelines on appropriate indications related to reimbursement policies?
www.cms.gov
Centers for Medicare & Medicaid services
What can cause peripheral constriction?
Patient being cold, anxious, tense, or in pain
All noninvasive studies are based on clinical standards and guidelines (protocols), which should include the following for each study:
Capabilities
Limitations
Patient positioning
Technique
Interpretation
What is the IAC?
Intersocietal Accreditation Commision
_________ states that all reading physicians in the facility must agree on and utilize uniform diagnostic criteria.
Intersocietal Accreditation Commision (IAC)
Some examples of required elements of a final report:
*Date of study
*Clinical Indication
*Description of study
*Description of positive and negative finding
*Description of disease in terms of location, extent, severity, and etiology
*Incidental findings
*Reason for technically limited or incomplete exam
*Summary/impressions/conclusions in view of the findings
*Comparison with a previous study
*Name of sonographer and interpreting physician
*Preliminary report
What is claudication?
Pain in muscles occurring during exercise but subsiding with rest.
True claudication results from inadequate blood supply to the exercising muscle which may be caused by:
Arterial spasm
Atherosclerosis
Arteriosclerosis
Occlusion
Differential diagnosis of claudication include:
Neurogenic (nerve involvement)
Musculoskeletal
Various types of claudication incude:
Buttocks claudication
Thigh claudication
Calf claudication
Which claudication suggests aortoiliac disease?
Buttocks claudication
If symptoms in buttock claudication is unilateral, it suggests ____________ disease.
Iliofemoral
Which claudication suggests distal external iliac/common femoral disease?
Thigh
Which claudication suggests femoral/popliteal disease?
Calf claudication
What is it called when a patient complains of pain in a specific part of the leg after walking two city blocks?
Two-Block claudication
What is ischemic rest pain?
A more severe symptom of diminished blood flow to the most distal portion of the extremity.
With ischemic rest pain, pain at rest usually occurs when the limb is not in a dependent position and the patient’s blood pressure is ___________.
Decreased
(ex: when sleeping)
With ischemic rest pain, symptoms occur in
forefoot
heel
toes
not in the calf
What is necrosis?
Tissue loss/death
What causes necrosis?
deficient or absent blood supply
What is the most severe symptom of arterial insufficiency?
Necrosis
What are the 5 p’s (symptoms) of acute arterial occlusion?
Pain
Pallor
Pulseless
Paresthesia
Paralysis
What are the extra 2 p’s of acute arterial occlusion?
Polar (cold)
Purplish
Occlusion may result from:
Thrombus
Embolism
Trauma
Symptoms of cold sensitivity include:
Pallor (paleness)
Cyanosis (bluish discoloration)
Rubor (dark red coloration)
Paresthesia (tingling/numbness)
Pain
__________ is a condition that exists when symptoms of intermittent ischemia of the fingers or toes occur in response to cold exposure well as emotional stress.
Raynaud’s phenomenon
What are the risk factors and contributing diseases?
Diabetes
Hypertension
Hyperlipidemia
Smoking
Advanced age
Family history
Male gender
What is the most common form of risk factor?
Diabetes mellitus
________ is more common among diabetics and occurs at a young age.
Atherosclerosis
Diabetics have a higher incidence of occlusive disease of the ________ artery and _____ vessels.
Distal popliteal artery and tibial vessels
Medical calcification develops in the ______ _______ arteries.
Lower extremity arteries
With diabetes, there is a ______ incidence of gangrenous changes and, ultimately, amputations.
higher
Poor sensation as a result of neuropathy leads to increased likelihood of _____ .
trauma
T/F? It is unclear whether high blood pressure is a causative factor or enhances and complicates the development of the atherosclerotic process.
True
______ ______ is associated with a greater incidence of coronary atherosclerosis and also increases an individual’s susceptibility to peripheral and cerebrovascular involvement.
Systemic hypertension
Elevated plasma lipids are closely associated with the development of atherosclerosis because hyperlipidemias are _______________.
Insoluble in water
Chemicals in cigarettes irritate the endothelia lining of the arteries in addition to causing ____________.
Vasoconstriction
What is the most common arterial pathology ?
Atherosclerosis
Atherosclerosis is applied to a number of pathologic conditions in which there is:
Thickening
Hardening
Loss of elasticity of walls
Atherosclerosis most often occurs in the:
*Carotid bifurcation
*Origins of the brachiocephalic vessel
*Origins of the visceral vessels
*Infrarenal aortoiliac system
*Common femoral bifurcation
*Superficial femoral artery at the adductor canal
*Popliteal trifurcation
What syndrome is caused by obstruction of the terminal aorta?
Leriche syndrome
A _______ is an obstruction of a blood vessel by a foreign substance or blood clot.
Embolism
What is the most frequent cause of embolism?
Plaque or thrombus breaking loose and traveling distally until it lodges in a small vessel.
What syndrome may be caused by ulcerated and/or atherosclerotic lesions, embolization, and inflammatory process of arteritis, and some angiographic procedures.
Blue toe syndrome
Pathology-related aneurysm types include:
True aneurysm
Dissecting aneurysm
Pseudoaneurysm
What type of aneurysm is a dilation of all three layers of the arterial wall, differentiating it from a false aneurysm, which does not contain all three layers.
True aneurysm
The most common location for arterial aneurysms is _________.
Infrarenal aorta
True or False: Patients with one aneurysm has a higher chance of having a second aneurysm (Usually located in the CFA or POP).
True
Some terms that relate to aneurysm shape include:
Focal aneurysm
Fusiform aneurysm
Saccular Aneurysm
Concentric Aneurysm
A diffuse, circumferential dilation of an arterial segment is a _________ aneurysm.
Fusiform
A localized outpouching of an artery, resulting from wall thinning and stretching is a _______ aneurysm.
Saccular
The main complications of aneurysm include:
- Rupture of aortic aneurysms
- Distal embolization of peripheral aneurysms
A ________ aneurysm occurs when a small tear of the intima allows blood to form a cavity between two wall layers.
Dissecting
A dissecting aorta usually occurs at _______.
Thoracic aorta
Two conditions must usually be met for a dissecting aneurysm to form:
Weakening of the media of the vessel and development of an intimal tear through which blood then leaks into the media.
What is a pseudoaneurysm?
A pulsating hematoma
True or False: With a pseudoaneurysm, there must be a communication from the main channel to the pulsatile structure in the tissue.
True
What is arteritis?
Inflammation of arterial wall
What are the types of arteritis?
Takayasu
Temporal arteritis
Polyarteritis disease
Buerger’s disease
What is the most common type of arteritis?
Berger’s disease (Thromboangiitis obliterans)
A congenital narrowing or stricture of the thoracic aorta that may affect the abdominal aorta as well is called ________.
Coarctation of the aorta
Clinical findings of coarctation of the aorta are:
Hypertension
Decreased pulses
Decreased segmental doppler pressures
True or False: Death can occur from the rupture of an aortic dissection.
True
