Arterial Vascular Disorders Flashcards
Define Hypertension
High blood pressure
Is hypertension common?
Yes, about 1/3 adults have it and 1/3 of them are undiagnosed.
Who has a higher incidence rate: males or females?
Males do up until the age of 55
After menopause, women exceed men.
What is prehypertension and how common is it?
It is being at the higher end of the normal range. About 1/3 of the population has this.
Which race has the highest incidence in the USA?
African Americans, an early onset is common
What is the nickname of hypertension
The Silent Killer
Is hypertension acute or insidious, what are the signs?
It is insidious, there are mild to no signs
What are the three types of hypertension?
- Primary Hypertension
- Secondary Hypertension
- Malignant or resistant hypertension
What is qualifies primary or essential hypertension?
- Blood pressure is consistently above 140/90 mm Hg
Where is vasoconstriction increased during primary or essential hypertension?
Increased in arteriolar vasoconstriction
What happens if the Kidneys sense a decreased blood flow?
The renin-angiotensin pathway is activated
What does the renin-angiotensin pathway result in?
A further increase of blood pressure
Over long periods of time, hypertension can cause (3).
Damage to arterial walls.
Aneurysms to form
Blood supply to an involved area may be reduced causing ischemia and necrosis of the tissues leading to loss of function.
What are the 4 areas most frequently damaged by hypertension?
- Kidneys
- Heart
- Brain
- Retina
What are the 4 areas most frequently damaged by hypertension?
- Kidneys
- Heart
- Brain
- Retina
What causes secondary hypertension?
It results from renal or endocrine disease or pheochromocytoma (a benign tumor of the adrenal medulla)
How do you treat secondary hypertension?
By fixing the underlying problem you will reduce the blood pressure.
How is Malignant or resistant hypertension categorized?
It is uncontrollable, severe, and rapidly progressive form of hypertension. It has many complications.
Diastolic pressure is extremely high.
Name the 6 predisposing factors of hypertension.
- Incidence increases with age
- Men are affected more frequently and more severely
- Incidence in women increases after middle age
- Genetic Factors
- Intake: Sodium intake, excessive alcohol intake, excessive food intake (obesity), smoking,
- Prolonged or recurrent stress
What are the clinical manifestations of hypertension?
Are there always symptoms of hypertension?
What is the primary sign?
- Frequently it is asymptomatic in the beginning
- Initials signs are vague and nonspecific: Fatigue, malaise, occipital headaches
- Consistently elevated blood pressure under various conditions is the primary sign
How is Essential hypertension treated?
In steps
What are the steps to treating essential hypertension?
- Lifestyle changes
- Reduction of sodium intake
- Weight reduction
- Reduction of stress
- Drugs
What types of drugs are used for primary hypertension?
- Diuretics
- ACE inhibitors
- Combinations of drugs
Define Artherosclerosis
A disease of the arteries characterized by plaques of fatty material on their inner walls
Where do the abnormalities lie in peripheral vascular disease and atherosclerosis?
They are any abnormalities in arteries or veins that are found outside the heart
Which disease is found to have an increased comorbidity with peripheral vascular disease and atherosclerosis?
Diabetes
What are the most common sites for peripheral vascular disease and atherosclerosis?
- Abdominal aorta
- Carotid arteries
- The femoral and iliac arteries
What diagnostic tests are performed for peripheral vascular disease and atherosclerosis?
- Doppler studies and arteriography: used to assess blood flow
- Plethysmography: measures the size of limbs and blood volume in organs or tissues
What are the common clinical manifestations of peripheral vascular disease and atherosclerosis?
- Increasing fatigue and weakness in the legs
- Intermittent claudication
- Sensory Impairment: tingling, burning, numbness
- Peripheral pulses distal to occlusion become weak
- Appearance of skin on the feet and legs changes
Define claudication
What is it associated with (when it comes to peripheral vascular disease and atherosclerosis)?
What is it caused by (when it comes to peripheral vascular disease and atherosclerosis)?
- Leg pain
- It is associated with exercise
- It is caused by muscle ischemia
During peripheral vascular disease and atherosclerosis, how does the appearance of the skin on the feet and legs change?
- Marked by pallor or cyanosis
- Skin dry and hairless
- Toenails are thick and hard
What are treatments for peripheral vascular disease and atherosclerosis?
- What must be maintained (2)
- What must be reduced (2)
- What must be stopped (if applicable to the patient)(1)
- What must be increased (2)
- What drugs are used (3)
- What must be watched for (1)
- What is required if gangrene develops (1)
- Maintain: control of blood glucose level and dependent position for legs (this improves arterial perfusion)
- Reduce: BMI (body mass index) and serum cholesterol level
- Stop: Smoking
- Increase: Activity and exercise
- Drugs: Platelet inhibitors, anticoagulants, peripheral vasodilators
- Watched for: Observe skin breakdown and treat promptly
- Gangrene: amputation
Define perfusion
flow of blood
What happens to the arterial walls during an aortic aneurysm?
Localized dilation and weakening of the arterial walls
Where do aortic aneurysms develop from?
A defect in the medial layer
What are the 3 different kinds of aortic aneurysms?
- Saccular
- Fusiform
- Dissecting aneurysm
Define a Saccular aortic aneurysm
Bulging wall on the side
Define a Fusiform aortic aneurysm
Circumferential dilation along a section of artery
Define a Dissecting aortic aneurysm
Develops when there is a tear in the intima of the wall and continues to dissect or separate tissues
What is the etiology of aortic aneurysms? (4)
- Atherosclerosis
- Trauma
- Syphilis and other infections
- Congenital defects
Are there any sounds associated with aortic aneurysms?
Bruit which is heard on auscultation
When doing an exam on a patient, where might one feel a clinical manifestation of an aortic aneurysm?
Upon palpation of the abdomen, a pulse may be felt.
When do symptoms/signs usually appear for aortic aneurysms?
Frequently they are asymptomatic until they become large and rupture.
What may the rupturing of and aortic aneurysm cause?
May lead to moderate bleeding but usually causes severe hemorrhage and death.
Name 4 diagnostic tests that can be performed for aortic aneurysms.
- Radiography
- Ultrasound
- CT scanning
- MRI
Name 4 treatments that can be done for aortic aneurysms
- Maintain what (1)?
- Prevent what (4)?
- What procedure may be needed (1)?
- Maintain: BP (blood pressure) at a normal level
- Prevent: sudden BP elevations caused by exertion, stress, coughing, and constipation
- Surgical repair
