CVS - Peripheral Arterial And Venous Disease Flashcards
Where is the long saphenous vein found in the ankle?
Anterior to the medial malleolus
How does the venous pump system work?
Muscles in the legs contract and squeeze the veins, propelling blood towards the heart. Valves prevent backflow of blood
What are varicose veins?
Tortuous, twisted or lengthened veins (usually in the legs)
What causes varicose veins?
The vein wall is inherently weak, so that leads to dilatation and separation of valve cusps, so they become incompetent
Give some symptoms of varicose veins
Heaviness, tension, aching, itching along the vein
What is thrombophlebitis?
A venous thrombosis produces an inflammatory response, including pain
Give some causes of calf muscle pump failure
- ‘failure’ of calf muscle contraction (obesity, immobility, reduced movement)
- deep vein incompetence
- volume overload
What is Virchow’s triad?
Three things that lead to thrombosis:
- changes in lining of vessel wall (endothelial damage)
- changes in flow of blood (stasis)
- changes in constituents of blood (hypercoagulability)
What is the difference between an arterial clot and a venous clot?
Arterial thrombosis is very platelet rich and uses extrinsic THEN intrinsic pathways.
Venous thrombi are fibrin rich and use the intrinsic THEN extrinsic pathway
What are the five signs of an inflammatory response?
Calor, dolor, rubor, tumor, functio laesa
What is a deep vein thrombosis?
A blood clot which develops within one of the deep veins in the body, usually in the leg
Give some symptoms of DVT
Pain, swelling, skin discolouration, skin warmth
Why is there an association between surgery and DVT?
- immobility prior to surgery and afterwards
- no calf muscle pump during surgery
- prothrombotic state following trauma of surgery
What are the signs/symptoms of acute ischaemia?
- pain
- paralysis
- paraesthesia
- pallor
- perishing cold
- pulseless
What is chronic peripheral arterial disease?
A build-up of fatty deposits in the arteries which restricts blood supply to leg muscles. Causes intermittent claudication, rest pain and ulceration/gangrene
What is claudication?
Pain in the muscles of the lower limb brought on by walking/exercise
What signs would be present in aortoiliac occlusion?
Bilateral buttock, thigh and calf claudication, absent lower limb pulses
What signs would be present in common iliac occlusion?
Right buttock, thigh and calf claudication, absent right lower limb pulses
What signs would be present in common femoral occlusion?
Right thigh and calf claudication, absent right lower limb pulses
What signs would be found in a patient with superficial femoral artery occlusion
- right calf claudication
- femoral pulse present but absent popliteal and pedal pulses
What is rest pain?
Pain in the foot that comes on when the patient goes to bed and is relieved by hanging the foot out of the bed - ischaemia is so severe that foot is ischaemic at rest
