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A_arterial duplex and indirect > signs/Sx/mechanisms > Flashcards

signs/Sx/mechanisms Flashcards

1
Q

with limb pain, (claudication) disease is usually _ to the symptoms

A

proximal

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2
Q

does the patient have good days and bad days?

A

if the pain is not consistent every time than problem may be neurogenic/ orthopedic in nature.

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3
Q

what is claudication

A

pain in muscle during activity and subsides with rest, due to inadequate blood supply .

pain subsides within minutes after ending of activity .

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4
Q

Ischemic rest pain is

A

severe symptom of reduced blood flow

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5
Q

where does ischemic rest pain usually present?

A

forefoot
heel -plantar
toes

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6
Q

what type of energy creates relief for ischemic rest pain?

A

potential energy/ hydrostatic pressure

pain occurs when the limb is not dependent.

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7
Q

end stage of chronic arterial disease

A

necrosis of tissue

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8
Q

claudication and ischemic rest pain is chronic arterial disease (T) or (F)

A

True- usually caused by atherosclerosis

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9
Q

Acute arterial occlusion signs and symptoms (p’s)

6

A 
6 (P's)
pain
pallor
pulselessness
paresthesia - numbness tingling 
paralysis
polar
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10
Q

(3) causes for acute arterial occlusion

A

thrombus
emboli
trauma

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11
Q

what makes acute arterial occlusion an emergency situation and not chronic occlusion

A

no time for development of collateral channels

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12
Q

Vasospastic disorders

A

Primary Raynaud’s

Secondary Raynaud’s

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13
Q

Primary Raynauds is marked by what

A

intermittent digital ischemia due to cold exposure to emational stress

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14
Q

what symptoms present with primary Raynauds

3

A

pallor
cyanosis
rubor - due to vasodialation may cause warmth due to ischemic cond’

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15
Q

Primary Raynauds is a _ condition

A

benign

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16
Q

Ischemia in Primary Raynauds is due to __

is common in __population, commonly__ and occurs __

A

digital arterial spasm
young women
hereditary
bilateral

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17
Q

Secondary Raynauds is also known as __

A

obstructive Raynauds syndrome

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18
Q

mechanism of Secondary Raynauds is

A

vasoconstriction of arterioles present with a FIXED artery obstruction

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19
Q

With secondary Raynauds ischemia is ___ present

A

constantly

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20
Q

Secondary Raynauds may be the beginnings of what other disease

A

Buerger’s which is Arteritis

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21
Q

what (3) signs of occlusion will present on physical exam

A

pallor
cyanosis
rubor

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22
Q

cyanosis is

A

concentration of deoxygenated hemoglobin

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23
Q

rubor suggests

A

dilated vessels

dilated vessels secondary to reactive hyperemia

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24
Q

reactive hyperemia is

A

aka venous hyperemia

increase in organ blood flow occurring following brief period of ischemia

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25
Q

what is the difference between hyperemia and congestion

A

hyperemia-
active process, red raised temp increased volume enhanced function

congestion
passive process, cyanosis , hypoxia, low temp, increased volume edema, decreased function,
eg; local obstruction or CHF

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26
Q

capillary filling test is ____ and accomplished how?

A

qualitiative

squeezing toe cut off circulation and seeing how blood returns to the skin

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27
Q

Refill time for qualitative capillary refill time is

A

3 seconds

greater than 3 seconds indicates ischemic conditions

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28
Q

elevation and dependency changes indicative of ischemic conditions appear how
(2)

A

pallor - elevation

ruborous discoloration- dependent position

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29
Q

aneurysms can be desctibed as ____ when palapated

A

bounding

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30
Q

pulses are graded on a scale of ___ to ___

A

0 - none

4+ - bounding

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31
Q

Arterial ulceration locations typically occur (inner or outer) area of LE or on tips of or between ____. Or where there is ____ from walking or footwear.

A

tibial area –OUTER ankle
on tips or between toes
preassure

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32
Q

Arterial ulcerations are characterized by a ______ look.

Usually ____ in shape. with ______, ____ wound margins.

A

punched -out look

well-defined, even wound margins

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33
Q

The wounds are (shallow/deep).

and (does/does not) bleed.

A

deep

does not bleed.

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34
Q

colors of arterial ulcerations

4

A

yellow
brown
grey
black

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35
Q

with arterial ulcers the affected area will have little to no ____, nails appear___ and hair____ with skin taking on shiny thin dry and taut appearance with delayed capillary return.

A

pulse
atrophic
hair loss

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36
Q

difference between arterial ulcer and venous ulcer

A

arterial ulcers- VERY Painful. temporary relief is gravity dependant

venous ulcers- redness and edema at site of ulcer and may be painless, and relief is found with elevating limb

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37
Q

palpable thrill is_____may indicate ____, ____, or ______

A

thrill is vibration that you FEEL
(you can FEEL a Thrill)
fistula, dialysis, post-stenotic turbulence

38
Q

palpable pulses are found over what LE vessels

6

A 
aorta
femoral
popliteal
dorsalis pedis (DPA)
posterior tibial (PTA)
39
Q

Bruits are _______ found by _____

A

noise you can hear
auscultation

BRUEE are loud

40
Q

Bruits are commonly mentioned with what exam

A

carotid

the dr heard one and wants to know were the stenosis is coming from

41
Q

auscltation of bruits can be found in the following (5) areas

A 
aorta
femoral
popliteal
carotid 
heart
42
Q

Risk factors for arterial disease

controllable factors

A

diabetes
HTN
hyperlipidemia
smoking

43
Q

uncontrollable arterial disease risk factors

A

age
male
family history

44
Q

Diabetes affects vessels through mechanism of ____________ and occurs at older or younger age

A

atherosclerosis

affects people at a younger age

45
Q

diabetes induced atherosclerosis has higher insidence of what (I2)location on LE

A

distal popliteal and tibial arteries

46
Q

medial calcification develops in LE arteries, this is associated with increased risk for ___________ events as the disease process affects what layer of the vessel.

