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RVT Review > Chapter 3 > Flashcards

Chapter 3 Flashcards

1
Q

T/F is it not important to keep a warm environment for arterial testing?

A

false

you want to keep it warm to permit peripheral dilation to occur

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2
Q

what are some some signs and symptoms of chronic occlusive disease?

A

a. claudication
b. ischemic rest pain
c. tissue loss

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3
Q

what is claudication?

A

pain in muscles usually occurring during exercise; symptoms subside with rest
discomfort is predictable and subsides min after exercise

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4
Q

why does claudication occur?

A

results from inadequate blood supply to the muscles

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5
Q

where is the level of disease for claudication?

A

level of disease usually proximal to location of symptoms

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6
Q

T/F pseudo- claudication mimics vascular symptoms

A

true

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7
Q

what are pseudo- claudication vascular symptoms really from?

A

they are neurogenic or orthopedic in origin

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8
Q

what is ischemic rest pain?

A

a more severe symptom of diminished blood flow

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9
Q

why does ischemic rest pain occur?

A

occurs when limb not dependent; BP decreased such as when sleeping

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10
Q

what is tissue loss?

A

necrosis or death of tissue

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11
Q

why does tissue loss occur?

A

due to deficient or absent blood supply

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12
Q

what are the six symptoms for acute arterial occlusion?

A

pain. pallor, pulslessness, paresthesia, paralysis, polar

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13
Q

what may acute arterial occlusion result from?

A

thrombus, embolism or trauma

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14
Q

T/F acute arterial occlusion is an emergency situation

A

true

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15
Q

why is acute arterial occlusion an emergency situation?

A

since the abrupt onset does not provide for the development of collateral channels

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16
Q

what is a vasospastic disorder?

A

raynauds

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17
Q

what is raynauds phenomenon?

A

a condition that exists when symptoms intermittent digital ischemia occur in response to cold exposure or emotional stress

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18
Q

what are the changes in skin color that occur with raynauds?

A

pallor (whiteness), cyanosis (bluish), or rubor (dark red)

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19
Q

what is primary raynauds?

A

ischemia due to digital arterial spasm

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20
Q

who is more prone for primary raynauds?

A

young females

may be hereditary, bilateral with 2 years of symptoms with no evidence of cause

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21
Q

T/F primary raynauds is a malignant condition with excellent prognosis

A

false

benign

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22
Q

what is another word for secondary raynauds?

A

obstructive raynauds syndrome

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23
Q

what is secondary raynauds?

A

normal vasoconstrictive responses of arterioles superimposed on a fixed artery obstruction. ischemia constantly present

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24
Q

what may be the first manifestation of buergers disease?

A

secondary raynauds

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25
Q

what is buergers diease?

A

inflammation and thrombolism in small / medium vessels
associated with smoking
can lead to gangrene

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26
Q

what is pallor and what is it caused from?

A

pale skin

result of deficient blood supply

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27
Q

what is rubor and what is it caused from ?

A

skin is reddened

suggest dilated vessels or vessels dilated secondary to reactive hyperemia

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28
Q

what is cyanosis and what is it caused from?

A

bluish discoloration

a concentration of deoxydenated hemoglobin

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29
Q

what will arterial lesions look like?

A

ulcerations located: tibial area, foot, toes
deep and more regular in shape
quite painful
gangrene

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30
Q

what is gangrene?

A

death of tissue, due to deficient or absent blood supply

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31
Q

what does an increase in the capillary refill time denotes?

A

an decreased in arterial perfusion

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32
Q

what color does the foot turn with elevation?

A

pallor

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33
Q

what does rhythmic throbbing of artery in time with heartbeat signifies?

A

adequate circulatory status

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34
Q

what does diminished/ absent pulse suggest?

A

arterial insufficiency

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35
Q

what are the grading scale for palpations?

A

0-4+
0=none
4+ Bounding

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36
Q

T/F aneurysms can be palpated and described as bounding

A

true

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37
Q

what may a palpable vibration or thrill over a pulse site indicate?

A

fistula, post-stenotic turbulence or a patent dialysis access site

38
Q

what are some arteries that are palpable pulses?

A

aorta, femoral, pop. DPA, PTA

39
Q

T/F peroneal artery is palpable

A

false

40
Q

what is another word for bruit?

A

auscultation

41
Q

T/F bruit ausculation is more often done with a carotid exam

A

true

42
Q

what may you use to hear the bruit?

A

stethoscope

43
Q

what are some risk factors for arterial testing?

A 
diabetes
hypertension
hyperlipidemia (high cholesterol)
smoking 
other (age, family history, male gender)
44
Q

what does diabetes cause?

A

atherosclerosis: more common at a younger age

45
Q

which areas have a higher incidence of disease with diabetics?

A

distal pop and tibial arteries

46
Q

what are other characteristics of arterial disease with diabetics?

A 
medial calcification develops in LE arteries 
poor sensation (neuropathy) may lead to increased injury
higher incidence of gangrenous changes, amputations
47
Q

what are some characteristics of arterial disease seen with hypertension?

