ch 10 arterial insufficiency ulcers Flashcards
80% of patients with PAD are current or former….
smokers
PRIMARY cause of arterial insufficiency
arteriosclerosis
The most common form of arteriosclerosis, and the leading cause of arterial insufficiency ulcers in the United States is
atherosclerosis
when circulating cholesterol is deposited on vessel walls, causing fatty streaks or plaques
atherosclerosis
activity-specific discomfort due to local ischemia, which stops within 1 to 5 minutes of ceasing the provocative activity
intermittent caludication
one of the first signs of arterial insufficiencey
intermittent claudication
Patients have at least ___% vessel stenosis if they are experiencing intermittent claudication
50%
The pain of intermittent claudication is repeatable and predictable at the same workload.
T or F
True
represents more significant arterial disease than intermittent claudication and is frequently characterized as a burning pain that is exacerbated at night or with elevation, and is relieved by dependency
ischemic rest pain
Intermittent claudication/ischemic rest pain are relieved by elevating the LE
T or F
False, dependent positions allow for gravity to aid in blood movement`
arterial insufficiency ulcers AKA
ischemic ulcers
Progression of atherosclerotic pain:
Arterial insufficiency → ______________→ Ischemic Rest Pain → ___________
Arterial insufficiency → Intermittent Claudication → Ischemic Rest Pain → Ulcer
1 modifiable risk factor for PVD
smoking
o People with DM have an increased prevalence of ______ arterial insufficiency, that is, their vessel walls tend to accumulate calcium
calcific
Most common site for arterial occlusion…
bifurcation of the femoral artery
Patients with delayed capillary refill time may have arterial insufficiency, normal capillary refill time is….
3 s
Venous filling time indications:
< 5 seconds =
5-15 seconds =
> 20 seconds =
< 5 seconds = venous insuff
5-15 seconds = normal
> 20 seconds = arterial insuff
Absence of a palpable pulse in both _____ arteries is evidence of peripheral arterial disease (PAD)
pedal (dorsal pedis)
Pulses should be assessed with the patient resting supine and are graded on a _______ scale ranged from absent to accentuated
0-3+
pain pattern of arterial insufficiency ulcers
severe, increased with elevation
position of arterial insufficiency ulcers
distal toes, dorsal foot, lateral leg
wound presentation of arterial insuff ulcers
pale granulation tissue
black eschar
gangrene
little to no drainage
periwound of arterial insuff ulcers
thin, shiny, dry, loss of hair
pulses correlated with arterial insuff ulcers
decreased, or absent
temperature near arterial insuff ulcers
decreased
Sharp debridement should be performed on dry, eschar-covered, uninfected arterial ulcers with low ABIs (certainly wounds with ABIs less than 0.3, and possibly less than 0.5)
T or F
False - should not
Avoid compression with arterial insuff ulcers
t or f
True
Gangrenous wounds should not be debrided by PTs and PTAs
t or f
True
LEADING cause of arterial insuff ulcers in the United States
atherosclerosis
Rubor of dependency test results:
1) a return to normal color in the tested foot within 15-20 seconds, and the color will be light red or pink
2) Pallor after 45-60 seconds of elevation
3) Pallor after 30-45 seconds of elevation
4) Pallor within 25 seconds of elevation
1) normal
2) mild arterial insuff
3) mod arterial insuff
4) severe arterial insuff
