The Vascular Physical Principles and Instrumentation Examination is a comprehensive and wide-ranging assessment for men and women who want to enter this rapidly growing area of health care. The examination features six general content areas: cerebrovascular, which makes up 25 to 35 percent of the exam; venous, comprising 25 to 35 percent of the test; peripheral arterial, composing 20 to 30 percent; abdomen and visceral, 5 to 15 percent; miscellaneous conditions and tests, another 5 to 15 percent; and quality assurance, 3 to 5 percent.
The cerebrovascular content area is divided into four subdomains: anatomy, physiology, and hemodynamics; mechanisms of disease; signs and symptoms; and testing. The anatomy, physiology, and hemodynamics subdomain covers the aortic arch, the upper extremity, the cervical carotid, the vertebral arteries, and the intracranial arteries (Circle of Willis). Mechanisms of disease addresses risk factors, atherosclerosis, dissection, thromboembolism, subclavian steal syndrome, carotid body tumor, fibromuscular dysplasia, and neointimal hyperplasia. The section on signs and symptoms reviews transient symptoms, stroke, and the physical exam. The testing subdomain addresses noninvasive testing (e.g., Duplex imaging and transcranial Doppler), miscellaneous diagnostic tests (e.g., arteriography, MR angiography, and CT), and treatment and follow-up (medical, endovascular, and surgical).
The venous content area of the Vascular Physical Principles and Instrumentation Examination contains the four same subdomains: anatomy, physiology, and hemodynamics; mechanisms of disease; signs and symptoms; and testing. The anatomy, physiology, and hemodynamics subdomain in this section covers the upper extremity, lower extremity, central area (i.e. vena cava, innominate veins, and brachiocephalic veins), and venous wall and valves. Mechanisms of disease addresses risk factors, acute venous thrombosis (both deep and superficial), chronic deep venous obstruction, chronic venous valvular insufficiency, varicose veins, congenital disorders, and pulmonary embolism. Signs and symptoms addresses acute and chronic symptoms, such as skin changes, lymphedema, and ulceration. The subdomain on testing covers noninvasive assessments, venography, and treatment methods, such as anticoagulation, thrombolytic therapy, vena caval filter, support hose, and surgery.
The peripheral arterial content area of the Vascular Physical Principles and Instrumentation Examination also has four similar subdomains: anatomy, physiology, and hemodynamics; mechanisms of disease; signs and symptoms; and testing of the upper and lower extremities.
The content area on abdomen and visceral covers the same sorts of topics, but with emphasis on diseases like renovascular hypertension, mesenteric ischemia, and portal hypertension.
The Vascular Physical Principles and Instrumentation Examination section, addressing miscellaneous conditions and tests,, includes preoperative vein mapping, pseudoaneurysms, dialysis access, organ transplants, impotence test, preoperative arterial mapping, temporal arteritis, thoracic outlet syndrome, and trauma.
The smallest but portion of the exam, the quality assurance content area, addresses statistics (e.g., sensitivity, specificity, positive and negative predictive value, and accuracy) and patient safety (e.g. infection control and medical emergencies).