CVS 6 Peripheral Arterial And Venous Disease

Question 1

describe the role of the calf muscles in blood circulation of the limbs

Answer 1

• veins have valves which permit unidirectional blood flow
• when calf muscle contract, the deep veins are compressed > blood flows upwards

Question 2

describe the role of perforating veins in the lower limbs

Answer 2

when calf muscle relax, blood is ‘sucked’ into deep veins via perforating veins from superficial veins

Question 3

what pathologies can occur in perforating veins of the lower limb

Answer 3

varicosities
when valves in the perforating veins become ineffective + valve cusps can separate

Question 4

what are varicose veins?

Answer 4

torturous, twisted or lengthened veins

Question 5

describe the pathophysiology behind varicose veins

Answer 5

vein walls are weak > dilation + separation of valve cusps > incompetent

Question 6

symptoms of varicose veins

Answer 6

heaviness
aching
muscle cramps
throbbing
varicose eczema
haemorrhage
ankle swelling

Question 7

risk factors of varicose veins

Answer 7

age
family history
sex - F>M
number of births
occupation - standing a lot

Question 8

what is thrombophlebitis

Answer 8

inflammatory process causes a venous thrombus to form + block vein in leg
- DVP
- superficial thrombophlebitis

Question 9

causes of calf muscle pump failure

Answer 9

• failure of contraction - immobility, obesity, reduced movement
• Deep vein incompetence
• superficial vein incompetence - volume overload

Question 10

what is the pathophysiology of thrombosis

Answer 10

Virchow’s traid
changes in:
- vessel wall lining
- flow
- constituents

Question 11

in terms of virchow’s triad, what is the most important factor relating to arterial thrombosis?

Answer 11

changes in the lining of the vessel wall

Question 12

in terms of virchow’s triad, what is the most important factor relating to venous thrombosis?

Answer 12

change in the flow of blood
stasis > venous thrombosis

Question 13

symptoms of DVT

Answer 13

pain - hard to walk
swelling
blue-red skin discoloration

Question 14

signs of DVT

Answer 14

calf tenderness
skin warmth + discoloration
distended, warm superficial veins
oedema
pyrexia

Question 15

what is peripheral arterial disease?

Answer 15

build up of fatty deposits in arteries which restricts blood supply to leg muscles

Question 16

what are two types of peripheral arterial disease?

Answer 16

acute + chronic limb ischaemia

Question 17

commonest causes for acute limb ischaemia

Answer 17

embolism - from heart or AAA
trauma

Question 18

signs and symptoms of acute limb ischaemia

Answer 18

6 Ps
pallor
pain
perishingly cold
paratheisa
paralysis
pulselessness

Question 19

clinical features of chronic limb isachemia

Answer 19

intermittent claudication
rest pain
ulceration/gangere

Question 20

describe aortoiliac occlusion

Answer 20

• bilateral buttock, thigh + calf claudication
• absent lower limb pulses

Question 21

describe common iliac occlusion (unilateral)

Answer 21

• right buttock, thigh + calf claudication
• absent right lower limb pulses

Question 22

describe common femoral occlusion (unilateral)

Answer 22

• right buttock, thigh + calf claudication
• absent right lower limb pulses

Question 23

describe superficial femoral artery occlusion

Answer 23

right calf claudication
femoral pulse present
absent popliteal + pedal pulses

Question 24

what is rest pain?
what is it relieved by?

Answer 24

pain in the foot that comes on when patient goes to bed
eases by hanging foot of bed

Question 25

Difference between an arterial and venous thrombosis

Answer 25

Arterial is platelet rich
Venous is fibrin rich

Question 26

What is claudication?

Answer 26

Cramping pain in leg induced by exercise