Illness script - week 2 Flashcards
Peripheral vascular disease
Describes a variety of conditions affecting the _____, _____, _____ and _____ in areas such as the _____, _____, and _____
Peripheral vascular disease
Describes a variety of conditions affecting the aorta, arteries, veins and lymphatics in areas such as the neck, abdomen and extremities
Arterial wall
1) _____: single layer of endothelial cells
2) _____: Elastin, collagen and muscular layer
3) _____: collagen layer
Arterial wall
1) Intima: single layer of endothelial cells
2) Media: Elastin, collagen and muscular layer
3) Adventitia: collagen later
Aneurysm
Abnormal _____ or _____ in the wall of a blood vessel such as an _____
Aneurysm
Abnormal swelling or bulge in the wall of a blood vessel such as an artery
Arterial disease
_____ condition in which a narrowed blood vessel reduces blood flow to the _____
Arterial disease
Circulatory condition in which a narrowed blood vessel reduces blood flow to the limbs
Thrombi
A blood _____ that forms in a blood vessel and _____ there
Thrombi
A blood clot that forms in a blood vessel and remains there
True aneurysm
Involves all 3 layers of the _____ wall
E.g. _____ disease and _____
True aneurysm
Involves all 3 layers of the arterial wall
E.g. Marfan’s disease and atherosclerosis
False aneurysm
Not an aneurysm but a _____ _____ which has developed from a disruption to __-__ layers of the arterial wall
False aneurysm
Not an aneurysm but a pulsatile haematoma which has developed from a disruption to 1-2 layers of the arterial wall
Atherosclerotic aneurysm
Commonly affects the _____ _____ below the _____ _____
Atherosclerotic aneurysm
Common affects the abdominal aorta below renal arteries
Fusiform
_____ shaped, circumference of artery, usually the _____ _____ _____ (AAA)
Fusiform
Spindle shaped, circumference of artery, usually the abdominal aortic aneurysm (AAA)
Saccular
_____ out to _____ side
Saccular
Ballooning out to one side
Medical management of Aneurysms
1) IV cannula
2) _____ cross match, _____, _____, _____ and _____
3) Oxygen
4) _____ (ECG)
5) _____ catheter
Medical management of Aneurysms
1) IV cannula
2) Blood cross match, haemoglobin, coagulation, electrolytes and creatine
3) Oxygen
4) Electrocardiograph (ECG)
5) Urinary catheter
Surgical intervention of Aneurysms
Incision in the mid line of the _____ and along the _____ length, a _____ is inserted to the un-involved proximal and distal ends of the _____, the wall is closed to prevent the _____ making direct contact with the _____
Surgical intervention of Aneurysms
Incision in the mid line of the abdominal and along the aneurysm length, a graft is inserted to the un-involved proximal and distal ends of the aorta, the wall is closed to prevent the graft making direct contact with the duodenum
Complications of Aneurysm surgery
1) Arrythmias
2) _____ _____ _____ (AMI)
3) Pulmonary _____
4) _____ and _____ failure
5) Haemorrhage
6) Graft _____
7) _____ _____ and _____ ischaemia
8) Infection
Complications of Aneurysm surgery
1) Arrythmias
2) Acute myocardial infarction (AMI)
3) Pulmonary oedema
4) Renal and respiratory failure
5) Haemorrhage
6) Graft occlusion
7) Spinal cord and mesenteric ischaemia
8) Infection
Peripheral arterial occulsive diesease
Acute caused by _____ which is a _____ from the heart of aneurysm, aggregate of fat which is commonly found in the _____ or _____
Peripheral arterial occulsive disease
Acute caused by emboli which is a thrombus from the heart or aneurysm which is aggregate of fat commonly found in the lungs or brains
Vascular trauma
Can be caused from a _____ _____ accident, _____ wound, _____ instruments, _____ injuries and _____
Vascular trauma
