Vas week 4: ABI and analog pedal artery waveforms bookwork

Which of the following risk factors is exclusive to arterial disease?

hyperlipidemia

Which of the following is an appropriate indication and shows medical necessity for performing an arterial pressure exam?

Preoperative assessment of healing potential

The most common mechanism of disease affecting the arterial blood supply is

Atherosclerosis

what is paresthesia?

sensation of “pins and needles”

What is the suggested amount of time to “rest” a patient before the exam in order to stabilize blood pressures?

5-10 min

what is the appropriate CW Doppler frequency to use for ABI analysis on an obese patient?

4 MHz

An ABI less than _____ suggests multilevel disease

0.50

A change in the ABI of >0.15 from one study to the next is _____.

Significant

The left brachial pressure is 142mmHg. the right brachial pressure is 118mmHg. the right dorsalis pedis pressure is 138mmHg. the right posterior tibial pressure is 128mmHg. Calculate the ankle-brachial index using the dorsalis pedis pressure.

0.97 (138/172)

A waveform pattern that is describe as triphasic would have

strong forward flow in late systole followed by flow reversal below the baseline

Arterial pressures can be _____ distally if the patient has developed good collateralization in the leg.

normal

Arterial pressures may be falsely _____ if taken with the patient in the sitting position.

elavated

ankle cuffs should be wrapped _____ cm(s) above the medial malleolus

2-3

avoid sampling the dorsalis pedis artery too close to the toes so as not to record a signal from the _____ instead

Plantar arch or a digital vessel

when taking the ankle pressures on the right leg, use the _____ arm brachial pressure to calculate the index

highest

If brachial pressures differ greatly, sample the _____ artery to check flow direction and rule out a subclavian steal

vertebral

The purpose of the ABI is to evaluate the _____ of disease

presence & severity

A hemodynamically significant lesion almost always causes a _____ in the ankle pressure

decrease or reduction

Calculate the ABI for each pedal artery bilaterally

Right PTA: 0.72 Left PTA: 0.55

Right DPA: 0.82 Left DPA: 0.59

Describe this pedal waveform:

Absent or non pulsatile

What would be the interpretation for this case? Describe the pedal waveform patterns and categorize the severity of the ABI

All waveforms are triphasic and all ABI’s are normal

Describe the left dorsalis pedal artery waveform pattern and categorize the severity of the ABI

Waveform is monophasic

200/154=2.6 : since the ABI is above 1.3 it is calcific and considered non-diagnostic

Explain the discrepancy between the ABI and waveform documented for the left DP

Artery is calcified which falsely elevates pressure measurements

Explain why the brachial pressures are low compared to the ankle pressures. What 2 disease processes could be going on?

How are arterial pressures affected by a critical narrowing of the arterial lumen?

Pressures decrease significantly

Define “Poikilothermia”

Ice cold limbs

If the dorsalis pedis arterial signal is not identified at the ankle, how else would you try to obtain pressure information?

After hearing the initial pulse, why is it important to make sure the pulse continues before recording the systolic pressure value?