Ch. 5

Question 1

Pressures __________ abnormally distal to disease

Answer 1

Drop

Question 2

ABI of <0.5 indicates?

Answer 2

Severe disease (rest pain)

Question 3

ABI of 0.5-0.8 indicates?

Answer 3

Moderate disease (claudication)

Question 4

ABI of 0.8-0.9 indicates?

Answer 4

Mild disease

Question 5

ABI of 0.9-1.0 indicates?

Answer 5

WNL or Minimal disease

Question 6

ABI of 1.0 indicates?

Answer 6

Normal

Question 7

Ankle > brachial indicates:

Answer 7

No disease proximally

Question 8

Ankle < Brachial indicates:

Answer 8

Theres disease

Question 9

Capabilities of segmental pressure testing (Lower extremities)

Answer 9

• Presence/absence of disease
• Approximate level & severity

Question 10

How do you calculate the ABI?

Answer 10

Ankle pressure / Highest brachial

Question 11

ABI stands for:

Answer 11

Ankle/brachial index

Question 12

When obtaining systolic pressure, pressures must be taken:

Answer 12

Distal to Proximal
(Ankle > Calf > Thigh)

Question 13

Obtaining systolic pressure:

Answer 13

• CW doppler to locate arterial pulse distally (PTA/DPA)
• Inflate cuff to suprasystolic pressure + 30 higher
• Deflate cuff
• Record pressure when pulse returns

Question 14

If cuff is too narrow =

Answer 14

Falsely high pressure

Question 15

If cuff is too wide =

Answer 15

Falsely low pressure

Question 16

Width of cuff =

Answer 16

1.2x greater than diameter of limb

Question 17

The cuff method is done when doing what type of testing?

Answer 17

Segmental pressure testing of lower extremities

Question 18

Limitations of segmental pressure testing (lower extremities)

Answer 18

• Not exact location
• Stenosis vs occlusion

Question 19

With the 3 cuff method where are the cuffs placed?

Answer 19

*Bilateral brachial cuffs
* 1 large thigh, 1 calf, 1 ankle

Question 20

____________ = incompressible vessels often seen in diabetic & end stage renal disease. Pressure will be inaccurately high

Answer 20

Medial calcinosis

Question 21

With the 4 cuff method where are the cuffs placed?

Answer 21

• Bilateral brachial cuffs
• 2 thighs, 1 calf, 1 ankle

Question 22

Technique for segmental pressure testing (lower extremities)

Answer 22

• Basal state (resting for 20 mins)
• Supine (no hydrostatic pressure)

Question 23

Patients with dialysis fistulas, stents, DVT or hx of lymphedema cannot have what exam?

Answer 23

Segmental pressure testing

Question 24

Hyperemia is prolonged in the ______ limb

Answer 24

Obstructed

Question 25

With reactive hyperemia a > 50% drop in pressure =

Answer 25

Multi level

Question 26

With reactive hyperemia a <50% drop in pressure =

Answer 26

Single level

Question 27

A big drop in pressures is considered a ________ reactive hyperemia

Answer 27

Abnormal

Question 28

Transient drop in pressure that returns to resting within 1 min (<34%) is considered a __________ reactive hyperemia

Answer 28

Normal

Question 29

To do a ___________ test you inflate thigh cuff to suprasystolic pressures 3-5 min. release cuff & record ankle pressures

Answer 29

Reactive hyperemia

Question 30

____________ produces ischemia & distal vasodilation. Cutting off the flow forces the body to vasodilate

Answer 30

Reactive hyperemia

Question 31

With exercise testing, if resting level returns <6 min =

Answer 31

Single level disease

Question 32

With exercise testing, if resting level returns > 6 min =

Answer 32

Mutli-level disease

Question 33

If exercise testing is abnormal, repeat ankle pressure every _____ min until return to resting level

Answer 33

2

Question 34

With exercise testing if test is abnormal there will be a _________ in ankle pressure

Answer 34

Decrease

Question 35

* Constant load treadmill * <12% grade elevation * 1.5 mph for 5 mins is what type of testing?

Answer 35

Exercise (Ankle cuffs on)

Question 36

You should not do __________ testing if patient is having difficult walking or breathing, severe HTN, cardiac Hx

Answer 36

Exercise

Question 37

_____________ testing allows to distinguish true VS psudo claudication

Answer 37

Exercise

Question 38

________ produces physiological stress on circulation & reproduce ischemia

Answer 38

Exercise testing

Question 39

Arterial obstructive disease will always __________ the pressures distally

Answer 39

Decrease

Question 40

A 30 or more drop difference between thigh & brachial means:

Answer 40

Disease between those levels

Question 41

A <30 difference between thigh & brachial levels is ___________

Answer 41

Normal

Question 42

With segmental criteria a 4 cuff study high thigh should be:

Answer 42

30 or more higher than highest brachial

Question 43

With segmental criteria a 3 cuff study thigh pressure should be:

Answer 43

Same or higher than brachial

Question 44

What is the purpose of exercise testing?

Answer 44

Stress the circulation