Arterial Pathology/ PT history and Physical Exam

Question 1

what is the most common arterial pathology

Answer 1

atherosclerosis obliterans (ASO)

Question 2

define atherosclerosis obliterans

Answer 2

thickening, hardening, and loss of elasticity of the arterial wall with deposition of plaque within the arterial wall (between the intimal and media)

Question 3

what are common locations for atherosclerosis obliterans

Answer 3

carotid bifurcation, aorta iliac system, common femoral artery bifurcation, distal superficial femoral artery

Question 4

most common symptom of PAD

Answer 4

exertional leg pain (claudication)

Question 5

what are the 6 P’s

Answer 5

Pain
Pallor (pale)
Pulselessness
Paresthesia (numbness)
Paralysis (unable to move)
Poikiloderma/Polar (cold)

Question 6

definition of an aneuryssm

Answer 6

dilated artery > 1 1/2 times the diameter of the adjacent artery

Question 7

what are the two morphology (shape) of aneurysms

Answer 7

fusiform and saccular

Question 8

define fusiform

Answer 8

spindle shaped aneurysms, diffuse, circumferential, variable in diameter and length (see page 32)

Question 9

define saccular

Answer 9

more spherical, often involving, a short segment of the vessel (see page 32)

Question 10

most common location for aneurysm

Answer 10

infrarenal abdominal aorta

Question 11

50% of patients with a popliteal aneurysm will have a ______

Answer 11

aortic aneurysm

Question 12

T or F: patients with a aneurysm have a much higher incidence of another

Answer 12

True

Question 13

most common cause of an aneurysm

Answer 13

atherosclerotic disease

Question 14

what are the causes of aneurysms

Answer 14

atherosclerotic disease, congenital, and infection (mycotic)

Question 15

What is the most frequent abdominal aortic aneurysm complication and what is the most frequent peripheral arterial aneurysm complication

Answer 15

abdominal aortic aneurysm - rupture

peripheral arterial aneurysm - embolization

Question 16

define arterial dissection

Answer 16

intimal wall layer develops a tear and fills with blood dividing the vessel into a true lumen and a “false” lumen

Question 17

what causes arterial dissection

Answer 17

spontaneous, trauma, hypertension

Question 18

most common location for dissecting aneurysm

Answer 18

thoracic aorta

Question 19

define coarctation of the aorta

Answer 19

congenital anomaly

stricture of the thoracic aorta

Question 20

symptoms of coarctation

Answer 20

lower extremity ischemia

leg pain

decreased/absent pulses

Question 21

define fibromuscular dysplasia (FMD)

Answer 21

non atherosclerotic disease

abnormal cellular growth in the walls of medium and large arteries

found in middle aged women

STRING OF PEARLS

Question 22

most common location of FMD

Answer 22

distal internal carotid arteries and/or renal arteries

Question 23

define arteritis

Answer 23

inflammation of the arterial wall, chronic inflammation may lead to thrombosis (thromboangiitis obliterans)

Question 24

most common location for arteritis

Answer 24

small vessels

ex: digital arteries, tibial vessels

Question 25

what are the types of arteritis

Answer 25

Buerger’s disease, Takayasu’s arteritis, temporal arteritis

Question 26

define buerger’s disease

Answer 26

men <40 y/o

heavy smokers

occlusion of distal arteries and rest pain/ulceration/gangrene

Question 27

define Takayasu’s arteritis

Answer 27

affects aortic arch and its branches

most common in females

pulselessness disease

chronic inflammation leads to obstruction.

Question 28

define temporal arteritis

Answer 28

affects temporal artery

left untreated may lead to blindness

Question 29

describe Raynaud’s phenomenon

Answer 29

intermittent digital ischemia (low blood flow) due to small vessel vasospasm (narrowing of arteries)

secondary to cold exposure or emotional stress

symptoms: digital ischemia with/without pain

Question 30

describe primary Raynaud’s

Answer 30

common in younger women

bilateral

benign conditions

Question 31

describe secondary Raynaud’s

Answer 31

vasoconstriction with another condition, tissue necrosis, ulceration

Question 32

define popliteal artery entrapment

Answer 32

popliteal artery is compressed by the medial head of the gastrocnemius muscle

congenital

may result in stenosis, aneurysm or occlusion

often found in young athletes

Question 33

describe thoracic outlet syndrome (TOS)

Answer 33

compression of the neurovascular bundle by the shoulder structures (cervical rib, clavicle, and scalene muscles)

symptoms occur when arm is in certain positions, symptoms are neurogenic

Question 34

describe Leriche syndrome

Answer 34

aortic iliac obstruction/occlusion

more common in male

absent femoral pulses

profound exertional pain in hips, thighs, and calves

pallor or coldness

impotence

Question 35

define pesudo-claudication

Answer 35

false claudication, neurogenic claudication

Question 36

define pallor in relation to patient condition

Answer 36

pale, white; the result of insufficient blood supplyl to the tissue

Question 37

define rubor in relation to patient condition

Answer 37

reddish, often with dependency, suggestive of dilated subcutaneous vessels secondary to ischemia/reactive hyperemia

Question 38

define cyanosis in relation to patient condition

Answer 38

bluish discoloration - high concentration of deoxygenated hemoglobin

Question 39

describe blue toe syndrome

Answer 39

suggestive of distal micro emboli.

possible source/most commonly thrombus formation within an aneurysm (aortic or popliteal)

Question 40

describe capillary refill time

Answer 40

increase in capillary refill time suggest decreased arterial pressure/perfusion

normal refill time is <3 seconds

Compare right to left side

Question 41

a palpable “thrill” is common in

Answer 41

arteriovenous fistula, a normally functioning dialysis access fistula, or possible post stenotic turbulence