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