Can be caused from a motor vehicle accident, gunshot wound, sharp instruments, crush injuries and fractures
Classic presentations of arterial occlusive disease - 6Ps
1) _____
2) _____
3) _____
4) _____
5) _____
6) _____
Classic presentations of arterial occlusive disease - 6Ps
1) Pain
2) Pallor
3) Pulselessnesss
4) Parasthesia
5) Paralysis
6) Poikilothermia
Diagnosing of arterial occlusion
1) _____/_____ scan
2) _____ _____ _____: used as a screen only
Diagnosing of arterial occlusion
1) Dupplex/doppler scan
2) Arterial brachial pressure: used as a screen only
Medical management of arterial occlusion
1) IV _____
2) _____/_____
3) _____ agent: _____, _____ _____ _____ activator (r-TPA)
4) Bed rest
5) Oral _____ for long-term therapy: _____
Medical management of arterial occlusion
1) IV heparin
2) Embolectomy/thrombectomy
3) Thrombolytic agent: streptokinase, recombinant tissue plasminogen activator (r-TPA)
4) Bed rest
5) Oral anticoagulants for long-term therapy: Warfarin
Ankle brachial pressure index
<0.5: \_\_\_\_\_ ulcer 0.5 - 0.7: \_\_\_\_\_ \_\_\_\_\_ ulcer 0.7 - 0.8: \_\_\_\_\_ ulcer >0.9: \_\_\_\_\_ ulcer >1.2: \_\_\_\_\_ \_\_\_\_\_ \_\_\_\_\_
Ankle brachial pressure index
<0.5: arterial ulcer 0.5 - 0.7: mixed arterial ulcer 0.7 - 0.8: venous ulcer >0.9: venous ulcer >1.2: possible calcified vessels
Chronic causes of arterial occlusion
1) Progressive _____, _____ and _____ of arteries in the extremities which affect the _____, _____, _____, _____ and _____ vessels
2) Smoking
3) _____ and _____ are the main risk factors
4) _____, _____ and _____ history
5) Common __ - __ year old _____ above the knees, _____ is below the knees
Chronic causes of arterial occlusion
1) Progressive narrowing, degeneration and obstruction of arteries in the extremities which affect the aortoiliac, fermoral, popiteal, tibial and peroneal vessels
2) Smoking
3) Hyperlipidaemia and hypertension are the main risk factors
4) Diaetes, obesity and family history
5) Commonly 60 - 80 year old males above the knees, diabetes is below the knees
Management of Arterial occlusion
1) Health promotion: _____, _____, _____ and _____
2) _____, _____, _____ and _____ (CWMS)
3) _____ pulses
4) _____ care
5) _____ _____ care and mobilsation
Management of arterial occlusion
1) Health promotion: Diet, lifestyle, exercise and footcare
2) Colour, warmth, movements and sensations (CWMS)
3) Peripheral pulses
4) Wound care
5) Pressure area care and mobilsation
Virchow’s triad
_____ stasis, _____ damage and hyper-_____ of _____
Virchow’s triad
Venous stasis, endothelial damage and hyper-coagulability of blood
_____, _____, _____, and _____ from a thrombus, it forms a tail behind the clot
If attached to the _____, the _____ process stops and _____ occurs and becomes an _____
RBCs, WBCs, platelets and fibrin form a thrombus, it forms a tail behind the clot
If attached to the lumen, the thrombotic process stops and lysis occurs and becomes an emboli
Superficial thrombophlebitis
Palpable, firm, _____ cord-like vein, area is tender to touch and has _____ and _____ skin
Superficial thombophlebitis
Palpable, firm, subcutaneous cord-like vein, area is tender to touch and has red and warm skin
Deep vein thrombophlebitis
May or may not have unilateral leg _____, _____, _____ skin and calf _____
Deep vein thrombophlebitis
May or may not have unilateral leg oedema, pain, warm skin and calf tenderness
Chronic venous insufficiency
Common complication that has valvular _____, _____, _____, secondary _____, _____ and limb _____
Chronic venous insufficiency
Common complication that has valvular destruction, oedema, pigmentation, secondary varicosities, ulceration and limb cyanosis
Management of thrombophlebitis
1) Mild _____ (_____) and NSAIDs (_____)
