Arterial Disease of the Limbs Flashcards
what is peripheral arterial disease
it is a common circulatory problem in which narrowed arteries reduce blood flow to your limbs, your extremities don’t receive enough blood flow to keep up with demand
what is chronic limb ischaemia
it is peripheral arterial disease that results in symptomatic reduced blood supply to the limbs
where does acute ischaemia occur
where there is a sudden lack of blood flow to a limb
it is inhibition of blood flow to/through the limb
what causes acute ischaemia
embolism or thrombosis
also rarely caused by dissection or trauma
describe diabetic foot disease
it is the foot affected by ulceration that is associated with neuropathy and/or peripheral arterial disease of the lower limb in a patient with diabetes
at what vertebral level does the aorta split into the iliac arteries
T10
what usually causes critical limb ischaemia
obstructive atherosclerotic disease
what can critical limb ischaemia also be caused by apart from obstructive atherosclerotic disease
atheroembolic or thromboembolic disease, vasculitis, in situ thrombosis related to hyper coagulable states, thromboangitis obliterans, cystic adventitial disease, popliteal entrapment, trauma
what does critical limb ischaemia refer to
a condition characterised by chronic ischaemic at-rest pain, ulcers, or gangrene in one or both legs attributable to objectively proven arterial occlusive disease
what are the risk factors of critical limb ischaemia
male age smoking hypercholesterolaemia hypertension diabetes
state peripheral arterial disease symptoms
painful cramping in your hip, thigh or calf muscles after certain activities, such as walking or climbing stairs
claudication
leg numbness or weakness
coldness in your lower leg or foot, especially when compared with the other side
shiny skin
brittle toenails
hair loss on your legs and feet
the pulse in your leg being very weak or undetectable
leg ulcers
symptoms associated with stage 1
asymptomatic
incomplete blood vessel obstruction
symptoms associated with stage 2
mild claudication pain in limb
symptoms associated with stage 2A
claudication when walking a distance of greater than 200m
symptoms associated with stage 2B
claudication when walking a distance of less than 200m
symptoms associated with stage 3
pain at rest, mostly in the feet
symptoms associated with stage 4
necrosis and/or gangrene of the limb
state 5 risk factors associated
over the age of 50 history of diabetes history of smoking obesity high blood pressure
state 3 signs of chronic ischaemia on examination
ulceration
pallor
hair loss
state 3 signs of chronic ischaemia when feeling
capillary refill times
temperature
pulses
peripheral sensatin
state the 2 special tests practiced on examination of peripheral arterial disease
the ankle brachial pressure index test and the Buerger’s test
describe the ankle brachial pressure index test
it is a test widely used to diagnose peripheral arterial disease, as well as assess how well you are responding to treatment
your blood pressure is measured in your upper arms and your ankles when your are lying down
measurements are taken with a Doppler probe
describe Buerger’s test
it is a noninvasive bedside test used to assess the adequacy of the arterial supply of the leg and is performed in 2 stages
the patient lies flat on his back with both legs elevated to an angle of 45 degrees
is there a cure for peripheral arterial disease
no, lifestyle changes and medication can help reduce the symptoms
