16. Peripheral Arterial And Venous Disease Flashcards
How does blood travel back up the leg?
Soleus and gastrocnemius muscle contribute to pushing blood against gravity back towards the heart
Valves open, blood pushed through to deep veins, valves close to prevent retrograde movement
What happens in peripheral venous disease?
Varicose veins - valve ineffective and blood movement is slow or even reversed (saphenous veins)
Walls of veins weaken, varicosities develop and valve cusps separate
Veins tend to be tortuous and twisted
What are the symptoms of peripheral venous disease?
Heaviness and aching, muscle cramps and throbbing, itchy skin
Haemorrhage
Varicose eczema
Superficial vein thrombophlebitis
Chronic venous insufficiency - oedema, haemosiderin staining, lipodermatosclerosis, venous ulceration
What is venous eczema?
Chronic, itchy red and swollen, tight and can lead to lipofermatosclerosis
Hard to touch
What is venous ulceration?
Chronic, painful, often develop around hard modular areas like medial malleolus
Development of chronic venous insufficiency in ~505 DVT patients
How is at risk of venous hypertension and calf muscle pump failure?
Elderly, immobile, obese, injured
How is venous hypertension treated?
Ligation and vein stripping
What are the alternative routes formed in the arterial system?
Collateral circulation
What causes acute limb ischaemia?
Occlusion occurs acutely (minutes to days)
Trauma ad embolism
What are the symptoms of acute leg ischaemia?
Pain Pallor Perishing with cold Pulseless Paraesthesia Paralysis or reduced power
What are the symptoms of chronic peripheral arterial disease?
Intermittent claudication of lower limb (cramping pain induced by exercise)
Pain goes away upon rest
What is the management for chronic peripheral arterial disease?
Exercise Smoking cessation Antiplatelet drugs Angioplasty Bypass graft
What are the symptoms of critical ischaemia?
Rest pain - blood supply so poor pain at rest, hanging foot out of bed relieves pain
What can untreated critical ischaemia lead to?
Ulceration and gangrene, viability of limb severely compromised
Where are the 4 areas you can palpate pulses in lower limb?
Femoral pulse
Popliteal pulse
Dorsalis pedis pulse
Posterior tibial pulse
