Chapter 9: Digits Plethysmography and pressures

Question 1

digit plethysmography and pressures helps to

Answer 1

detect presence of arterial disease
differentiate fixed arterial obstruction from vasoplasm
asses effects of treament

Question 2

limitations of digit plethysmography and pressures

Answer 2

quality of tracings effects by vasoconstriction from temperature (pt coming in from cold weather, cold room)
bandages that can’t be removed
ulcers
patient with tremor

Question 3

with volume plethymography cuffs applied too tightly can

Answer 3

obliterate or diminish pulse waveforms

Question 4

with photo plethysmography improper skin contact will cause

Answer 4

poor results

Question 5

patient positioning for digit plethysmography and pressures

Answer 5

toe evaluation: supine with some elevation of head

finger evaluation: sitting with arms resting on pillow placed on patients lap

Question 6

technique for toe plethysmography

Answer 6

pt kept as warm as possible
study done in combination with a complete LE arterial exam or limited ABI
cuff atleast 1.2 times the size of toe (2.5-3cm) applied to base of big toe

Question 7

usual method for obtaining great toe pressures is

Answer 7

PPG

Question 8

PPG great toe pressures method

Answer 8

cuff placed at base of great toe
photocell attached to plantar side of toe using tape or velcro
pulses recorded
paper speed slowed to 5mm/sec
cuff inflated 20-30 mmHg above highest brachial
cuff deflated waiting for return of first pule to define pressure level

Question 9

Fingers without cold stress technique

Answer 9

complete UE arterial study
eval doppler signals and obtain pressures
doppler palmar arch to verify patency
apply finger cuffs (2-2.5cm)
pressures and waveforms obtained similar to toes

Question 10

fingers with cold stress are preformed

Answer 10

in cases of symptoms occurring due to cold sensitivity

Question 11

fingers with cold stress technique

Answer 11

after resting hands are immersed in cold water for 3 minutes

waveforms and pressures obtained following cold stress immediately after and then 5 minutes after

Question 12

what should you document in fingers with cold stress technique

Answer 12

skin color

Question 13

interpretation of digital plethysmography normal waveforms:

Answer 13

sharp upstroke during peak systole

prolonged down-stroke with notch (reflected wave) approximately halfway down

Question 14

interpretation of digital plethysmography abnormal obstructive waveforms:

Answer 14

slow upslope
rounded peak
downslope bows away from baseline

Question 15

occlusion located anywhere proximal to the tip of finger causes

Answer 15

pulses to assume obstructive form

Question 16

abnormal peaked waveform qualities

Answer 16

upslope slower than normal
sharp anacrotic notch is present
reflected wave located high on the downslope
characteristics of normal and obstructive waveforms

Question 17

organic (fixed) obstructive disease has

Answer 17

abnormal doppler arterial signals, systolic pressures and PPG tracings

Question 18

Functional (intermittent) obstructive disease has

Answer 18

normal doppler arterial signals, systolic pressures and PPG tracings
has abnormal findings after cold stimulation

Question 19

sumner and strandness say peaked pulse is seen

Answer 19

with patients with raynauds

Question 20

UE digits normal finger/brachial indices

Answer 20

.8-.9

Question 21

Toe/brachial indices

Answer 21

vary from 60-80% if brachial pressure

Question 22

the presence of artificially high ankle pressures from arterial calcinosis usually

Answer 22

negates a toe/ankle P index

Question 23

the pressure index seen with digital artery occlusion is

Answer 23

severely reduced