A

systemic hypertension is associated with greater incidence of coronary atherosclerosis

48
Q

what are some characteristics seen with hyperlipidemia?

A

elevated plasma lipids closely associated with development of atherosclerosis

49
Q

what is a frequent cause of hyperlipidemia?

A

diet high in animal fat, metabolic problems associated with heredity

50
Q

how does smoking play a role in arterial disease?

A

the chemical in cigarettes irritate the endothelial lining of the vessels causing vasoconstriction

51
Q

what are some mechanisms of disease?

A

atherosclerosis
embolism
aneurysm
non-atherosclerotic lesions

52
Q

what is another name for atherosclerosis?

A

obliterans

53
Q

what is atherosclerosis?

A

most common arterial pathology.

thickening, hardening, and loss of elasticity of the artery walls

54
Q

what part of the vessel does atherosclerosis commonly affect?

A

intima and media layer

55
Q

what are major risk factors for atherosclerosis?

A

smoking, hyperlipidema, and family history

less important factors: HTN, diabetes, sedentary lifestyle and arterial wall shear/ stress

56
Q

what are common sites for atherosclerosis?

A 
carotid bif 
vessel origins
infra-renal aorto-iliac system
CFA bif 
SFA at the adductor canal 
trifurcation region
57
Q

what is Leriche syndrome?

A

caused by obstruction of the aorta

58
Q

who is more at risk for Leriche syndrome?

A

males

59
Q

what is Leriche syndrome characterized by?

A

fatigue in hips, thigh, or calves with exercise
absence of femoral pulses
impotence
pallor or coldness of LE

60
Q

what is an embolism?

A

obstruction of vessel by foreign substance or blood clot

61
Q

T/F embolism may be solid, liquid, or gaseous

A

true

may arise from the body or enter from without

62
Q

what is the most frequent cause of an embolism?

A

small plaque breaks loose

e.g atherosclerotic lesion, arteritis, or angiographic procedure and travels distally until lodges in small vessel

63
Q

what can happen as a result of an embolism to a small vessel?

A

blue toe syndrome

64
Q

what is blue toe syndrome?

A

toe ischemia

can improve and mainly from other small branches

65
Q

what is an aneurysm?

A

true aneurysm is a dilation of all three arterial layers of the wall

66
Q

what is fusiform aneurysm?

A

diffuse, circumferential dilation

67
Q

what is saccular aneurysm?

A

localized out- pouching

68
Q

what is a dissecting aneurysm?

A

occurs when a small tear of the inner wall allows blood to form cavity between two wall layers.

69
Q

where do dissecting aneursyms most often happen?

A

thoracic aorta

70
Q

what is a pseudo aneurysm?

A

results from a defect in the main artery wall

e.g post catheter insertion

71
Q

what do pseudo aneurysm must have?

A

must be a channel communication from main artery to pulsatile structure outside vessel walls
aka neck

72
Q

where is the most common location for a true aneursym?

A

infrarenal aorta

73
Q

what are other locations for a true aneursym?

A

thoracic aorta, femoral, pop, renal

74
Q

T/F patients with one aneurysm do not have a higher chance for another aneurysm

A

false

they do have a higher chance

75
Q

what are some causes of true aneursym?

A

poor nutrition, congenital defect, infection, or atherosclerosis

76
Q

what is the most frequent complication for an aneurysm?

A

rupture

embolization of the peripheral aneursyms

77
Q

what are some non-atherosclerotic lesions?

A 
arteritis 
coarctation of the aorta 
dissection 
vasospastics disorders 
entrapment syndrome
78
Q

which arteries can arteritis affect?

A

tibial and peroneal arteries as well as smaller distal arterioles and nutrient vessels

79
Q

what is arteritis?

A

inflammation of arterial wall which can lead to thrombosis of the vessel

80
Q

what is a type of arteritis?

A

buergers disease

81
Q

what is another name for buergers disease?

A

thromboangiitis obliterans

82
Q

T/F arteritis is associated with heaving smoking?

A

true

83
Q

what is the age and gender group for arteritis?

A

men <40years old

84
Q

what are some symptoms that patient presents with arteritis?

A

occlusions of the distal arteries
rest pain
ischemic ulceration present

85
Q

what is coarctation of the aorta?

A

congenital narrowing or stricture of the thoracic aorta but may affect abdominal aorta as well

86
Q

what is a congenital anomaly of the arterial system?

A

coarctation of the aorta

87
Q

what are clinical findings for coarctation of the aorta?

A

HTN due to decreased kidney perfusion

manifestation of LE ischemia e.g decreased pulses and/or segmental presures

88
Q

what is dissection?

A

media is weakened, intima develop tear through which blood leaks into media (false lumen)

89
Q

what is a distinguishing ultrasound feature of dissection?

A

a think membrane diving the arterial lumen into 2 compartment

90
Q

which arteries does dissection affect?

A

aorta and peripheral arteries

91
Q

what are complications of dissection?

A

stenosis, occulsion or thrombosis

92
Q

what can aortic dissections which extend to the iliacs lead to?

A

may occur consequent to HTN or severe chest trauma

can lead to death

RVT Review (30 decks)

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