Chapter 11 Flashcards
(17 cards)
What is Intermittent Claudication?
Pain that occurs in large muscle groups during activity, described as fatigue, cramping, aching, or tiredness
Commonly affects calf, thigh, or buttocks and occurs distal to the disease site.
What relieves claudication symptoms?
Quiet standing
Symptoms are easily reproducible with the same activity level.
Which diseases can mimic claudication?
• Spinal stenosis
• Herniated disk
• Osteoarthritis
These conditions can present similar symptoms to PAOD.
What are advanced indicators of PAOD?
• Toenail thickening
• Loss of toe hair
• Skin discoloration
• Elevation pallor/dependent rubor
• Ulceration/gangrene
• Blue toes may indicate aneurysmal disease
These symptoms suggest more severe arterial disease.
What key elements should be included in patient history for PAOD assessment?
• Verify patient details
• Obtain relevant medical history
• Check coexisting conditions
• Review:
* Stroke/TIA history
* Coronary artery disease
* Hypertension
* Diabetes
* Lipid disorders
* Smoking history
* Family cardiac/vascular history
* Exercise activity
Comprehensive history aids in accurate diagnosis.
What is the recommended patient positioning for PAOD examination?
Supine with head slightly raised, legs externally rotated, knees flexed, and use pillow support as needed
Proper positioning enhances the examination process.
What is the normal Ankle Brachial Index (ABI)?
Approximately 1.0
ABI is calculated by dividing the highest ankle systolic pressure by the highest brachial systolic pressure.
What indicates a significant change in ABI between studies?
0.15
Lower values indicate worsening PAOD.
What does a pressure drop >30 mm Hg between segments indicate?
Obstruction
This is assessed using segmental limb systolic pressures.
What are typical treadmill settings for exercise testing in patients with intermittent claudication?
• 10% grade
• 1-2 mph
• Maximum 5 minutes
Exercise testing helps evaluate claudication severity.
What are the categories of Doppler waveform analysis?
- Triphasic
- Biphasic (bidirectional/unidirectional)
- Monophasic (moderate/severe, severe/critical)
———————-
Multiphasic & Monophasic
Waveform analysis provides insight into arterial health.
What does plethysmography measure?
Volume changes in limb, reflecting total arterial segment perfusion
Useful for patients with calcified arteries.
How common is upper extremity PAOD?
Occurs in <5% of cases
It is less common compared to lower extremity PAOD.
What conditions are commonly associated with upper extremity PAOD?
• Thoracic Outlet Syndrome
• Raynaud disease/phenomenon
These conditions can impact blood flow in the upper extremities.
What characterizes primary Raynaud’s phenomenon?
Vasospasm only
Primary Raynaud’s does not involve fixed obstruction.
What is a key takeaway regarding techniques for assessing arterial disease?
Multiple techniques exist for assessing arterial disease
A comprehensive evaluation requires a combination of methods.
Why is early detection crucial in managing PAOD?
It allows for timely intervention and treatment
Early detection can prevent progression of the disease.
