Arterial Pathology/ PT history and Physical Exam Flashcards
what is the most common arterial pathology
atherosclerosis obliterans (ASO)
define atherosclerosis obliterans
thickening, hardening, and loss of elasticity of the arterial wall with deposition of plaque within the arterial wall (between the intimal and media)
what are common locations for atherosclerosis obliterans
carotid bifurcation, aorta iliac system, common femoral artery bifurcation, distal superficial femoral artery
most common symptom of PAD
exertional leg pain (claudication)
what are the 6 P’s
Pain
Pallor (pale)
Pulselessness
Paresthesia (numbness)
Paralysis (unable to move)
Poikiloderma/Polar (cold)
definition of an aneuryssm
dilated artery > 1 1/2 times the diameter of the adjacent artery
what are the two morphology (shape) of aneurysms
fusiform and saccular
define fusiform
spindle shaped aneurysms, diffuse, circumferential, variable in diameter and length (see page 32)
define saccular
more spherical, often involving, a short segment of the vessel (see page 32)
most common location for aneurysm
infrarenal abdominal aorta
50% of patients with a popliteal aneurysm will have a ______
aortic aneurysm
T or F: patients with a aneurysm have a much higher incidence of another
True
most common cause of an aneurysm
atherosclerotic disease
what are the causes of aneurysms
atherosclerotic disease, congenital, and infection (mycotic)
What is the most frequent abdominal aortic aneurysm complication and what is the most frequent peripheral arterial aneurysm complication
abdominal aortic aneurysm - rupture
peripheral arterial aneurysm - embolization
define arterial dissection
intimal wall layer develops a tear and fills with blood dividing the vessel into a true lumen and a “false” lumen
what causes arterial dissection
spontaneous, trauma, hypertension
most common location for dissecting aneurysm
thoracic aorta
define coarctation of the aorta
congenital anomaly
stricture of the thoracic aorta
symptoms of coarctation
lower extremity ischemia
leg pain
decreased/absent pulses
define fibromuscular dysplasia (FMD)
non atherosclerotic disease
abnormal cellular growth in the walls of medium and large arteries
found in middle aged women
STRING OF PEARLS
most common location of FMD
distal internal carotid arteries and/or renal arteries
define arteritis
inflammation of the arterial wall, chronic inflammation may lead to thrombosis (thromboangiitis obliterans)
most common location for arteritis
small vessels
ex: digital arteries, tibial vessels
what are the types of arteritis
Buerger’s disease, Takayasu’s arteritis, temporal arteritis
define buerger’s disease
men <40 y/o
heavy smokers
occlusion of distal arteries and rest pain/ulceration/gangrene
define Takayasu’s arteritis
affects aortic arch and its branches
most common in females
pulselessness disease
chronic inflammation leads to obstruction.
define temporal arteritis
affects temporal artery
left untreated may lead to blindness
describe Raynaud’s phenomenon
intermittent digital ischemia (low blood flow) due to small vessel vasospasm (narrowing of arteries)
secondary to cold exposure or emotional stress
symptoms: digital ischemia with/without pain
describe primary Raynaud’s
common in younger women
bilateral
benign conditions
describe secondary Raynaud’s
vasoconstriction with another condition, tissue necrosis, ulceration
define popliteal artery entrapment
popliteal artery is compressed by the medial head of the gastrocnemius muscle
congenital
may result in stenosis, aneurysm or occlusion
often found in young athletes
describe thoracic outlet syndrome (TOS)
compression of the neurovascular bundle by the shoulder structures (cervical rib, clavicle, and scalene muscles)
symptoms occur when arm is in certain positions, symptoms are neurogenic
describe Leriche syndrome
aortic iliac obstruction/occlusion
more common in male
absent femoral pulses
profound exertional pain in hips, thighs, and calves
pallor or coldness
impotence
define pesudo-claudication
false claudication, neurogenic claudication
define pallor in relation to patient condition
pale, white; the result of insufficient blood supplyl to the tissue
define rubor in relation to patient condition
reddish, often with dependency, suggestive of dilated subcutaneous vessels secondary to ischemia/reactive hyperemia
define cyanosis in relation to patient condition
bluish discoloration - high concentration of deoxygenated hemoglobin
describe blue toe syndrome
suggestive of distal micro emboli.
possible source/most commonly thrombus formation within an aneurysm (aortic or popliteal)
describe capillary refill time
increase in capillary refill time suggest decreased arterial pressure/perfusion
normal refill time is <3 seconds
Compare right to left side
a palpable “thrill” is common in
arteriovenous fistula, a normally functioning dialysis access fistula, or possible post stenotic turbulence
