Atypical Vascular Disorders Flashcards
what is an arteriovenous fistula?
abnormal direct communication between an artery and a vein
arteriovenous fistulas
size of connection and location is important in the development of ___
CHF
traumatic arteriovenous fistulas - ___ connections
congenital arteriovenous fistulas - ___ connections
traumatic arteriovenous fistulas - single connections
congenital arteriovenous fistulas - numerous connections
____ located fistulas are less likely to cause CHF but more likely to cause ___
peripherally located fistulas are more likely to cause ischemia
___ and ___ predict the resistance a fistula offers
diameter and length
arterial proximal to the fistula has greatly ___ flow, especially during diastole
increased flow
arterial flow distal to the fistula can be normal or become more ___
pulsatile
arteriovenous fistulas
BP in the distal artery is always ___
reduced
direction of blood flow may be normal if the fistula resistance exceeds that of the ___
distal vascular bed
flow through the fistula is ___
turbulent
venous flow approaching the fistula is ___
phasic
venous flow moving away from the fistula is ___
phasic and pulsatile
chronic, large fistulas may cause ____ in the distal vein
retrograde (valves are incompetent)
what is compartment syndrome?
build up of pressure around muscles
compartment syndromes are caused by ____
swelling within the osteofascial compartments of the leg, arm, or abdomen
compartment syndrome most commonly results from ___
ischemic injury to the capillary bed
compartment syndrome
___ are more susceptible to ischemia
___ occurs later
nerves are more susceptible to ischemia
muscle necrosis occurs later
4 clinical findings of compartment syndrome
parathesis
pain
weakness of involved muscle
tension of the compartment
compartment syndrome treatment involves ___
fasciotomy - cutting the connective tissue layer surrounding muscles to relieve pressure build up
what is cystic adventitial disease?
cystic fluid accumulates in the wall of the peripheral artery which causes narrowing or occlusion of the vessel
cystic adventitial disease most commonly affects what artery?
popliteal artery
cystic adventitial disease is most common in ___
males 40-50 years old
3 symptoms of cystic adventitial disease
claudication
bruit
loss of distal pulses during flexion or hand/foot
what is popliteal artery entrapment syndrome?
popliteal artery is compressed by the medial head of the gastrocnemius muscle or fibrous bands
popliteal artery entrapment syndrome is most common in ___
young athletes
popliteal artery entrapment syndrome
knee extended + active plantar flexion or passive dorsiflexion of foot =
knee extended + active plantar flexion or passive dorsiflexion of foot = pulses diminish
thoracic outlet syndrome (TOS) - arterial component occurs when ___
neurovascular bundle is compressed between the collarbone and first rib
thoracic outlet syndrome (TOS) - arterial component symptoms (3)
numbness/tingling of arm
pain in shoulders or upper arm
weakening grip
thoracic outlet syndrome (TOS) - arterial component
___% of the population have asymptomatic compression
20-30%
thoracic outlet syndrome (TOS) - arterial component
___ and/or ___ are utilized to detect arterial changes
plethsmographic techniques and/or Doppler analysis
thoracic outlet syndrome (TOS) - arterial component
___ is attached to index finger
___ monitors radial artery
___ monitors pulse volume waveforms
PPG sensor is attached to index finger
CW Doppler monitors radial artery
brachial cuff monitors pulse volume waveforms
what is Adson maneuver positioning?
exaggerated military stance with head turned sharply towards the arm being tested
thoracic outlet syndrome (TOS) - arterial component treatment consists of (2)
shoulder exercises
surgery - resecting the first rib with or without scalene muscle splitting
