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Vascular sonogrpahy
Vascular test 2 Arterial Symptoms
| Question | Answer |
|---|---|
| Why should the environment be warm for an arterial exam? | To reduce vaso-constriction |
| What are some signs and symptoms of chronic arterial insufficiency? (5 of them) | Intermittent claudication, ischemic rest pain, non-healing ulcers, gangrene, and trophic changes |
| what are some trophic changes? (3 of them) | hair loss, thick nails, shiny scaly skin |
| What is intermittent claudication? | Pain in large muscle groups caused by activity- often progressive and relieved by rest |
| Where does intermittent claudication usually occur? | Calf. thigh or buttocks |
| For intermittent claudication where does the site of symptoms occur to the site of the disease? (Prox or Distal) | site of symptoms occur DISTAL to the site of disease |
| What are some true claudication symptoms? | Easily reproducible with the same amount of activity, limit patient's walking distance |
| Is peripheral resistance affected with mild to moderate disease? | Maybe not |
| What happens to arterioles with moderate to severe disease? | They vasodilate at REST (this lowers resistance) |
| What kind of waveform results from moderate to severe disease? | Monophasic with delayed time (TARDUS PARVUS) |
| Tardus parvus is what to disease? | DISTAL |
| What does ischemic rest pain represent? | increasing severity of disease |
| what type of pain occurs while patient is lying down or at rest? | ischemic rest pain |
| Where is ischemic rest pain often experienced on the body? | Heel, Toe, or Top of foot |
| What are the symptoms of advanced PAOD? (6 of them) | thickening of toenails, loss of toe hair, skin discoloration/scaly, elevation pallor/dependent rubor, ulceration, gangrene |
| What are the symptoms of ACUTE arterial insufficiency? (6 P's) | Pallor, Pulselessness, Paralysis, Paresthesia, Pain, Polar (coolness) |
| What may cause ACUTE arterial insufficiency? | Thrombus, embolus, trauma |
| Why is ACUTE arterial insufficiency an emergency situation? | Because there is not enough time for collaterals to be made |
| What are the main arterial risk factors? (4 of them) | Diabetes, Hypertension, Hyperlipidemia, Smoking |
| What is the most common arterial pathology? | Atherosclerosis (plaque) |
| What is atherosclerosis? | The thickening, hardening, and loss of elasticity of arterial walls |
| What pathology often occurs at bifurcations and vascular origins? | Atherosclerosis |
| What causes "Blue Toe Syndrome"? | An Embolism |
| What is a true aneurysm? | All 3 layers of the artery are dilated |
| What type of aneurysm has circumferential dilatation? | Fusiform |
| Which type of aneurysm has a localized outpouching? | Saccular |
| What is a dissecting aneurysm? | When a small tear in intima permits blood flow between intima and media |
| Where do aneurysms more often occur? | Infra-renal (below the kidneys) |
| What is the cause of aneurysms? | Unknown-- May be congenital, infection, trauma, or atherosclerosis |
| What are some complications of aneurysms? (3 of them) | Aortic aneurysm rupture, Distal embolus in peripheral aneurysm, Thrombus can form at aneurysm walls |
| What is a pseudoaneurysm? | "Pulsating hematoma". Results from hole/weakness in artery wall |
| What must a pseudoaneurysm have to be considered a pseudoaneurysm? | A neck/track |
| What kind of flow pattern does a pseudoaneurysm have? | Swirling pattern (Yin Yang sign) |
| What kind of flow foes a pseudoaneurysm have in the neck? | To-and-Fro flow in neck and swirling in sac |
| What is the congenital narrowing of the thoracic aorta called? | A Coarctation of the aorta |
| What can aortic coarctation cause? | HTN due to decreased kidney perfusion, may result in lower extremity ischemia |
| What is inflammation of the artery wall known as? | Arteritis |
| What are the 3 types of arteritis? | Takayasu's, Temporal, and Buerger's disease |
| What is the most common type of arteritis? | Buerger's disease AKA Thromnoangiitis Obliterans |
| What is the other name of Buerger's disease? | Thromboangiitis Obliterans |
| What type of arteritis is associated with HEAVY SMOKING in men younger than 40? | Buerger's |
| How does Buerger's present? | Distal arterial occlusions, rest pain and ischemic ulceration early on, gangrene |
| Dissection results from weakened _______, resulting in the ______ tearing away? | Weakened MEDIA, Intima tearing away |
| Intermittent ischemia of the fingers/toes in response to cold or stress is known as ________? | Raynaud's phenomenon |
| How many types of Raynaud's phenomenon are there and what are they? | 2 types, primary and secondary |
| what are the characteristic of PRIMARY Raynaud's phenomenon? (4 of them) | Idiopathic or spastic Raynaud's syndrome Caused by digital arterial spasm; benign Common in young women; may be hereditary Usually bilateral; long history with NO progression |
| What are the characteristic of SECONDARY Raynaud's phenomenon? (2 of them) | Ischemia is constantly present, disease process/ abnormality, Vasoconstrictive responsive arterioles superimposed on a fixed arterial obstruction |
| What is entrapment syndrome? | When the artey is compress by calf muscle (gastrocnemius muscle) |
| What syndrome is commonly seen in young, athletic men? | Entrapment syndrome |
| What does Pallor mean? | Skin is pale; deficient in blood supply |
| What does rubor mean? | Skin is red (dependent rubor); dilated, damaged vessels |
| What does Cyanosis mean? | Bluish discoloration; skin and mucous membranes (de-oxygenated blood) |
| What are characteristics of arterial ulcerations? (4 of them) | Deep and Regular in shape, Located over bony areas (ex. tibia), Very painful |
| What causes gangrene? | Tissue death due to absent blood flow |
| What are trophic changes? (3 of them) | Loss of hair Shiny, scaly skin Thickened toenails |
| What does increased capillary refill time suggest? | Decreased perfusions |
| Pallor caused by elevating an extremity signifies what? | Decreased circulation, poor perfusion |
| How are pulses graded? (what scale) | Scale of 0-4+ |
| _____ will bound and are easily palpated? | Aneurysms |
| What are common sites for palpation in lower extremity? (4 of them) | Femoral, Popliteal, Dorsalis Pedis, and Posterior Tibial Arteries |
| What is abnormal, low frequency sounds caused by significant stenosis leading to distal vibration? | BRUIT |
| How are bruits graded? | By the physician listening (mild, moderate, or severe) |
| What percentage of stenosis can cause bruits to disappear? | Severe (>90%) stenosis |
| What can make a bruit difficult to hear? | decreased cardiac output |
| What type of waveform should be expected of a NORMAL rested artery? | HIGH resistance (forward flow, back flow, forward again) TRIPHASIC or MULTIPHASIC |
| What is the effect or exercise on the arterioles? (4 of them) | Vasodilation occurs- allows more blood to enter Waveform becomes low resistance Peripheral resistance decreases significantly Blood flows in antegrade direction throughout the cardiac cycle |
Created by:
EmilyGriffin
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