Chapter 3: Arterial Testing
Terms in this set (87)
Signs and symptoms of chronic occlusive disease
-Ischemic rest pain
Signs and symptoms of claudication
Pain in muscles during exercise, subsides with rest
What does claudication result from?
inadequate blood supply to muscle
Where is the level of disease usually when someone has claudication
proximal to symptoms
pseudo-claudication mimics vascular symptoms but is where in origin?
neurogenic or orthopedic
What is a more severe symptom of chronic occlusive disease?
ischemic rest pain due to diminished blood flow
When does ischemic rest pain occur
when pt is supine and limb is not dependent
what is tissue loss due to?
deficient or absent blood supply
Symptoms of ACUTE arterial occlusive disease (6 P's)
Pain, Pallor, Pulselessness, paresthesia (nerve pain), paralysis, polar (stiff)
What may ACUTE arterial occlusive disease be a result of?
thrombus, embolism, or trauma
Why is ACUTE arterial occlusion an emergency situation?
because collaterals do not develop
A condition that exists when symptoms of intermittent digital ischemia occur in response to cold exposure or emotional stress.
Symptoms with Raynaud's phenomenon
pallor, cyanosis, rubor (dark red)
Spasms occur by themselves = what type of Raynaud's?
ischemia due to digital arterial spasms
Primary Raynaud's phenomenon
What type of Raynaud's phenomenon is
-common in young women
-may be hereditary
-Hx of symptoms for 2 years w/o progression/evidence of cause
What type of Raynaud's phenomenon is benign with excellent prognosis?
Underlying artery is not healthy with what type of Raynaud's phenomenon
What is another name for secondary Raynaud's?
Obstructive Raynaud's syndrome
Normal vasoconstrictive responses of arterioles superimposed on a fixed artery obstruction.
What is constantly present with secondary Raynaud's?
Secondary Raynaud's may be the first manifestation of ________________________ disease?
how will the skin appear with deficient blood supply
how will the skin appear when there are dilated vessels?
a concentration of deoxygenated hemoglobin
how do arterial ulcers appear?
deep more regular in shape
where are common places for arterial ulcers
death of tissue usually due to deficient or absent blood supply
a _______________________ in capillary refill time denotes decreased arterial perfusion
How will the foot coloration appear when elevated?
how will the foot coloration appears when hanging (dependency) ?
pulse scale (0-4+)
1-barely palpable, intermittent
2-weak, possibly thready, but constantly palpable and with consistent quality
3- normal strength and quality
4-bounding, easily palpable, may be visible
What would an aneurysm be classified as on the pulse scale?
What may cause a palpable thrill or vibration?
-patent dialysis access site
Where can you find palp pulses?
What artery Is not palp?
Raynaud's phenomenon is an example of what type of disorder
vasospastic (sudden constriction of blood vessels)
bruit auscultation is mostly done with carotid and hearts, but what are some additional sites?
What are some arterial risk factors with diabetes
atherosclerosis ( more common in younger aged)
Where is there a higher incidence of arterial disease in pt's with diabetes?
Dist pop A's and PTA's
What is assoc. with a greater incidence of coronary atherosclerosis?
Causes of hyperlipidemia
diet high in animal fat, metabolic problems assoc. with heredity
How does smoking affect blood vessels?
they irritate the endothelial lining and cause vasoconstriction
What are some non controllable risk factors for arterial disease?
what is the most common arterial pathology?
thickening, hardening, loss of elasticity of the walls
Atherosclerotic changes occur in what layer of the vessels
intima and media
What layer is not affected by atherosclerosis
Most common sites for atherosclerosis
-infra-renal, aorto-iliac system
-SFA at adductor canal level (Dist SFA)
Example of atherosclerosis
What is Leriche syndrome caused by
obstruction of the AO
Who does Leriche syndrome occur in
Symptoms of Leriche syndrome
- fatigue in hips, thighs, or calves with exercise
-absence of femoral pulses
-impotence ("dick don't work"-Wes)
Obstruction of vessel by foreign substance or blood clot
How may emboli appear
solid, liquid or gaseous
most frequent cause of embolism
small plaque breaks loose
Example of embolism
-Blue toe syndrome
What is a true aneurysm
-dilation of all 3 arterial wall layers
Example of aneuysms
diffuse, circumferential dilatation
small tear in the inner wall allows blood to form cavity between 2 wall layers
Where do dissecting aneurysms usually occur?
What results from a defect in the main artery wall. (post cath insertion)
(must be a channel communication from main artery to pulsatile structure outside vessel walls)
Where is the most common location for a true aneurysm
Possible causes for aneurysms
What are the most frequent complications with aneurysms
-rupture of aneurysm
-embolization of peripheral aneurysms
Where does arteritis occur?
tibial and peroneal arteries
inflammation of arterial wall leads to ______________________ of the vessel
What is the most common type of arteritis?
Beurgers disease aka
What can arteritis be caused by
heavy cigarette smoking
What age group does arteritis usually affect
men <40 yr's old
What is the main finding assoc. with arteritis
What are symptoms?
-occlusion of the distal arteries
What pathology affects the smaller vessels
coartation of the AO is usually seen in what pt's
Congenital narrowing or stricture of thoracic AO
coarctation of AO
clinical findings with coarctation of AO
-HTN due to decreased kidney perfusion
-LE ischemia (decreased pulses)
An enzyme that converts angiotension to angiotensin
Thin membrane dividing the arterial lumen into 2 compartments
What arterial layer is weakened with dissection
What arterial layer develops a tear through which blood leaks into the media (false lumen)
How are the velocities in each lumen with dissection
the flow velocities are different
Aortic dissections can extend into iliacs and may occur consequent to what
HTN or severe chest trauma
complications of dissection
-occlusion or thrombosis
non atherosclerotic lesions
-Coarctation of AO