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level: Peripheral vasculature

Questions and Answers List

level questions: Peripheral vasculature

Question	Answer
chronic vein insufficiency and ulceration	What is this?
1. Inspection 2. Auscultation/palpation 3. Palpation/auscultation	Physical examination
Size and symmetry Color Radial and brachial pulse Epitrochlear lymph nodes	What to inspect in the arms?
Aortic width Pulsatile mass	What to inspect in the abdomen?
Size and symmetry Skin color Pulse of femoral, popliteal, dorsalis pedis and tibial Inguinal lymph nodes (horizontal and vertical) Peripheral edema	What to inspect in the legs?
Used to assess if the blood flow to hand is normal If positive: patient does NOT have adequate blood flow to hand-> no catheterization	Allen's Test
In systole Aorta, renal, iliac and femoral arteries	Where and when is it normal to hear bruits in the abdomen?
not more than 3 cm	What is the normal width of the aorta?
the 6 P's pain pallor poikilothermia paresthesia pulse paralysis	What are the signs of acute limb ischemia?
atheromatosis an accumulation and swelling in artery walls made up of macrophages, or debris, and contain lipids (cholesterol and fatty acids), calcium and a variable amount of fibrous connective tissue	What is the main cause of peripheral arterial disease (PAD)?
- known atherosclerosis in coronary, carotid or renal arteries - age above 70 - younger if: diabetic, smoking, dyslipidemia or hypertension - leg symptoms (intermittent claudication, resting pain) - abnormal pulse	What are "red flags" for PAD
symptom that describes muscle pain on mild exertion (ache, cramp, numbness or sense of fatigue), classically in the calf muscle, which occurs during exercise, such as walking, and is relieved by a short period of rest caused by blockage of arteries early symptom of PAD	intermittent claudication
the ratio of the blood pressure at the ankle to the blood pressure in the upper arm Compared to the arm, lower blood pressure in the leg suggests blocked arteries due to PAD Normal: 0.9-1.3 Mild PAD: 0.6-0.89 Moderate PAD: 0.4-0.59 Severe PAD: less than 0.39	Ankle-brachial index
hypertension in young age (less than 30) Severe or resistant hypertension Unexplained small kidney Sudden unexplained pulmonary edema, especially with worsening renal function Renal function worsening, particularly after use of ACE inhibitors (angiotensin-converting enzyme - dilate blood vessels) and ARB (angiotensin II receptor blockers)	Red flags for renal disease
Sudden back, flank or abdominal pain (rapidly growing or ruptured aneurysm) pulsatile abdominal mass increased aorta width (over 3 cm)	Red flags for abdominal aorta aneurysm (AAA)