Upper Extremity Testing

Multiple Choice

Which of the following is a common symptom of arterial disease in the upper extremities?

• Arm/hand weakness with exercise

• Swelling of the ankles

• Frequent headaches

• Blurred vision

Multiple Choice

Which of the following is NOT a component of the baseline physiologic exam to rule out arterial occlusive disease in upper extremity testing?

• Segmental arm pressures

• Pulse volume recording

• Doppler waveform analysis

• Electrocardiogram

Open Ended

Describe how the baseline upper extremity segmental study (pulse volume recording) helps in diagnosing vascular diseases of the arm.

Multiple Choice

What does a pressure gradient of ≥ 20 mmHg between brachial pressures indicate?

• Subclavian artery disease

• Brachial artery disease

• Raynaud's phenomenon

• Normal vascular function

Multiple Select

Which of the following methods can be used to monitor limb function during a Thoracic Outlet Syndrome test?

• CW-Doppler on radial artery

• Pulse volume recording (PVR) of arms

• PPG on index finger

• Electroencephalogram

Multiple Choice

Which arm position is referred to as the 'stick-up' or costo-clavicular position in traditional TOS test positions?

• Abducted 90 degrees to torso

• Elevated 180 degrees above head

• Adson’s test (30° abduction)

• Elbows at side and to the back, hands up, shoulders pressed downward and back

Multiple Choice

What is the definitive positive finding in a TOS study that suggests vascular compression?

• Increase in amplitude of waveform tracings

• Loss of pulsatility or flatline waveform in symptomatic position

• Decrease in amplitude during resting position

• Waveform tracings remain similar to baseline in all positions

Multiple Choice

Which findings would indicate a positive cold immersion study?

• Waveforms return to baseline amplitude within 5 minutes

• Waveforms do not return to baseline amplitude for more than 10 minutes

• Temperature increases rapidly after immersion

• No change in waveform amplitude

Multiple Choice

What does a persistent decrease in digital waveform amplitude for 10 minutes or longer after cold immersion indicate?

• Normal vascular response

• Vasospastic disorder or Raynaud’s syndrome

• Peripheral neuropathy

• Infection

Multiple Choice

Based on the case study and waveform results, what is the most likely cause of reduced perfusion in the left 3rd, 4th, and 5th digits?

• Raynaud’s syndrome

• Fixed occlusive disease

• Peripheral neuropathy

• Normal physiologic variation

Multiple Choice

Which of the following tests can be used to assess palmar arch patency before radial artery harvest?

• Allen Test

• Doppler Ultrasound

• Electrocardiogram

• Chest X-ray

Multiple Choice

Which of the following is NOT a symptom of arterial disease in the upper extremities?

• Arm/hand weakness with exercise

• Reduced or absent pulses

• Hand numbness/weakness/pain, position related

• Increased sweating