Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

RVT Review > Chapter 5 > Flashcards

Chapter 5 Flashcards

1
Q

what are some capabilities for Doppler segmental pressures (LE)?

A

asses presence/ severity of arterial disease

combined with Doppler velocity or volume pulse waveforms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what are some limitations of Doppler segmental pressures?

A
  • cannot discriminate b/w stenosis and occlusion, precisely localize area of obstruction, nor discriminate between CFA and EIA disease
  • calcified vessels (medial calcinosis) render falsely elevated Doppler pressures e.g diabetics, ESRD
  • uncompensated CHF may result in decreased ABIs
  • artifactually elevated high thigh pressures when narrow cuff used on thigh
  • difficult to interpret in presence of multi-level disease
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

what is patient positioning for ABI?

A

patient should rest 20 min prior to exam especially when vascular disease present
supine, with legs at the same level as heart, so that HP cannot affect the BP measurements

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What happens to the BP readings when the cuff is too large?

A

falsely lower

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What happens to the BP readings when the cuff is too narrow?

A

falsely higher

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

what is the technique used for ABIs?

A

place cuff straight on the extremity site, not encircling any bony prominence
should fit snugly
ideally the cuff bladder should be places over the artery
ensure the bladder inflation transmits pressure quickly into the tissue to compress the artery
width of cuff should be about 20 % greater than diameter of limb

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

what should the size of the cuff width be to the diameter of the limb?

A

20%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

where should you place cuffs for a four cuff method?

A 
brachial (upper arm)
high thigh
above the knee (low thigh)
below the knee (calf)
ankle
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what size cuff should be used for LE ABI?

A

12 x 40 cm with longer cuff bladders for thighs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

what should you place cuffs for a 3 cuff method?

A

brachial (upper arm)
one thigh cuff
below the knee (calf)
ankle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

what cuff size should be used for the one thigh for a 3 cuff method?

A

19x40cm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

what is the difference between a 3 and 4 cuff method?

A

two thigh cuffs proved proximal and distal pressure measurements but artifactually elevated BPs are obtained
the 3 cuff method utilizes one large thigh cuff providing a more accurate pressure reading

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

how can you optimize the Doppler signal?

A

use a 8-10 MHz probe
angle the CW Doppler 45-60 degrees to the skin
due to vessel angulation, prove angle behind the knee may be closer to 90 degrees to the skin
angle the probe so blood flow moved antegrade

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

what is the order of segmental pressures?

A

brachial
ankle (PTA or DPA or pero, if necessary)
calf (PTA or DPA whichever had the highest pressure)
above the knee (same as calf, can use pop a if needed)
high thigh (same as above knee)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

T/F you must start at the ankle and move proximally to eliminate the possibility of underestimating the systolic pressure measurement

A

true

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

T/F the lower of the two pedal Doppler pressures is used to obtain the remainder of the segmental pressures

A

false

higher not lower

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

how much should you inflate the cuff?

A

complete cessation of blood flow is required
cuffs inflated 20-30 mmHg beyond last audible Doppler arterial signal
or
inflate the cuff 20-30 mmHg higher than the highest brachial pressure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

how long should you wait before inflating the same cuff again?

A

1 min

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

how is the systolic pressure recorded?

A

as that pressure at which the first audible Doppler arterial signal returns

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

how do you calculate ABI?

A

by dividing the ankle pressure by the higher of the two brachial pressures

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

what is another term for ABI?

A

ankle/arm pressure index (API)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

what is the normal ABI measurement?

A

> 1.0 -1.3

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

what value will a asymptomatic disease or mild arterial disease have?

A

> 0.9-1.0

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

what will be claudication numbers?

A

0.5-0.9

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

what is >0.9-1.0?

A

asymptomatic disease or mild arterial disease have?

26
Q

what is 0.5-0.9?

A

claudication

27
Q

what is rest pain number?

A

<0.5

28
Q

what ABI value will incompressible vessels have?

