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Clinical Pod Med Exam 2 > Non-invasive arterial exam > Flashcards

Non-invasive arterial exam Flashcards

1
Q

what are the 6 basic non-invasive lab tests for diagnosing PVD in the lower extremity?

A
  1. segmental BP
  2. doppler ultrasound
  3. toe blood pressures
  4. ABI
  5. plethysmography
  6. transcutaneous oxygen pressure
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2
Q

describe the change in pressure from mid thigh to ankle as you do a segmental BP.

A

pressure will decrease normally from mid-thigh to ankle

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3
Q

what are some signs of obstruction when taking a segmental BP?

A

> 20-30mmHg difference btwn adjacent cuffs
30mmHg change along leg from thigh to ankle
20mmHg difference btwn opposite leg, at same level

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4
Q

what does the ABI tell you?

A

ankle systolic BP/ brachial systolic BP

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5
Q

what does the ABI measure?

A

measures arterial flow only to the ankle

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6
Q

what are the ABI values needed for successful healing after foot surgeries?

A

ABI >0.35 in arteriosclerosis

>0.45 in diabetics

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7
Q

what is the normal ABI range?

A

0.9 to 1.3

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8
Q

an ABI of 0.7 is classified as what?

A

intermittent claudication

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9
Q

an ABI of 0.5 is classified as what?

A

rest pain

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10
Q

an ABI of 0.3 is classified as what?

A

skin loss

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11
Q

why do diabetics have falsely elevated ABI values?

A

due to severe arterial calcification- so it takes more cuff pressures to constrict the arteries

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12
Q

what is the ABI for intermittent claudication?

A

0.7

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13
Q

what is the ABI for rest pain?

A

0.5

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14
Q

what is the ABI for skin loss/ulcers?

A

0.3

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15
Q

___ is a function of how fast blood cells are moving

A

Pitch

*the faster the cells move, the higher the pitch

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16
Q

___ is a function of how many blood cells the ultrasound waves hit

A

Loudness

*the more cells hit, the louder the sound

17
Q

what relationship does aortic pressure and velocity of blood flow have with each other?

A

directly proportional

*peak aortic pressure corresponds to peak flow velocity of vessels

18
Q

what does a normal doppler US waveform look like?

A

triphasic (3 sounds and 3 peaks)

19
Q

what does a mild obstruction doppler US waveform look like?

A

biphasic

20
Q

if there was loss of arterial rebound due to calcification of artery, what would the doppler US waveform look like?

A

mild obstruction- biphasic

21
Q

what would a moderate obstruction doppler US waveform look like?

A

monophasic

22
Q

what would a severe obstruction doppler US waveform look like?

A

no sound

23
Q

what 3 things should you listen for with Doppler?

A
  1. # of sounds
  2. pitch
  3. loudness
24
Q

Describe what you would expect to hear on Doppler if your probe was over the obstruction.

A

pitch is higher but loudness is lower

of RBC flowing thru is less, but those that are squeezing thru are flowing faster!

25
Q

Describe what you would expect to hear on Doppler if your probe was on either side of the obstruction?

A

pitch is lower but loudness is higher

there is a greater # of RBC collecting there, but their velocity is lower

26
Q

healing potential can be measured by what 2 ways?

A
  1. absolute pressures

2. toe-brachial index

27
Q

what absolute pressure do you need to have good healing potential?

A

> 45mmHg

28
Q

what toe-brachial index do you need to have high healing potential?

A

> 0.6

29
Q

what toe-brachial index do you need to have moderate healing potential?

A

> 0.4

30
Q

what toe-brachial index do you need to have low healing potential?

A

> 0.2

31
Q

what toe-brachial index will not heal?

A

below 0.2

32
Q

what is plethysmography?how can it be measured?

A

takes advtg of the fact that as the artery fills with blood, it expands and contracts as it empties

  • Photoplethysmography (PPG): infared light and photocells
  • pressure cuffs- pneumoplethysmography or pulse volume recording (PVR) or pressure cuff recording (PCR)
33
Q

what is photoplethysmography (PPG)?

A

uses a light probe to detect how much blood has entered the artery

34
Q

what does a normal waveform for photo plethysmography look like?

A

2 distinct peaks w/ a distinct dichrotic notch

*the greater the volume of blood, the more RBC, and the more color change and the more defined the peaks

35
Q

what does a normal waveform for a PVR look like?

A

1 rounded peak

*no dichrotic notch like there is in the arm and on PPG

36
Q

what is transcutaneous oxygen pressure (TcPO2)?

A

measures partial oxygen tension on skin surface

the more RBC to the skin, the more O2

37
Q

how does TcO2 relate to arterial PO2?

A

TcPO2= arterial PO2

38
Q

what range for TcO2 is best to indicate good healing potential?

A

10-50mmgHg

*>40 is best standard to use

Clinical Pod Med Exam 2 (15 decks)

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