CVS 6 Peripheral Arterial And Venous Disease Flashcards
describe the role of the calf muscles in blood circulation of the limbs
- veins have valves which permit unidirectional blood flow
- when calf muscle contract, the deep veins are compressed > blood flows upwards
describe the role of perforating veins in the lower limbs
when calf muscle relax, blood is ‘sucked’ into deep veins via perforating veins from superficial veins
what pathologies can occur in perforating veins of the lower limb
varicosities
when valves in the perforating veins become ineffective + valve cusps can separate
what are varicose veins?
torturous, twisted or lengthened veins
describe the pathophysiology behind varicose veins
vein walls are weak > dilation + separation of valve cusps > incompetent
symptoms of varicose veins
heaviness
aching
muscle cramps
throbbing
varicose eczema
haemorrhage
ankle swelling
risk factors of varicose veins
age
family history
sex - F>M
number of births
occupation - standing a lot
what is thrombophlebitis
inflammatory process causes a venous thrombus to form + block vein in leg
- DVP
- superficial thrombophlebitis
causes of calf muscle pump failure
- failure of contraction - immobility, obesity, reduced movement
- Deep vein incompetence
- superficial vein incompetence - volume overload
what is the pathophysiology of thrombosis
Virchow’s traid
changes in:
- vessel wall lining
- flow
- constituents
in terms of virchow’s triad, what is the most important factor relating to arterial thrombosis?
changes in the lining of the vessel wall
in terms of virchow’s triad, what is the most important factor relating to venous thrombosis?
change in the flow of blood
stasis > venous thrombosis
symptoms of DVT
pain - hard to walk
swelling
blue-red skin discoloration
signs of DVT
calf tenderness
skin warmth + discoloration
distended, warm superficial veins
oedema
pyrexia
what is peripheral arterial disease?
build up of fatty deposits in arteries which restricts blood supply to leg muscles
what are two types of peripheral arterial disease?
acute + chronic limb ischaemia
commonest causes for acute limb ischaemia
embolism - from heart or AAA
trauma
signs and symptoms of acute limb ischaemia
6 Ps
pallor
pain
perishingly cold
paratheisa
paralysis
pulselessness
clinical features of chronic limb isachemia
intermittent claudication
rest pain
ulceration/gangere
describe aortoiliac occlusion
- bilateral buttock, thigh + calf claudication
- absent lower limb pulses
describe common iliac occlusion (unilateral)
- right buttock, thigh + calf claudication
- absent right lower limb pulses
describe common femoral occlusion (unilateral)
- right buttock, thigh + calf claudication
- absent right lower limb pulses
describe superficial femoral artery occlusion
right calf claudication
femoral pulse present
absent popliteal + pedal pulses
what is rest pain?
what is it relieved by?
pain in the foot that comes on when patient goes to bed
eases by hanging foot of bed
Difference between an arterial and venous thrombosis
Arterial is platelet rich
Venous is fibrin rich
What is claudication?
Cramping pain in leg induced by exercise
