Term
What is blood flow directly propertional to? How is this measured? |
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Definition
perfusion pressure; pulses |
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Term
What is blood flow inversely related to? |
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Definition
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Term
In a major artery, this will result in a drop in perfusion pressure distal to an occlusion. |
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Definition
A hemodynamically significant obstruction |
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Term
True or false, Blood volume and blood flow vary with exercise. |
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Definition
False! Blood volume is always constant. |
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Term
Name the disease that is a progressive degenerative disease affecting the intimal lining of major arteries. |
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Definition
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Term
Name the 7 risk factors for atherosclerosis. |
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Definition
1. hyperlipidemia 2. cigarette smoking 3. hypertension 4.diabetes mellitus 5. age 6. homocysteine elevation 7. fibrinogen concentration (viscosity) |
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Term
Name the risk factors for atherosclerosis that are patient induced. (X2) |
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Definition
Hyperlipidemia; Cigarette Smoking. |
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Term
Which risk factors for atherosclerosis are independent of the patient? (X5) |
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Definition
Hypertension, Diabetes mellitus, age, homocysteine elevations, fibrinogen concentrations. |
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Term
Name the three stages of atherogenesis in order of severity. |
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Definition
Fatty Streak, Fibrous Plaque, Advanced Atheroschlerotic lesion. |
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Term
___ cholesterol increases risk of atherogenesis, _____ cholesterol decreases risk of atherogenesis. |
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Definition
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Term
Which of the following are roles of epithelial cells during atherogenesis?
-more than one may be correct-
a. secrete growth factors
b. takes up oxidized LDL
c.secrete vasoactive agents
d. collagen formation
e. attracts leukocytes. |
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Definition
A, C, D
Epithelial cells secrete growth factors and vasoactive agents, and collagen formation occurs. |
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Term
All of the following are true of the role of macrophages in atherogenesis EXCEPT:
a. attract smooth muscle cells
b. stimulate production of endothelial cells
c. stimulates production of growth factors
d. dispose of oxidized LDL
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Definition
D. Dispose of oxidized LDL
Macrophages attract smooth muscle cells, stimulate production of endothelial cells and growth factors, and take up oxidized LDL |
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Term
Name the cell associated with the following roles:
1.secrete growth factors
2. secrete vasoactive agents
3. attract leukocytes and sm. m. cells
4. adhesion-aggregation reaction |
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Definition
These are all roles of platelets.
Platelets secrete growth factors and vasoactive agents, attract leukocytes and smooth muscle cells, and have an adhesion-aggregation reaction |
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Term
What are fatty streaks made of? |
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Definition
Foam cells
(more specifically, accumulations of lipid laden macrophages) |
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Term
True or False.
Fibrous plaque is more likely to form at straight areas of arteries. |
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Definition
False.
Fibrous plaque forms at branches, angles, and bifurcations of arteries. |
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Term
What are foam cells derived from? |
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Definition
Macrophages & Myointimal Cells (modified sm. m cells) |
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Term
Identify the stage of athroschlerosis.
1. a central core of macrophage foam cells exist.
2. Fibrous cap may rupture due to stress
3. extracellular lipid matrix expands
4. cellular necrosis occurs |
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Definition
This is Advanced Atherosclerotic Lesion
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Term
what are two complications of advanced plaque? |
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Definition
plaque ulceration may produce embolic debris
&
induced thrombus formation |
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Term
Identify the results of Atherosclerosis:
a. stenosis
b. occlusion
c. gangrene
d. embolism
e. aneurysm
f. all but one is correct |
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Definition
F. all but one is correct.
Results of atherosclerosis are occlusion, stenosis, embolism, and aneurysm. |
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Term
______(a)_____- any indication of disease perceived by patient
_______(b)______ any sign or circumstance that points to or shows the cause of a disease |
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Definition
(a) Symptom
(b) Clinical Indication |
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Term
A patient comes to you for a test with complaints of an aching, cramping pain in the calf, thigh , hip, and buttock. The patients pain has been slowly increasing over the last two weeks. What is the likely cause of the patients visit? |
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Definition
The patient has Intermittent Claudication.
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Term
True or False.
Intermittent Claudication cannot be reproduced by a consistant amount of exercise. |
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Definition
False.
Intermittent Claudication is reproducible by a consistant amount of exercise. |
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Term
Name the common identifiers of Intermittent Claudication. |
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Definition
-aching/cramping in hip, calf, thigh, or buttock resulting from ischemia
-gradual onset
-reproducible with consistant exercise
-prompty relieved by stopping exercise
-shorter distance possible when walking uphill |
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Term
A patient is sent to your lab with complaints of a dull aching sensation in his toes and forefoot. He tells you that his pain occurs primarily when he is trying to sleep and when he sits in this lazy boy chair, but is better during the day when walking around. What does your patient have? |
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Definition
Your patient has Ischemic Rest Pain.
