Worksheets261 exam C - segmental pressures
Total questions: 51
Worksheet time: 29mins
What is peripheral arterial disease ?
Disease of the arteries of the arms and legs
Disease of the veins in the arms and legs
Disease of the arteries in the arms only
Disease of the arteries in the legs only
What is the most common symptom of PAD affecting the lower extremities?
Paralysis
Parethesia
Intermittent claudication
Thrombus
What is leg discomfort caused by activity that is relieved with cessation of activity?
Intermittent claudication
parethesia
Thrombus
PAD
When do we start a PAD exam?
After 10-20 mins of exercise
After 10-15 mins of exercise
After 5-10 mins of exercise
Before exercise
What should the width of the cuff be?
At least 25% wider than diameter of limb segment
At least 30% wider than diameter of limb segment
At least 20% wider than diameter of limb segment
At least 20% narrower than diameter of limb segment
What would the pressure be if the cuff is too narrow?
Falsely lower
Falsely elevated
It doesn’t matter the pressure is the same either way
Won’t read the pressure at all
What would the pressure be if the cuff is too wide ?
Falsely lower
Falsely elevated
Cuff size doesn’t matter the pressure with read the same
Pressure can’t be read at all
What cuff size is adequate in most patients for brachial ?
10 cm
10-12 cm
10-15 cm
15 cm
What cuff size for is adequate for most patients for ankle level ?
10 cm
10-12 cm
10-15 cm
15 cm
Where are cuffs placed for upper extremity evaluations ?
Upper arm
Forearm
Wrist
Elbow
Is 3 cuff or 4 cuff method more accurate?
3
4
Both have same/similar results
2 thigh cuffs provide proximal and distal pressure measurements but artifactually evaluated blood pressures are obtained at the ___
Brachial
High thigh
Calf
Low thigh
What is each cuff inflated to for PVR?
50-55 mmHg
50-60 mmHg
55-65 mmHg
50-65 mmHg
What do we do 1st for indirect arterial testing ?
(a)
What is PVR assessing ?
Change in limb size when blood enters the area
Change in cuff size when blood enters the area
Change in limb size when blood exits the area
Change in cuff size when blood exits the area
What doe PVR waveforms relate to?
Moment-to-moment volume changes
Second-to-second volume changes
Difference between arterial & venous outflow
Systolic velocity of arterial flow to venous flow
___ limb volume increases rapidly during SYSTOLE creating a brisk upstroke and well-defined peak
Abnormal
Normal
What probe is used for segmental pressures?
8-10 MHz Doppler
7-10 MHz Doppler
4-7 MHz Doppler
1-3 MHz Doppler
Angle the CW Doppler probe ___ to the skin
45° - 90°
45° - 60 °
30° - 60°
30° - 45°
When may the Doppler angle be better at 90°
Behind the knee
Above the knee
At the ankle
On top of foot
We angle the probe so that blood flow moves ___
Retrograde
Antegrade
Bidirectional
Unidirectional
What is another name or type of monitor for segmental pressure exam ?
Strip-cheat recorder
Strip-chart recorder
Recorder display
there isn’t one
The cuff is deflated slowly at a rate of approximately ___
2 mmHg/s
3 mmHg/s
4 mmHg/s
5 mmHg/s
The pressure at which the audible Doppler signal returns is the ___ at the level of the cuff
Systolic pressure
Diastolic pressure
How do we calculate ABI
highest brachial systolic pressure / highest systolic pressure at the ankle
Highest diastolic pressure at the ankle / highest brachial systolic pressure
Highest systolic pressure at the ankle / highest brachial systolic pressure
Highest systolic pressure at the ankle / highest brachial diastolic pressure
What ABI is considered incompressible or unreliable ?
> 1.3 - 1.7
> 1.3 - 1.5
< 1.3 - 1.5
1.3
What is normal ABI
> 1
0.5 - 0.8
> 0.9 - 1.0
0.8 - 0.9
What ABI may be WNL
> 1
> 0.9 - 1.0
0.8 - 0.9
0.5 - 0.8
What ABI is mild arterial disease
0.8 - 0.9
0.5 - 0.8
0.9 - 1.0
1
What ABI is claudication
0.6 - 0.9
0.5 - 0.9
0.8 - 0.9
0.5 - 0.8
What ABI is rest pain
> 0.5
< 0.5
< 1
> 1
What waveforms are triphasic or biphasic & bidirectional
Resting Doppler waveforms distal to the knee
Resting Doppler waveforms proximal to the knee
Resting Doppler waveforms distal to calf
Resting Doppler waveforms proximal to calf
What waveforms exhibit a diacritic notch
Plethysmography
Platypusmogrphy
Photography
Plethysmograft
What waveforms have a well-defined peak ?
Continuous
Pulse
Systolic
Diastolic
What is normal ABI for resting & post exercise ?
0.90 - 1.30
0.9 - 1
0.80-0.90
0.50 - 0.80
Resting & post-exercise toe-brachial indices are ___
> 0.80
< 0.80
< 0.90
> 0.90
Single (wide) above-knee cuff systolic pressure is ___
Equal to lower brachial
Equal to higher brachial
Higher than higher brachial
Lower than higher brachial
High thigh (narrow) cuff systolic pressure is ___
Equal to higher brachial
Equal to lower brachial
>\= 30 mmHg about higher brachial
>\= 30 mmHg below higher brachial
All pulse waveforms have ___
Short diastolic upstroke
Short systolic upstroke
Tall diastolic upstroke
Tall systolic upstroke
What is the pulse waveform systolic measurement (if possible)
< 130 m/s
> 135 m/s
< 135 m/s
> 130 m/s
What is the difference between adjacent limb segments ?
</= 20 mmHg
>/= 20 mmHg
</= 30 mmHg
>/= 30 mmHg
What is the difference between brachial systolic pressures ?
</= 20 mmHg
>/= 20 mmHg
</= 30 mmHg
>/= 30 mmHg
What helps differentiate true vs false claudication?
Rest testing
Standing still for 1 minute
Exercise testing
Laying down for 1 minute
What is exercise testing ?
Patient walks up and down the hall for 5 minutes
Patient walks on treadmill with </= 12 % incline at 2 mph for 5 minutes or until symptoms
Patient walks on treadmill with </= 12 % incline at 1.5 mph for 5 minutes or until symptoms
What do we document for exercise testing ?
Walking duration
MPH
onset
Location of symptoms
Progression of symptoms
Where are post-exercise Doppler pressures obtained ?
left ankle then highest brachial
Right ankle then higher brachial
both ankles then higher brachial
Both ankles then lower brachial
With drop after exercise, when are pressures obtained?
Every 2 minutes until pre-exercise pressures are attained
Every 3 minutes until pre+exercise pressures are attained
Every 4 minutes until pre+exercise pressures are attained
Every 5 minutes until pre+exercise pressures are attained
What is single level disease ?
Takes 6-12 minutes for ABIs to increase back to resting levels after they dropped to low unrecordable levels after exercise
Takes 2-6 minutes for ABIs to increase back to resting levels after they dropped to low unrecordable levels after exercise
What is multi-level disease ?
Takes 2-6 minutes for ABIs to increase back to resting levels after they dropped to low unrecordable levels after exercise
Takes 6-12 minutes for ABIs to increase back to resting levels after they dropped to low unrecordable levels after exercise
Calcified vessels render falsely ___ Doppler pressures
Lower
Elevated
What can we not discriminate b/w ?
Stenosis & occlusion
Precisely localized area of obstruction
CFA & external iliac disease