2) IV _____ and oral _____: to treat _____ _____
3) _____ _____ _____ time (APPT) and _____ _____ _____ (INR) for clotting profile
4) _____
Management of thrombophlebitis
1) Mild analgesics (aspirin) and NSAIDs (ibuprofen)
2) IV heparin, and oral warfarin: to treat DVT
3) Activated partial prothrombin time (APPT) and international normalised ration (INR) for clotting profile
4) Embolectomy
Pulmonary embolism
A blood clot in an artery which stops blood flow to part of the _____, commonly originates from the right _____, up to the right _____ and into the right _____
__% originates as a _____ from _____ and _____ _____ veins
Can also be caused by _____ _____
Pulmonary embolism
A blood clot in an artery which stops blood flow to part of the lung, commonly originates from the right leg, up to the right heart and into the right lung
95% originates as a thrombi from calf and deep thigh veins
Can also be caused by arterial fibrillation
Diagnosing pulmonary embolism
1) _____ X-ray
2) _____ (ECG)
3) __ and __ changes
4) _____ _____ _____ test (ABG)
5) _____ _____/_____ lung scan
diagnosing pulmonary embolism
1) Chest X-ray
2) Electrocardiograph (ECG)
3) ST and T changes
4) Arterial blood gas test (ABG)
5) Radionuclide ventilation/perfusion lung scan
Symptoms of pulmonary embolism
1) _____
2) _____
3) _____
4) _____
5) _____
6) _____
Symptoms of pulmonary embolism
1) Pain
2) Dyspnea
3) Apprehension
4) Cough
5) Haemoptysis
6) Sweats
Signs of pulmonary embolism
1) _____
2) Accentuated pulmonic S__ and/or _____ rhythm
3) _____
4) Fever and/or _____
5) _____
6) _____ _____
signs of pulmonary embolism
1) Tachypnea
2) Accentuated pulmonic S2 and/or gallop rhythm
3) Tachycardia
4) Fever and/or diaphoresis (sweating)
5) DVT
6) Peripheral oedema
Complications of pulmonary embolism
1) _____ _____
2) _____ _____
complications of pulmonary embolism
1) Pulmonary infarction
2) Pulmonary hypertension
Comorbidities of pulmonary embolism
1) _____
2) _____ _____
3) _____ _____ _____ _____
Comorbidities of pulmonary embolism
1) Immobility
2) Venous damage
3) Chronic obstructive pulmonary disease (COPD)
Management of pulmonary embolism
1) IV _____
2) Oral _____
3) _____ agents: _____, _____ _____ _____ _____ (r-TPA)
4) _____ _____: _____ _____ _____ _____ (APPT) and _____ _____ _____ (INR)
management of pulmonary embolism
1) IV herparin
2) Oral warfarin
3) Thrombolytic agents: streptokinase, recombinant tissue plasminogen activator (r-TPA)
4) Clotting profiles: Activated partial prothrombin time APPT and International nationalised ration INR
Chronic venous insufficiency
Insufficient blood _____ to the _____ due to _____, _____ dysfunction or _____ retention
This can lead to _____ hypertension within the veins and causing an _____ response
Chronic venous insufficiency
Insufficient blood return to the heart due to obstruction, valvular dysfunction or fluid retention
This can lead to venous hypertension within the veins and causing an inflammatory response
Ulcer types
1) Venous: located from _____ _____ to _____, _____ in colour, highly _____, irregular shape, oedema, _____ edges
2) Arterial: located from _____ and _____, punched out look, painful, shiny, _____ legs, atrophy, blanching, _____ pen woud
3) Diabetes: located from the _____ and _____, mostly _____ in aetiology, _____ _____ or new diagnosis of diabetes
Ulcer types
1) Venous: located from lower leg to ankle, dusky in colour, highly exudating, irregular shape, oedema, macerated edges
2) Arterial: located from foot and ankle, punched out look, painful, shiny, hairless legs, atrophy, blanching, erythmic pen wound
3) Diabetes: Located from the foot and ankle, mostly arterial in aetiology, patient history or new diagnosis of diabetes