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Term
Name the characteristics of Ischemic Rest Pain. |
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Definition
-dull aching in forefoot or toes
-pain worse when supine
-pain relieved by dangling the affected foot |
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Term
In the event that Ischemic rest pain is left untreated, what will occur? |
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Definition
tissue necrosis.
(This in turn can lead to uclers/abraisions
and eventually gangrene) |
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Term
Diminished or absent pulses, pallor and cool limb, loss of hair, thickened toes, and delayed return of capillary blush are all examples of:
a. gangrene
b. intermittent claudication
c. Clinical indication
d. symptoms |
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Definition
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Term
Name the category.
1. osteoarthritis
2. neuralspinal compression
3. venous disease
4. diabetic neuritis |
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Definition
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Term
What traits/symptoms indicate venous disease? |
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Definition
Pain with dependency
&
Relief by elevation |
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Term
Name the Classifications of Lower Extremity Atherosclerosis. |
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Definition
Classifications of Lower Extremity Atherosclerosis:
Stage 1 Pathological changes in arteries
Stage 2 Intermittent Claudication
Stage 3 Rest Pain
Stage 4 Presence of trophic lesions |
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Term
When taking segmental pressures, where are the cuffs placed in the four cuff method? |
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Definition
Ankle (above malleoli)
Calf (below tibial tubercle)
Low Thigh (above patella)
High Thigh (below groin) |
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Term
In this physiologic test cuffs are inflated and doppler signal signifying the return of blood flow in the ankle is used to establish blood pressure. |
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Definition
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Term
What is the main concern in seg pressures when testing the thigh? |
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Definition
Hemodynamically significant aortoiliac occlusive disease |
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Term
For what type of patient is it critical to take foot and toe segmental pressures? |
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Definition
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Term
ABI's
<1.0 = Abnormal or Normal?
>1.3 = Abnormal or Normal? |
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Definition
<1.0 is abnormal
>1.3 is abnormal
The normal range is 1.0-1.3 |
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Term
Finish the Sentence.
When ankle pressures are less then 55 mmhg..... |
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Definition
ischemic ulcers will not heal
(ankle p <55mmHg-ischemic ulcers wont heal) |
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Term
Finish the Sentence.
In diabetics, ankle pressure..........ischemic ulcers still may not heal due to small vessel disease. |
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Definition
...greater then 55mmHg.... |
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Term
When is prognosis for healing any kind of foot sugery or injury not good? |
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Definition
when toe pressure is less then 30 mmHg |
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Term
In what physiologic test is a measured quantity of air placed into cuffs around extremity and measured for volume changes? |
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Definition
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Term
Correct the information in the following sentence.
While performing a PVR exam, the patient must be standing up. Cuffs may be wrapped tightly or loosly depending on the size and comfort of the patient. The cuffs are placed on the extremity and must be bilateral. |
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Definition
While performing a PVR exam, the patient must be supine. Cuffs must meet criteria or be rewrapped. The cuffs are placed on the extremity and must be bilateral. |
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Term
What is the normal ABI range? |
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Definition
The normal ABI range is 1.01-1.21 |
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Term
What is the ABI range for Intermittent Claudication? |
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Definition
The normal Intermittent Claudication range is .44-.74 |
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Term
What is the ABI range for Ischemic Rest Pain? |
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Definition
The ABI range for Ischemic Rest Pain is .13-.39 |
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Term
What is the ABI range for Impending Tissue Necrosis? |
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Definition
The ABI range for impending tissue necrosis is -.03-.13 |
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Term
The brachial to high thigh difference in pressure gradient should be what? What vessels would disease in this area be corresponding to? |
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Definition
The brachial-high thigh difference should be +30-40. Abnormal findings here could indicate problems in the aorta, iliac a, CFA and SFA. |
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Term
What is the normal gradient difference between high thigh to low thigh? Artery(s) here? |
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Definition
Normal difference between high thigh and low thigh is 5-3 mmHg; SFA |
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Term
What is the gradient difference between above the knee to below the knee? Corresponding Arteries? |
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Definition
above-knee to below-knee difference is 12; distal SFA and Pop. A. |
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Term
What is the gradient difference below the knee to the ankle? |
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Definition
the gradient difference below the knee to the ankle is 10-11. It correlates with the trifurcation vessels. |
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Term
After exercise testing, what signifies claudication? |
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Definition
A pressure drop in diseased ankle. |
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Term
What can affect PVR wave amplitude? |
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Definition
stroke volume, BP, and vasomotor tone |
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Term
Exercise tests are done to differentiate between what two types of claudification? |
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Definition
exercise tests differentiate between vasculogenic claudication and psuedoclaudication. |
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Term
Persons with hemodynamically significant lesions will have a(n) (increase;decrease)in ankle pressure. |
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Definition
persons with hemodynamically significant lesions will have a decrease in ankle pressure |
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Term
Hemodynamically significant lesion the degree of pressure drop is ________ to flow across the lesion. |
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Definition
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Term
In low flow state, pressure drop _______. If flow increases, pressure drop _______. |
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Definition
Low flow state--> pressure drop low Flow increases--> pressure drop increases |
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