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PVI > Arterial Hemodynamics > Flashcards

Arterial Hemodynamics Flashcards

(72 cards)

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1
Q

cuff size affects limbs pressures

A

too narrow - falsely high too wide - falsely low

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2
Q

ABI > 1.4

A

diabetes

chronic renal failure

medial calcification

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3
Q

significance of 15 mm difference PT and DP

A

proximal disease

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4
Q

ABI uses which pressures for brachial and DP/PT

A

highest brachial pressure

highest DP or PT

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5
Q

30 mm hg gradient btw segments

A

significant disease

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6
Q

pressures may not drop

A

due to compensation from collaterals

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7
Q

pressures reflect function

A

not anatomy

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8
Q

pressure difference arm and proximal thigh

A

20-30 mm

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9
Q

contraindications for exercise testing

A

recent coronary event

shortness of breath

arthritis

ABI < 0.5

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10
Q

key in exercise testing

A

drop in pressure 20% not ABI (may increase)

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11
Q

treadmill exercise

A

10-12 % incline - start 1 mph - increase to 2.5

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12
Q

significance of recovery from exercise < 5 min

A

good collateralization

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13
Q

PPG

A

photoelectric plesmothography

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14
Q

normal PVR

A

dicrotic notch

sharp systolic upstroke

narrow peak

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15
Q

dicrotic notch

A

reflected wave

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16
Q

PVR amplitude dependent on following

PVR measures cuff pressure changes due to cuff volume which reflects changes in limb volume

A

stroke volume

blood pressure

vasomotor tone

blood volume

limb size

limb position

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17
Q

PVR waveforms with obesity & edema

A

attenuate

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18
Q

pressures for PVR

A

65 mm limbs/ 40 mm digits

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19
Q

PVR (measure over 3-4 cycles)

A

measures global perfusion under cuff

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20
Q

abnormal PVR

A

dampened upstroke

peak round and delayed

no dicrotic notch

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21
Q

PPG

A

light sensitive diode detects RBC

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22
Q

toe brachial index

A

toe pressure over highest brachial pressure

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23
Q

severe disease toe index

A

0.11-0.34

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24
Q

mild moderate toe index

A

0.35-0.64

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25
normal toe index
\> 0.65
26
able to differentiate stenosis versus occlusion
NO
27
patients in which to measure toe index
diabetes medial calcification
28
primary testing pitfalls
inflow stenosis inability to distinguish stenosis and occlusion noncritical stenosis
29
Normal ABI/waveforms but claudication
stress exam - if positive then duplex
30
common iliac aneurysm
2.0 cm 1.7 cm per Pellerito 1,5 cm upper normal
31
criteria for femoral or popliteal aneurysm
increase by 50%
32
AAA rupture risk
43 % if \> 6 cm 10-20 % risk of rupture
33
characteristics of endoleak
spongy aneurysm sac areas of decreased echogenicity pulsations
34
meaning of 20-49% stenosis
plaque without velocity elevation
35
ratio for 50-75% stenosis
2:1 velocity ratio
36
velocity ratio for \>75% stenosis
3:1
37
significance of tandem lesion on velocity
decreases velocity elevation
38
popliteal and tibial velocities
60's
39
SFA velocity CFA velocity
90 +/- 15 cm/sec 115 +/- 25 cm/sec
40
criteria for occlusion
pre occlusive thump internal echoes prominent collaterals no flow
41
velocity criteria for bypass graft failure (lower extremity) (not for \> 6 mm vein grafts) \*\*\*\*
45 cm/sec
42
ischemia of extremities involving upper extremities
5% of disease
43
wrist brachial index
0.9 - 1.1
44
digit brachial index
\>= 0.9
45
significant brachial pressure difference
20 mm
46
Allen test
PPG on 3rd digit intact arch if waveform reverses incomplete arch if waveform stops
47
5% of UE disease is large vessel
90-95% UE disease is small vessel
48
nipple or peak of top of waveform
vasospasm
49
characteristics of arteritis
smooth circumferential
50
popliteal entrapment
hyperextension of knee passive dorsiflexion active plantar flexion
51
low thigh and calf pressures
fem pop disease
52
low toe pressure
vasospasm versus small vessel disease
53
difference between Doppler and PVR
direct versus global perfusion
54
low pressures in foot ankle
use CW
55
sonographic appearance of endoleaks
spongy hypoechoic or anechoic area
56
endoleak type I
attachment site high pressure poor apposition hyperdense on precontrast type IA - proximal type IB - distal iliac artery
57
endoleak type II
most common retrograde from excluded aortic branch lumbar or IMA
58
type III endoleak
high pressure structural failure of graft holes in fabric junctional separations leak through body of stent graft poor apportion or separation of graft or graft rupture or tear of graft may see high velocity jet
59
type IV endoleak
immediately after placement ransient graft porosity blush on angio at time of placement diagnosis of exclusion
60
type V endoleak
endotension persistent growth without visible cause
61
PPG waveform with double peak (early anacrotic notch and high dicrotic notch) means
Raynaud's disease
62
PPG in incomplete arch
after release of either radial or ulnar no bouncing waveform
63
ratio for 76-99% stenosis
3:1
64
ratio for 50-75%
2:1
65
significance of pandiastolic flow
aortic insufficiency
66
popliteal entrapment - plantar flexion
velocity elevates to 327 cm/sec
67
CW continuous wave Doppler
2 crystals 5-10 mHz Doppler probe 45-60 degrees
68
what is this waveform demonstrating
hyperemia
69
exercise testing recovery \< 5 min
adequate collateralization
70
exercise testing recovery \> 10 min
poor collateralization
71
waveform finding
serrated margin post stenotic turbulence
72
popliteal velocity
69 +/- 15 mm

PVI (9 decks)

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