A

> 1.3-1.5

29
Q

what ankle pressure may suggest symptoms at rest?

A

<50 mmHg vs ABI of .5

30
Q

what ABI would suggest a single segment disease?

A

> .5

31
Q

what ABI would suggest multiple lesions?

A
32
Q

segmental pressure drop of what number between two consecutive levels means?

A

(20-30) or >30 mmHg

suggest significant obstruction

33
Q

a horizontal difference of what number suggests obstructive disease at or above the level in the leg with the lower pressure?

A

> 20-30

34
Q

what is true for a high thigh pressure in a four cuff method?

A

the high thigh pressure is normally > 30 mmHg than highest brachial pressure

35
Q

what is true about the pressures AK and BK for a four cuff method?

A

the AK and BK pressures should be at least the same as the highest brachial

36
Q

What is true about the thigh pressure in a 3 cuff method?

A

thigh pressure is similar to the highest brachial pressure

37
Q

T/F the 3 cuff method allow for differentiation of HT to AK pressures

A

false

it does not

38
Q

what are the toes pressure that is evident in foot and toes that ulcers failed to heal?

A

<30mmHg

39
Q

T/F toe pressures are more relied upon than ankle pressures on patients such as diabetics

A

true

40
Q

what does exercise help differentiate?

A

between true and pseudo-claudication

41
Q

T/F you should compare resting values to those obtained after exercise

A

true

42
Q

what are some contradictions for exercising a patient?

A

shortness of breath, HTN, cardiac problems, stroke, walking problems

43
Q

T/F you want to preform a exercise testing after obtaining a resting ABI

A

true

44
Q

what is the technique for exercising your patient?

A

patients walks on a constant load treadmill at a <12% elevation
document: duration of walking, MPH, onset of symptoms, location and progression of symptoms

45
Q

what is the speed you should have the treadmill set to?

A

1.5 MPH for a max of 5 min or until symptoms increase to such severity that patient must stop

46
Q

post exercise what should you document

A

Doppler pressures at both ankles (abnormal one first) then higher brachial pressure

47
Q

what are normal ABIs after exercise?

A

immediately following exercise the ABI should increase

48
Q

what are abnormal ABIs after exercise?

A

ABI decreases minimally or to a severe amount

49
Q

within how many minutes should you retake ABI pressures?

A

every 2 min until pre exercise pressures are obtained

50
Q

what does the interpretation incorporates?

A
  • duration of exercise
  • length of time to recover
  • pressure changes from pre to post exercise
51
Q

what are some characteristics of single level disease?

A

takes 2 to 6 min for ABIs to increase back to resting levels after they dropped to low or unrecordable levels after exercise

52
Q

what are some characteristics of multiple level disease?

A

takes from 6-12 min from the ABIs to increase back to resting levels after they remained low or at unrecordable levels after exercise

53
Q

when is reactive hyperemia used?

A

its an alternate method for stressing the peripheral circulation. used when patients cannot walk long enough, use a cane or walker, have pulmonary problems, poor cardiac status, or other situations

54
Q

what cuff sizes are used for reactive hyperemia?

A

19x40

55
Q

what does reactive hyperemia produce?

A

produces ischemia and vasodilation distal to the occluding cuffs

56
Q

for reactive hyperemia how much should you inflate the cuff?

A

to suprasystolic pressure levels which is usually 20-30 mmHg above the higher brachial BP maintaining the pressure 3-5min

57
Q

how long should you keep the cuffs inflated for in a reactive hyperemia study?

A

3-5min

58
Q

what is the percentage of normalcy of the limbs to show after an reactive hyperemia?

A

17-34%

59
Q

what percentage will a single level disease show for RH?

A

<50% drop in ankle pressure

60
Q

what percentage will a multi-level disease show for RH?

A

> 50% ankle pressure drop

61
Q

what is the preferable test that produces stress that reproduces a patients ischemic symptoms?

A

treadmill

RVT Review (30 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions