Vascular Tech Chap 9
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Created by:
sonotrixie on November 21, 2010
Subjects:
digit plethysmography and pressures
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38 terms
Terms | Definitions |
|---|---|
 digit plethysmography and pressures | help detect presence of arterial disease. |
| digit plethysmography and pressures | Differentiate fixed arterial obstruction from vasospasm. |
| the vasoconstricted state | Quality of tracings greatly affected by the ______ ______ of atreries before testing begins. (has patient come in from cold weather? been smoking? nervous?) |
| volume plethysmography | with _______ ________ cuffs applied to tightly, can obliterate or diminish the pulse wave forms. |
| photo plethysmography | with ________ ________ improper contact with skin surface will cause poor results. |
| limitations | bandages that can't be removed; ulcerations and/or gangrene may prevent placement of cuff or photocell. |
| limitations | patient with extremity tremor. |
| Toe evaluation | supine with some elevation of head |
| finger evalutation | sitting with arms resting on pillow placed on pts lap. |
| LE arterial exam or ABI | toes should be done in combo with: |
| 1.2 times that of the toe | an appropriately sized cuff, the width at least? is applied to the base of the great toe. |
| end point detector | photocell is? |
| toe pressures: | digit cuff placed at base of great toe. |
| toe pressures | photocell attached to plantar side of toe using double sided tape or velcro strip. |
| toe pressures | pulsed are recorded, paper speed = 5mm/sec |
| toe pressures | while pulsations are recorded, cuff is inflated to 20-30 mmHg above highest brachial p. |
| toe pressures | No pulsations should be seen. |
| toe pressures | Cuff is slowly deflated, watching for return of first pulse to define the pressure level. |
| toe pressures | Can also be with volume plethysmography |
| 3 | select ___ fingers each hand. |
| fingers without cold stress tech | eval doppler signals (tri, bi, mono) and obtain pressures |
| palmer arch | doppler exam of the _____ _____ to verify patency. |
| fingers | apply finger cuffs (sz 2-2.5 cm) |
| fingers without cold stress tech | pressures and waveforms obtained ( similar to toes) |
| Fingers with cold stress | performed in cases of symptomes occuring due to cold sensitivity. (toes can also be evaluated) |
| 3 min for cold stress | After resting study is performed, hands are immersed in ice cold water for ____ ___ if possible. |
| immediately after and five min after | following cold stress, waveforms and pressures are obtained: |
| fingers with cold stress | document patient symptoms, skin color observations and other pertinent findings on the report form. |
| normal waveform qualites: | sharp upstroke during peak systole prolonged down-stroke with notch (reflected wave) approx half way down. Amplitude is usually greater than toe tracings |
| abnormal Obstructive waveform qualities | Occlusion located anywhere prox to the tip of the finger caused the pulse to assume an obstructive form. Slow upstroke to rounded peak Downslope that bows away from baseline |
| Raynauds disease | Upslope is slower than normal Sharp, (anacrotic) notch is present Reflected wave is located high on the downslope Has characteristics of both normal and the obstructive waveforms |
| Organic (fixed) | obstructive disease has abnormal doppler arterial signals, systolic pressures and PPG tracings. |
| Functional (intermittent) | obstructive disease has normal Doppler arterial signals, systolic pressures, and/or PPG tracings; but abnormal findings after cold stimulation. |
| 5 min | Following cold immersion, abnormal cold sensitivity is likely if the amplitude fails to return to baseline levels within _____. |
| 0.8-0.9 | Normal Finger/brachial indices |
| * 60 - 80 % | Normal toe p's vary from ________ of brachial pressure |
| * arterial calcinosis | The presence of artifactually high ankle pressures from ____ _____ usually negates a toe/ankle pressure index. |
| severly reduced pressure | Digital artery occlusion: |
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