Arterial Ulcers-Test 2

Question 1

Where are arterial ulcerations generally located?

Answer 1

Distal extremity

usually on the foot or toes

Question 2

What causes ulcerations of the extremities?

Answer 2

Lack of blood flow, makes it hard for anything to heal

Question 3

Why is diagnosis (arterial ulceration) generally missed in patients?

Answer 3

Intermittent claudication
Vague reports of impaired mobility
Leg weakness

Question 4

Ankle brachial index (ABI) lower than _______ indicates impaired blood flow

Answer 4

.90

Question 5

Who is lower extremity arterial disease (LEAD) prevalent in?

Answer 5

the elderly

18-29% of people +60

Question 6

How many people in the US have LEAD?

Answer 6

5-10 million

Question 7

T/F lead is asymptomatic until its in advanced stages

Answer 7

TRUE

Question 8

What are some clinical indications of arterial ulcers?

Answer 8

-Intermittent claudication
-Extreme pain (decreased with rest, increased with exercise or elevation)
-Decreased or absent pedal pulse
-Decreased temp of the distal limb
-Distinct, well defined would edges
-Deep wound bed with pale and minimal drainage
Cyanosis, anhydrous skin (blush, dry skin)

Question 9

What is the most common cause of LEAD and ischemic ulcers?

Answer 9

Atherosclerosis

Question 10

What causes the blood vessels to narrow in atherosclerosis?

Answer 10

Plaque formation and enlargement
Endothelial injury
*when vessels are completely occluded the vessels around it have to find a way to get the blood moving, causes dilation of the smaller vessels because the larger vessels get occluded

Question 11

What causes endothelial damage?

Answer 11

Vessel walls become more thick and fibrotic due to internal damage
Damage triggers inflammatory response (collagen and other connective tissue proteins are deposited. Thicker more fibrotic vessel walls leads to more damage and more hardening, viscous cycle)

Question 12

How does atherosclerotic plaque form?

Answer 12

begins with a lesion known as “fatty streak”

plaque hardens over time due to calcium salts and cholesterol crystals

Question 13

As plaque hardens, vessel is ____________

Answer 13

less elastic

Question 14

Risk factors of LEAD? (13)

Answer 14

Smoking
Diabetes
Dyslipidemia
Hypertension
Obesity
Inactivity
Social Isolation
Stress
Advanced Age
Male
Postmenopausal women
Family history
African American ethinicity

Question 15

How does spontaneous ulceration happen

Answer 15

Results from progressive occlusion

–Cellular ischemia and tissue dealth

Question 16

What is involved in spontaneous ulceration?

Answer 16

Toes and distal foot, everything distal to the clot is affected

Question 17

LEAD patients with decreased mobility are at a higher risk or _____ ______

Answer 17

Pressure ulcers

Question 18

T/F Pressure ulcers may occur rapidly in patients with LEAD but are avoidable

Answer 18

TRUE

Question 19

T/F Minor trauma does not cause arterial ulcerations?

Answer 19

FALSE

-Does result in arterial ulceration, not enough O2 to the tissue to heal