Common sites of PVD Flashcards
What are the three common sites of PVD?
1) aortoiliac (below renal arteries to inguinal ligaments)
2) femoralpopiteal (from inguinal ligaments to popliteal fossa)
3) distal (tibial
What are the three clinical categories of PVD?
asymptomatic
claudication
threatened limb (rest pain. tissue loss)
If an individual is a smoker with PVD what should you suspect?
atherosclerosis
What is this:
bilateral buttock, thigh, leg claudication
impotence
leriche syndrome
What is a good way to resolve claudication?
stop smoking and exercise
What are the 5 p’s of acute ischemia?
pulseless pallor paralysis painful parasthesias
There is a large (blank) that communicates w. circumflex iliac into common femoral artery
iliolumbar branch
There is an anastomotic connection B/w inferior gluteal artery and branches of (blank)
profundus femorus (meidal and lateral circumflex )
What part of the femoral artery turns into the popliteal artery?
superficial femoral artery (becomes popliteal once it goes through adductor magnus hiatus)
What is the most commonly occluded vessel in the body?
the superficial femoral artery
The superficial femoral artery collaterals with the profunda femoris via the (blank)
descending branch of the lateral circumflex
What besides the obturator artery supplies the adductor compartment?
the perforating vessels of the profunda femoris
What is the A/A index?
the ratio b/w the BP taken in the arm and the BP taken in the ankle
if the A/A index is lower, is this more or less severe?
low index= more severe
So there are three arteries to the foot, how many have to be occluded for you to lose your foot?
you have to lose all three
What can A fib do to your femoral artery?
you can get a clot in the left auricle which will result in an embolis at the bifurcation of the femoral artery
Where do you most commonly get compartment syndrome in your leg? What nerve is found here? What would happen if damage this nerve?
anterior compartment
peroneal nerve
foot drop
What is the most sensitive area in the body to ischemia?
nervous tissue
What is this:
cramping with use (flow rate to lower extremities 220 CC /min, can go up indefinitely with exercise)-> flow rate at rest is fine but as soon as they get up and walk they cannot augument flow rates accurately to nourish the muscles which is felt as pain or stiffness.
claudication
What is this:
(specific for vascular disease)-> occurs in the foot even when they are sitting around. If you hang the foot down it augments the blood flow a little bit, if you are lying with your foot up it makes it worse
Rest pain
What is this:
ischemia always occurs in the tips of the toes first, always occurs most distal to the process
ischemic necrosis
What is this:
lack of sensation in the foot resulting in wearing shoes that don’t fit or putting pressure where it shouldn’t be which results in a ulcer (happens with diabetes)
neuropathic ulcer
What is this:
always occur above the malleoli, never in the toes. When your valves aren’t working you get back flow
venous ulcer
What is this:
used to describe tissue that is dead. This is a venous ulcer. (greater saphenous vein communicates with deep vein via perforators, when these valves aren’t working you get these ulcers)
Frank Gangrene
How do you know someone has claudication?
hurts with use
How do you know someone has a threatened limb?
they have rest pain or tissue loss
If your feet or something look well nourished or normal but have an ulcer what kind of ulcer do they have?
they have neuropathic ulcer
What makes up the pedal pulse?
posterior tibial pulse and dorsalis pedis pulse
HOw do you grade a pulse?
out of 4
What is important about doing a saphenous vein graft?
you need to reverse it so that your valves will continue to prevent backflow.
Veins dilate due to increased (blank)
increased blood flow
Veins thickens due to increased (blank)
pressure
