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PPG for final

PPG documents venous insuffciency
PPG has a quantitate venous (not qual) this gives number
screening procedure for detection of venous reflux PPG
Limitations of PPG acute dvt (contra), improper placement (like on varicose veins wont get accurate), thickening of skin ( bec/ wont penetration), or non intact skin (cant use tape)
PT positioning for PPG pt has dangling legs and non weight bearing
This measures volume changes these are physical properties of PPG
photo is not true plethysmography because its not true wont measure volume just light reflection
Photo is done where? in microcirculation
Photocell consitst of light emitting diode and photo sensor
diode trasmits infared light into subcut. Tissue, this is reflected back to sensor
Is light absorbed with photo pleth? no it is reflected back
what determines the reflection of the light in PPG cutaneous blood flow how fast
blood attenuates light in proportion to its content in the tissue
increased blood flow results in decreased reflection (but this is displayed as an increase/positive deflection on the waveform bigger waveform)
DC mode used for venous (doppler). detects slower changes in blood content.
AC mode used for arterial. Detects fast changes in blood content
calibration for PPG do not calibrate as with air pleth why? need same size or gain throughout so show signif. volume difference
tiny arterial pulsations normal for tiny veins
where put sensors 5
What use with strip recorder slow speed (5 mm/sec)
stylus records on heat sensitive paper
what do you instruct pt to do at beginning of exam? complete a series of exaggerated dorsiflexions to empty calf veins
what do you do if pt can not do dorsi flexions? manually compress calves bilaterally to ensure consistency
Why continue to obtain tracing after flexions/compressions? to record venous refill time/venous reactive time(VRT)
if the VRT is <20 sec what do you do? repeat the exam to eliminate influence of superficial system
what is a normal VRT? > or greater than 20 seconds without tourniquet
Interpretation VRT is quantitative
for superficial incompetence in VRT is? Less than 20 seconds w/o tourniquet but normalizes (>20) w/ tourniquet
deep system incompetence in VRT is? VRT of <20 sec. W/ and w/o tourniquet application
Artifact due to pt movement study technically impossible due duplex
Absent deflections or gross irregular tracings? ensure equipment is on DC mode and PPG settings
Deflections off the scale or barely discernible? adjust gain setting (only at first of test)
Normal then? normal VRT
Short time VRT then repeat then normal means superficial venous incompetence
short time VRT then repeat then short means deep venous incompetence
Created by: hseratt