Arterial Disease of the Limbs - Presentation, Investigation & Therapy Flashcards
What are examples of arterial diseases of the limbs?
Peripheral artery disease
Acute limb ischaemia
Diabetic foot disease
What is A?
Aorta
What is B?
Illiac arteries
What is C?
Common femoral artery
What is D?
Profunda femoris
What is E?
Superficial femoral artery
What is F?
Poplital artery
What is G?
Anterior tibial artery
What is H?
Dorsalis pedis
What is I?
Posterior tibial artery
What is J?
Peroneal artery
What are normal palpable pulses of the lower limbs?
Aorta
Common femoral artery
Popliteal artery
Posterior tibial pulse
Dorsalis pedis pulse
Where is the aorta palpable?
Where is the common femoral artery palpable?
Mid-inguinal point, half way between the anterior superior iliac spine and the pubic symphysis
Where is the popliteal artery palpable?
Use both hands to feel dleep in the popliteal fossa, leg relaxed into your hands
Where is the posterior tibial pulse palpable?
Half-way between the medial malleolus and the achilles tendon
Where is the dorsalis pedis pulse palpable?
Lateral to the extensor hallucis longus tendon
What does CLI stand for?
Critical limb ischaemia
What is critical limb ischaemia?
Advanced stage of peripheral artery diseases
What is the pathophysiology of critical limb ischaemia?
Atherosclerotic diseases of the arteries to the lower limbs
Vasculitis
Buerger’s disease
What is vasculitis?
Disorders that destroy blood vessels by inflammation
What are disorders that destroy blood vessels by inflammation called?
Vasculitis
What is Buerger’s disease?
Inflammation and thrombosis in small and medium sized blood vessels, typically in the legs
What is inflammation and thrombosis in small and medium sized blood vessels, typically in the legs called?
Buerger’s disease
What do critical limb diseases use the same process as?
Coronary and carotid atherosclerotic disease
What are some risk factors for critical limb ischaemia?
Male
Age
Smoking
Hypercholesterolaemia
Hypertension
Diabetes
Are males or females more at risk from critical limb disease?
Males
What classification is used to classify the stages of peripheral artery disease?
Fontaine classification
What are the different classes of peripheral artery disease?
Stage I
Stage II
Stage III
Stage IV
What is stage I peripheral artery disease?
Asymptomatic, incomplete blood vessel obstruction
What is stage II peripheral artery disease?
Mild claudication pain in the limb
What is stage III peripheral artery disease?
Rest pain, mostly in the feet
What is stage IV peripheral artery disease?
Necrosis and/or gangrene of the limb
Which stage of peripheral artery disease has a A and B?
As well as stage II there is,
Stage IIA
Stage IIB
What is stage IIA peripheral artery disease?
Claudication when walking a distance greater than 200m
What is stage IIB peripheral arterial disease?
Claudication when walking a distance less than 200m
What stages of peripheral artery disease are considered to be criticial limb ischaemia?
Stages III and IV
What is claudication?
A condition in which cramping pain in the leg is induced by exercise. typically caused by obstruction of the artery
What is a condition in which cramping of the leg is induced by exercise, typically caused by obstruction of the arteries?
Claudication
What are common findings in the history for peripheral artery disease?
Claudication
Tissue loss
Rest pain
What questions should be asked for claudication in a history?
Exercise tolerance
Effect of incline
Change over time
Relieved by rest?
Where in the leg
Type of pain
Bilateral?
What questions should be asked for rest pain in the history of peripheral vascular disease?
Type of pain
Relieving factors
What questions should be asked fpr tissue loss in the history?
Duration
History of trauma
Peripheral sensation