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Test 5 Flashcards

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1
Q

why do women have a higher risk for DVT’s?

A

high levels of estrogen

may promote clotting and the large uterus can press against vessels and slow blood flow

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2
Q

where does pressure increase the pressure?

A

veins in pelvis and legs

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3
Q

how long does the risk for blood clots in women continue in pregnant women?

A

up to 6 weeks after you have the baby

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4
Q

why does your blood clot more easily when you pregnant?

A

body’s way of preventing too much blood loss during childbirth

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5
Q

what contains the female hormone estrogen?

A
  • combined contraceptive pill

- HRT

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6
Q

what does estrogen do to your blood?

A

causes blood to clot more easily

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7
Q

is there a increased risk for progesterone only?

A

no

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8
Q

what can be a significant risk factor for DVT’s?

A

travel

-sluggish blood flow in the bent and stationary legs

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9
Q

how does surgery increase for blood clots?

A
  • injury to your veins or surgery can slow blood flow

- general anesthetics can make them wider which can increase blood pooling then clotting

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10
Q

how does a cast increase risk for DVT’s?

A

injury to the vein during injury

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11
Q

why do cancer patients have a higher risk for DVT’s?

A

higher number of platelets and clotting factors in their blood (because cancer cells produce and release chemicals that stimulate the body to make platelets)

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12
Q

what are platlets?

A

blood cells that play an important role in helping your blood to clot

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13
Q

why may cancer patients under treatment have an increased risk?

A

when chemotherapy kills cancer cells, the cells can release substances that cause an increase in blood clotting. (coagulation)

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14
Q

what cancer treatment drug increases blood clots?

A

tamoxifen

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15
Q

what disease increases the disease of IBD?

A

IBD

-ulcerative colitis

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16
Q

what hospital stay may increase DVT?

A

having an operation for an inflammatory or abdominal condition such as appendicitis

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17
Q

cellulitis

A

bacterial infection if the deep layer of skin (dermis)

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18
Q

lymphedema

A

swelling in an arm or leg

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19
Q

tennis leg

A

term describing pain in leg caused by a tear in the inner head of gastrocnemius and plantaris muscle

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20
Q

muscle tear appeaerance

A

well localized hypo echoic interposed between medial head of the gastrocnemius and the soleus muscle, typical of a tear

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21
Q

bakers cyst

A

longitudinal image of the calf

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22
Q

what is seen posterior to knee joint in ruptured baker’s cyst?

A

hypo echoic effusion

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23
Q

what is the path of the ruptures bakers cyst?

A

superficially to medial head of gastrocnemius and dissects between the gastrocnemius and the soleus towards the ankle joint

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24
Q

where does the bakers cyst extend?

