Digit Plethysmography and pressures Flashcards
(25 cards)
Quality of tracings greatly affected by the vasoconstricted state of arteries before testing begins. (patient just come in from cold weather? Patient been smoking?)
Limitations
Volume plethysmography Cuffs applied to tightly can diminish the wave forms.
Limitations
Photo plethysmography Improper contact with the skin surface will cause poor results
Limitations
Supine with some elevation of head
Toe evaluation
Sitting with arms resting on pillow placed on patient’s lap
Finger evaluation
The study is done with a combination with a complete LE arterial exam, or a limited version such as an ABI
Toe technique
The width of the cuff should be at least how much greater than the toe?
1.2
The size of the cuff is
2.5 - 3 cm
The cuff is placed at the ______ of the toe?
base
While pulsations are being recorded cuff is inflated to
20 - 30mmHg above highest brachial P.
(toe)
Cuff is slowly deflated, watching for the return of the _______
first pulse to define the pressure levels
(toe)
Upper extremity arterial study is completed initially
Fingers without cold stress
After resting study is performed, hands are immersed in ice cold water for?
3 minutes if possible (induce spasms)
After the cold stress waveforms and pressures are obtained?
Immediately after and five minutes after
Sharp upstroke during systole
Reflected wave seen on down slope
Normal waveform qualities
Slow upslope to rounded peak
Downslope that bows away from baseline
Abnormal waveforms qualities
Upslope is slowed
Reflected wave located high on the downslope
Has qualities of both normal and obstructive waveforms.
Abnormal peaked waveform qualities
obstructive disease has abnormal Doppler arterial signals, systolic pressures and PPG tracings
Organic (fixed)
Disease has normal Doppler signals and pressures, and / or PPG tracings; but abnormal after cold stress.
Functional (intermittent)
Pulse is unique to the waveform contours of patients with Raynaud’s phenomena
“peaked”
Following cold immersion, abnormal cold sensitivity is likely if the amplitude fails to return to the baseline levels within
5 minutes
Finger/brachial indices 0.8 - 0.9
UE digits
Toe/Brachial Index (TBI)
LE digits
Normal toe pressure vary from ________ of brachial pressures
60-80%