A

cardiovascular

medial layer of the vessel is affected

47
Q

diabetes induced atherosclerotic disease is associated with a higher incidence of what end stage symptoms

A

gangrene and amputations

caused by lack of feeling due to co occurring neuropathy

48
Q

hypertension affects arterial disease by one of what two processes

A

cause or enhance atherosclerotic processes

49
Q

what causes hyperlipidemia

A

diet high in fat, metabolic tissues based on heredity

50
Q

how does smoking induce atherosclerotic disease

A

chemicals irritate artery intimal lining causing vasoCONSTRICTION

51
Q

what is ASO

A

atherosclerosis obliterans

52
Q

atherosclerosis obliterans is

A

hardening of the artery thickening and loss of elasticity

53
Q

in ASO where do changes occur in the vessel wall

A

intima and media

54
Q

what are most important risk factors for ASO:

3

A

smoking
hyperlipidemia
family history

55
Q

other risk factors for ASO

A

HTNm diabetes, sedentary lifestyle and arterial wall shear / stress

56
Q

most common sites for ASO

A 
(Think Bifurcations)
carotid bifurcation 
aorto-iliac system *
CFA bifurcation
SFA-distal
57
Q

what is Leriche Syndrome

A

Ao occlusion

58
Q

Leriche syndrome affects ____population and is characterized by what 4 symptoms

A

Leriche syndrome affects male population more

fatigue in lower extremities (hips thighs calves) with excercize
absence of femoral pulses
impotence
pallor and coldness of LE

59
Q

Acute occlusion is marked by ______, or ______. and can come in the form of ___, ___, or ____.

A

thrombus or plaque that has become mobile and traveled to a diameter vessel that it occludes

solid , liquid or gas

60
Q

what is trash foot? and is related to sedentary atherosclerosis or embolism
onset usually is duration of ____ days

A

blue toe syndrome and is related to embolism
ischemia develops and improves due to collaterazation
1-2 days out …

61
Q

what are main cause of embolism- 3

A

small plaque break loose due to
atherosclerotic lesion
arteritis
angiographic procedure

62
Q

what other disease should be suspected if blue toe syndrome is present

A

AAA

63
Q

what kind of aneurysm is the most common type of aneurysm

A

true aneurysm

64
Q

define true aneurysm

name 2 subtypes of true aneurysm

A

dilatation of all tree arterial wall layers

saccular and fusiform

65
Q

define saccular aneurysm

A

sac-like localized dilation

66
Q

define fusiform aneurysm

A

circumferential

diffuse dilation

67
Q

____ aneurysm is small tear of the ____ wall which allows blood to form between two layers in arterial wall

A

dissecting

intimal wall tear

68
Q

where is most common place for dissecting aneurysm

A

thoracic

69
Q

pseudoaneurysm the ___ arterial layer is affected, is usually ______ cause. And is presented as ______ structure usually found in ____area

A

outter arterial wall
iatrogenic cause
pulsatile structure outside vessel wall
groin area

70
Q

what is most common site for true aneurysm

A

infrarenal

71
Q

locations for aneurysm :

5

A 
infrarenal
renal
popliteal artery 
commmon femoral
thoracic
72
Q

50% of patients with _________ are bilateral and include AAA

A

popliteal aneurysm

73
Q

more often if aneurysm is in the CFA and popliteal artery have a higher insidence of ____

A

another aneurysm elsewhere

74
Q

what are risk factors for true aneurysm

4

A

poor nutrition
atherosclerosis
infection
myrafans syndrome

75
Q

most frequent complication of AAA is _____ and accumulates ______inside

A

rupture

thrombus

76
Q

most frequent complication of peripheral aneurysm is ______ and accumulates _____inside

A

embolization

thrombus `

77
Q

non atherosclerotic lesions

5

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

Arteritis affects what vessels

2

A

think distal arterioles– small vessels
tibial
peroneal

79
Q

inflammation of the arterial wall can lead to ________

A

thrombosis

80
Q

most common type of arteritis

A

buerger’s disease

81
Q

buerger’s disease is also called

A

thrombo-angitis obliterans

82
Q

buergers disease affects men _____ who smoke heavily

A

<40 yrs of age

83
Q

patients present with _______ of distal arteries

A

occlusion

84
Q

Buerger’s disease patiens present with

3

A

ischemic fingers
ischemic ulceration
rest pain

85
Q

Coarctation of the Aorta causes ______ in the artery

A

strictiure

congenital narrowing of the thoracic aorta , can present in the abdominal aorta as well

86
Q

Clinical findings with coarctation of the aorta

2

A

HTN due to decreased kidney profusion

LE ischemia –reduced pulses

87
Q

Dissection of arteries can affect both Aorta and peripheral arteries (T/F)

A

True

88
Q

What are sonographic characteristics of a dissection

A

intimal flap

two flow patterns within the lumen- bidirectional flow

89
Q

flow _____ will differ in each lumen in dissections

A

velocities

90
Q

complications of dissection include

4

A

stenosis
occlusion
thrombosis
rupture

91
Q

Aortic dissections can extend to _______ and could be due to ______, _____, or be _________.

A

iliacs.

HTN, severe chest trauma, or be spontaneous

92
Q

is Ultrasound important diagnositc tool in identifing dissections

A

yes

A_arterial duplex and indirect (13 decks)

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