A

proximal to the formation of the schilles tendon by the soleus and gastrocnemius

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25
what are vascular diagnostic procedures?
- duplex imaging - ABI measurements - segmental pressures - exercise testing - reactive hyperemia - plethysmography, pneumo and photo - digital pressures - cold stress - penile
26
ankle-brachial index
comparison of ankle blood pressure to brachial blood pressure
27
what does ankle-brachial index effecient for?
documenting the presence of lower extremity arterial disease
28
ABI less than what has a sensitivity of 90% and specificity of 98% for detecting a stenosis over 50%
less than 0.9
29
where are blood pressure cuffs placed?
both arms and ankles
30
what pressure do you use for ABI?
highest brachial pressure and the highest of the 2 ankle pressures
31
how do you calculate ABI?
1. brachial is taken on BOTH arms 2. highest brachial systolic number is used 3. posterior tibial and dorsalis pedis pressures are obtained 4. highest systloic of 2 pressures is used in ratio ankle/brachial
32
dorsalis pedis artery?
distal anterior tibial artery
33
what is a normal result in a ABI ratio?
greater than 0.9
34
what ABI indicates PAD?
under 0.9
35
the lower the ABI __________
the more severe the disease will be
36
what arteries can be assessed with doppler?
common femoral femoral popliteal calf
37
what ratio indicates atleast 50% stenosis-using PSV?
a ratio of 2 or more between normal and stenosed segment
38
what are used to measure BP in legs?
doppler ultrasound | blood pressure cuffs
39
when are segmental pressures taken?
when there is intermittent claudication
40
intermittent clauducation
pain subsides when walking ceases and resumes when walking resumes
41
what is the BP in legs similar to?
BP in arms
42
when there are lower pressure in legs, what does this mean?
plaque
43
who are segmental pressures usually done on?
diabetics-prone to small vessel disease
44
what is an indicator of severity of PAD with exercising?
fall in ankle systolic pressure after exercise
45
describe exercise testing
Pressures are recorded at rest,then the patient is placed on treadmill for 3 minutes or as long as they can withstand the pain=claudication
46
the higher the fall in pressure=____________
the more severe the PAD will be
47
what is an alternative test for patients with heart conditions or shortness of breath?
reactive hyperemia test
48
describe reactive hyperemia test
1. thigh cuffs are inflated for 3-5 minutes than deflated 2. ankle cuffs are inflated immediately and briefly, than deflated slowly 3. using doppler, BP's are taken at both ankles
49
using reactive hyperemia test, what indicates PAD?
over 50% or more decrease in ankle pressure
50
Plethysmography
pulse volume reading | measures blood flow within the arteries
51
when may Plethysmography be used?
- PAD - arm artery disease - thoracic outlet syndrome - Raynauds disease
52
how many cuffs are used in Plethysmography?
3-4 blood pressure cuffs on thighs, calves, and ankles
53
what is Plethysmography used in conjunction with?
segmental pressures
54
Pneumoplethysmography (PPG)
ABI is measured first
55
PPG toe pressure
uses an infrared PPG to determine small vessel vasculature distal to ankle
56
what are toe pressure studies useful to determine?
ulcer healing potential in the diabetic foot
57
PPG-venous reflux testing
measures effciency of musculovenous calf pump
58
what does PPG-venous reflux testing measure?
changes in skin blood volume using a small light probe places on skin above ankle
59
describe how venous reflux is determined?
1. After exercising the calf by moving the foot up and down at the ankle, the patient rests 2. The rate at which the blood returns to the skin is measured 3. Poor emptying of the skin = venous reflux
60
why is the assessment and diagnosis of lower limb peripheral arterial occlusive disease (PAD) is important?
it can lead progressively to disabling claudication, ischaemic rest pain and gangrene
61
Pulse contours can be used to obtain the same information obtained from ___________
digital arteries
62
what do pressure measurements of the toe allow us to predict?
the healing potential of foot lesion
63
over 90% of foot lesions heal when toe pressure exceeds _________
30 mmHg
64
what toe pressure are consistent with rest pain?
under 20 mmHg
65
where are toe pressures especially useful in?
diabetic patients with in compressible calcific ankle arteries
66
Photoplethysmography PPG
provides more reliable results and offers the you to view a waveform of blood flow from the tip of the toe
67
In diabetic patients, what would ABI readings above 1.3 indicate?
hardening of the leg arteries
68
why do hardening of leg arteries produce high ABI?
because arteries require more pressure to compress and toe arteries are used as an alternative
69
when should diabetics take the ABI/toe test??
annually
70
where are digital pressures placed?
pneumatic toe cuffs on big toe, ankle, and arm
71
what does digital pressures predict?
outcome of future amputation due to PAD of small vessels in foot
72
TBI
toe brachial index
73
TBI over 0.8
no significant PAD
74
TBI 0.2-0.5
claudication
75
TBI less than 0.2
rest pain
76
what is the cold stress test?
assesses the change in circulation of the digits in response to induced vasospasm
77
what is used in a cold stress test?
- PPG - PVR - digital thermisters - doppler and segmental pressures
78
describe cold stress test
1. waveforms are all recorded prior to cold water bath 2. waveforms are recorded post cold water bath immediately and at several intervals until temperatures return to normal 3. waveforms are analyzed and compared for change
79
when is a penile doppler used?
presence of impotence-ED
80
what may penile doppler be the result of?
nervous, arterial, venous and sinusoidal factors
81
what are taken with doppler of the cavernosal artery?
baseline PSV and EDV
82
what is used before doing a penile doppler?
60 mg of papavarine is injected intercavernosally to induce erection
83
when is PSV and EDV measures in penile doppler?
5, 10, 15 & 20 minutes
84
PSV penile doppler
indicator for arterial dysfunction
85
EDV penile doppler
indicator for venous dysfunction
86
what is MRI used for?
image arterial blood vessels for stenoses, occlusions, and aneurysms
87
what does MRI display?
blood flowing through the vessel
88
duplex imaging
- safe - inexpensive - non-invasive - reliable
89
what does duplex imaging help screen?
PAD | venous disease
90
what is the drawback of duplex imaging?
accuracy however is operator dependant

Vascular (10 decks)

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