Week 7 Flashcards
(29 cards)
Where does the axillary artery run?
From the first rib to the arm pit (terres major)
Where is the most common location for AS in the UE?
SCA
What is TOC?
Thoracic Outlet Compression
Describe TOC
Brachial nerve plexus, SCA, and SCV compressed between the clavicle and 1st rib
What are the symptoms of TOC?
Pain Digital Discoloration Numbness/tingling Swelling (Vein) Color change
Describe subclavian steal syndrome
L SCA obstruction causes L Vertebral artery to act as a collateral and “steal” flow from R. Vertebral artery intended for the brain
Can cause dizziness when using arm
Describe Primary Raynaud’s
No underlying disease
Post vasospasm, arterial size returns to normal
Does not result in sever ischemia requiring amputation
Describe Secondary Raynaud’s
Underlying disease = scleroderma or lupus
Leads to severe ischemia which could lead to amputation
What locations should you perform an UE CW doppler exam?
SCA, AX A, BR A, RAD A, ULN A
T/R. You should see reverse flow in the a normal UE doppler exam.
False. Normal is triphasic but no reverse flow
Where are obstructions most common in the UE?
SCA
What qualifies as evidence of a significant obstruction when comparing right and left brachial pressures?
> 20 mmHg difference
T/F. Forearm pressures are normally higher than arm
True
What difference is significant between arm and forearm
> 20 mmHg
Forearm / Brachial ratio should be __________.
1.0 or greater
What are the contraindications to performing UE seg pressures?
IV or line
Dialysis Graft
Mastectomy on the same side
Describe UE exercise testing
baseline, lift 2 lb weight for 3 minutes, repeat brachial pressures every minute until baseline or 10 minutes
Normal response for exercise testing is _____________.
slight increase or no change in pressure
Abnormal response for exercise testing is _____________
decrease in pressure from baseline with slow return
What distinguishes as abnormal UE PVR?
loss of nicrotic notch, rounding and flattening of wave
What is the purpose of the Allen’s Test?
To determine if the palmar arch is complete or incomplete
The digital / brachial ratio should be calculated using the _____________.
Highest brachial pressure
What is the normal value for Digital / Brachial ratio
0.8
What is the abnormal value for digital / brachial ratio
<0.8
