Lecture 14 - PVD Flashcards
What is peripheral artery disease
Stenosis/occlusion in the peripheral arteries that mainly affects LE
What are the 3 categories of peripheral artery disease
- Intermittent Claudication: Symptoms occur only during physical activity
- Asymptomatic Disease: Asymptomatic because activity level never exceeds the threshold
- Limb-threatening Ischemia: Clinical syndrome, chronic, advance limb ischemia, rest pain, non-healing ulceration, gangrene
What disease cause obstruction
Mainly atherosclerosis, but can be nonatherosclerotic:
1. Buerger disease: Blood vessels inflamed causing blockage (usually males over 45 who smoke)
2. Vasculitis: Blood vessel inflammation resulting in thickening and restricted blood flow to organs resulting in tissue damage
3. Fibromuscular dysplasia: Primarily affects females that causes stenosis, dissection, or aneurysm (impacts walls of arteries)
What is artherosclerosis
IT is a chronic, slow, progressive disorder that causes plaque to accumulate resulting in loss of elasticity, stenosis, and and obstruction. The plaque can burst resulting in a thrombosis resulting in ischemia
What are 3 complications of atherosclerosis
- Polyvascular disease
- Chronic Kidney Disease
- Aneurysm: Bulge in weakened area of arterial wall
What are 4 signs of atherosclerosis
What are the 4 most frequent arteries that atherosclerosis occurs in
Circled in red
Risk factors of peripheral artery disease
Name types of polyvascular diseases and the areas they impact
What are 8 symptoms of ischemia
What are 5 characteristics of dry gangrene
What are 4 characteristics of wet gangrene
What is an endarterectomy and when is it used
What is a bypass
What are 6 complications of aortobifemoral bypass
When do we use extra-anatomic bypasses and how should patients lie down after this surgery
Thrombus
Blood clot formed within a vessel
Embolus
Fragment of thrombus, fat, plaque, bacterial vegetation or air that travels and obstructs blood flow in an area other than its origin
Thromboembolism
A thrombus that becomes an embolism
What are risk factors of an embolus/thrombus in peripheral vascular system
-Cardiac history (MI, aneurism)
-Cancer
-Inherited blood clotting disorders
-Medications
What are the 7 P’s
What are pain characteristics of a thrombus/embolus
What are pallor characteristics of a thrombus/embolus
What are pulselessness characteristics of a thrombus/embolus
What are paralysis characteristics of a thrombus/embolus
What are paresthesia characteristics of a thrombus/embolus
What are pressure characteristics of a thrombus/embolus
What are poikilothermia characteristics of a thrombus/embolus
What is a fasciotomy and why are they performed
They are an incision to the skin used to relieve pressure
What is a 4 compartment fasciotomy and what is the process to closing it
Incision made through skin and fascia (medial and lateral) to decrease pressure in the muscle compartment that is then left open until swelling decreases. Once swelling decrease can close one or both sides and if need and skin graft can be used to achieve closure
What is acute compartment syndrome and why does it occur
Serious/emergent that is caused by increased intercompartment pressure which decreases perfusion pressure to tissues within that compartment. It occurs from fractures, crush injuries circumferential burn, electrical injuries, hematomas, revascularization procedures, cast, circular dressings.
What is chronic venous insufficiency and its causes
What are 6 symptoms of chronic venous insufficiency
Compare and contrast arterial vs venous disorders in terms of clinical findings
List some characteries of diabetes mellitus and how its related to microvascular disease
Describe retinopathy (microvascular disease)
Describe nephropathy (microvascular disease)
Describe neuropathy (microvascular disease)
What are the 4 major types of neuropathy
What are the 3 primary areas affected by autonomic neuropathy
What are 6 characteristics of peripheral neuropathy
List 6 characteristics of diabetes mellitus and its link to peripheral vascular disease
What are 7 implications to sensory loss
What are 3 implications of motor loss
What are 3 education pieces if motor loss occurs
What is and causes the diabetic foot
Sensory, motor, and autonomic consequences of neuropathy lead to diabetic foot and neuropathic ulceration
What is a neuropathic ulceration
What is osteomyletis
Infection of the bone that spreads from nearby tissue or blood stream
What are 4 symptoms of osteomyelitis
What is a darco shoe
Allows for protection of the foot and toes
What does PT assessment and treatment look like POD #1 for PVD
What does PT assessment and treatment look like POD #2 for PVD
What does PT assessment and treatment look like POD #3 & 4 for PVD
What does PT assessment and treatment look like POD #5 for PVD
Describe the pathophysiology of PVD (Atherosclerosis for lower extremity)
How does exercise impact peripheral artery disease
Characteries to differentiate between intermittent claudication and pseudo claudication
