Chapter 18 - Clinical evaluation of the arterial system

Question 1

6 P’s of acute arterial occlusion

Answer 1

1) pain 2) pallor 3) pulselessness 4) paresthesia 5) paralysis 6) poikilothermia

Question 2

Leriche’s syndrome

Answer 2

1) intermittent claudication 2) impotence 3) absent femoral pulse 4) atrophy of LE 5) pale extremity and foot

Question 3

Venous claudication symptoms

Answer 3

tight, bruising pain after walking and sudsides slowly relieves faster with elevation

Question 4

Venous compartment syndrome

Answer 4

Calf muscle tight bursting pain relief faster with elevation

Question 5

Nerve root compression symptoms

Answer 5

Radiates down leg, sharp lancinating pain slow relief

Question 6

Neurospinal root compression symptoms

Answer 6

Weakness > pain relieved by position change, lumbar spine flexion

Question 7

Rose questionnaire utilization

Answer 7

Arthritis with decreased ABI to assess contribution to claudication 1) pain in either leg on walking 2) pain with standing or sitting 3) pain in calf 4) pain when walking uphill 5) pain when walking at ordinary pace 6) disappear with walking ever 7) what to do if while walking 8) what happens if stand still

Question 8

Differentiating neuropathic and ischemic pain

Answer 8

Neuropathic pain is constant and unrelieved by dependency

Question 9

PAD signs

Answer 9

1) atrophy of calf 2) hair loss over lower leg/foot 3) thickening nails 4) skin atrophy 5) decrease subcu tissue 6) fragile shiny skin 7) dependent rubor 8) reddish digits

Question 10

Wound characteristics

Answer 10

1) Size 2) undermining 3) appearance 4) exudate 5) wound edge

Question 11

Livedo reticularis describe

Answer 11

1) macular, violaceous connecting rings 2) hypoxia and collateral formation caused this 4) secondary to vasculitis, calciphylaxis, atheroemboli, hyperviscosity syndrome, endocrine abn or infection 5) other manifestation: splinter hemorrhage, focal cyanosis, punctate lesions

Question 12

Palpate carotid pulse here

Answer 12

Midneck anterior to SCM

Question 13

Palpate subclavian pulse

Answer 13

Supraclavicular fossa

Question 14

Palpate axillary pulse

Answer 14

lateral to clavicle along deltopectoral groove or in axilla

Question 15

Rate of absent dorsal pedal pulse

Answer 15

10%

Question 16

Relationship between bruit and degree of stenosis

Answer 16

Pitch and duration of systolic bruit correlated with increasing severity of arterial narrowing

Question 17

Diastole bruits

Answer 17

Bruits that extend into diastole = AVF

Question 18

Rate of incomplete palmar arch

Answer 18

10%

Question 19

Differential diagnosis of common leg ulcers

Answer 19

TABLE 18.4

Question 20

Characterization of areas of ulcerations and tissue loss

Answer 20

TABLE 18.5