Claudication Flashcards
what is claudication?
intermittent leg pain due to low flow states
location of disease if calf claudication
femoral disease
location of disease if buttock claudication
internal iliac disease
location of disease if thigh claudication
external iliac
which artery supplies buttock?
internal iliac
location of disease if bilateral leg pain?
aorta
Fontaine classification of PAD
- asymptomatic
- intermittent claudication
- ischaemic rest pain
- ulceration/ gangrene (critical ischaemia)
when can ABPI’s cause falsely high results?
calcified vessels
diagnosis of PAD
colour duplex
investigation of choice if considering intervention of PAD
MR/CT angiography
how does blood get from superficial to deep veins?
via perforator veins at saphenofemoral and saphenopopliteal junctions
what is the saphena varix?
dilatation of saphenous vein at its confluence with femoral vein
transmits a cough impulse so can be mistaken for a hernia, but on inspection has a blueish tinge
what is critical limb ischaemia?
end-stage PAD where there is inadequate blood supply to the foot at rest
presentation of critical limb ischaemia
burning pain worse at night when leg is raised
define gangrene
death of tissue specifically due to inadequate blood supply
what is Leriche syndrome?
occlusion in distal aorta and proximal common iliac arteries (aortoiliac atherosclerosis)
triad in Leriche syndrome
- thigh/ buttock claudication
- absent femoral pulses
- male impotence
what is dependent rubor?
deep red colour when limb is lower than the rest of the body
what is Buerger’s angle?
angle at which the leg turns pale due to inadequate blood supply
why does the leg go blue then dark red when moved t below the level of the heart?
vasodilation in response to waste products of anaerobic metabolism
what does a midline sternotomy scar suggest?
previous CABG
what does a scar on the inner calf suggest?
saphenous vein harvesting for CABG
