Correct Answers! (Graded A+)
where would you palpate the brachial pulse? - medial to biceps tendon near elbow crease
where would you palpate femoral artery? - medial to ASIS
where do you palpate popliteal artery? - back of knee, medial to biceps femoris tendon
where do you palpate posterior tib artery? - behind medial malleolus
where do you palpate dorsalis pedis? - between the first and second metatarsal
you are in a 1pm session and your patient forgot to eat today, you try to find their radial pulse but it
is diminished and barely palpable... what grade of pulse do they have? - 1
a person with a full, increased pulse will have what grade? - 3
decreased/absent pulses are associated with ____ or dysfunction - PAD
T/F: you start with the most proximal pulse when measuring - F; distal first!
what position would you put a patient in to palpate a LE pulse? what pulse would you start with? -
put pt in supine and start with pedal pulse (b/c its most distal)
_____ ____ are blockages of large to medium size arteries supplying blood to the LEs -
atherosclerosis obliterans
thromboangioitis obliterans or ______ disease is an inflammatory process that causes vessel
blockage of (central/peripheral) arteries and veins - Buerger; peripheral
*i remember it by: if you only eat burgers you will have blockages... despite what liver king says
,______ ____ are abnormal communications between the arteries and veins WITHOUT connecting
capillaries - arteriovenous fistulas
what is a fistula? - Abnormal connection between two tubes
_____ phenomena is bilateral paroxysmal ischemia of the fingers and toes - raynaud
What does paroxysmal mean? - It comes and goes, sudden onset
T/F: Buerger's disease affects the peripheral blood vessels (both arteries and veins) - T
T/F: Buerger's disease affects mainly the extremities - T (hence why its a peripheral disease....
lightbulb!)
what disease is often found in young men ages 20-45 and is directly correlated to heavy smoking
history? - Buerger's
*if they stop smoking, the outcome turns favorable for tx; if not, can progress to gangrene and
amputations
____ disease is an episodic vasoSPASTIC disorder characterized by digital color change (white to blue
to red) with exposure to a cold environment or emotional stress - Raynaud's
the color change in Raynaud's is due to what 3 events? - 1. vasoconstriction
2. cyanosis
3. vasodilation
T/F: Raynaud's pts do not have palpable peripheral pulses - F; they do!!!
what makes Raynaud's disease turn into Raynaud's phenomenon? - phenomenon = if disease is
associated with another systemic or regional disorder
All of the following are risk factors for PAD EXCEPT:
, A. Smoking
B. HTN
C. Cholesterol <200
D. DM for 10+ years
E. Sedentary lifestyle - C. Cholesterol OVER 200
Are males or females at a higher risk for PAD? - males
why is a sedentary lifestyle a risk for PAD? - veins need muscle contraction to increase their blood
flow to the body since they don't have valves!
Is it important to know if a pt potentially at risk for PAD disease has recently had prolonged bed rest?
- YES (DVTs)
what types of pain can be caused by bed rest combined with leg elevation and reduced CO? -
nocturnal and rest
what type of pain in PAD is associated with advanced occlusive disease (greater than 90% occlusion)?
- rest pain
*nocturnal pain is first then can develop into rest pain as occlusion progresses
______ is a non-invasive test that compares the BP obtained with a doppler probe in the dorsalis
pedis to the BP in the brachial artery - ABI
what is a normal ABI? - >/= 1.0
what ABI value is high risk and indicates severe arterial disease? - <.49
limitations to ABI include DM, elevated BP, and medial calcific _____; what test can you do instead of
ABI if these are present? - stenosis; toe brachial index