Physiological Adaptation Q 169
Claudication is a well-known effect of peripheral vascular disease. Which of the following facts about claudication is correct? Select all that apply.
A. It results when oxygen demand is greater than oxygen supply.
B. It is characterized by pain that often occurs during rest.
C. It is a result of tissue hypoxia.
D. It is characterized by cramping and weakness.
E. It is relieved after a short rest.
Correct Answer: A, C, D, & E.
Claudication describes the pain experienced by a patient with peripheral vascular disease when oxygen demand in the leg muscles exceeds the oxygen supply. This most often occurs during activity when demand increases in muscle tissue, and usually relieved after rest. The tissue becomes hypoxic, causing cramping, weakness, and discomfort.
Option A: Intermittent claudication (IC) typically refers to lower extremity skeletal muscle pain that occurs during exercise. IC presents when there is insufficient oxygen delivery to meet the metabolic requirements of the skeletal muscles.
Option B: Pain occurs during activity when demand increases in muscle tissues, not when at rest. IC is commonly localized to the thigh, hip, buttock, and calf muscles. Pain within these muscle groups is reproducibly induced by walking and relieved with rest. The severity of pain can sometimes correlate with the degree of stenosis or blockage in arteries supplying the lower extremities.
Option C: The key feature of intermittent claudication is that the muscle discomfort is reproducible. The pain usually comes on during physical activity and subsides after a period of rest. The key reason for the pain is inadequate blood flow.
Option D: Physical examination of these patients may show evidence of arterial insufficiency. The affected limb may feel cool and have diminished pulses. The physical examination should include an assessment of femoral, popliteal, dorsalis pedis, and posterior tibial artery pulses.
Option E: Structured walking programs improve pain-free walking distance better than pharmacologic therapy alone. It is important to note that continued smoking with walking therapy restricts improvement in these patients.