Limb ischaemia Flashcards
What is partial chronic limb ischaemia?
intermittent claudication
When is pain worse in intermittent claudication?
on walking
When is pain worse in spinal stenosis?
worse on standing
What is risk of limb loss from intermittent claudication?
v low
Treament of intermittent claudication?
lifestyle changes
What is a sign of worsening of intermittent claudication?
pain at rest, especially at night (ischaemic night pain)
Where is pain in ischaemic night pain?
toes/forefoot
If night pain is further up leg, what is it?
NOT ischaemic night pain
What relieves ischaemic night pain?
standing up, foot getting cold
What is it that causes the pain in claudication?
lactic acid
What is there increased risk of if rest pain is present?
gangrene, limb loss, ulcer
In which type of ulcer is surrounding skin normal?
arterial
Which ulcer type has sloping edges?
venous
What is critical limb ischaemia?
rest pain or tissue loss caused by ARTERIAL insufficiency
Risk of limb loss at 1 year with critical limb ischaemia?
50%
What are the 6Ps of acute limb ischaemia?
pain, pallor, pulseless, paraesthesia, perishing cold, paralysis
Causes of acute limb ischaemia?
trauma
embolus
Which fibres carry pain?
c fibres
Which fibres carry light touch?
A fibres
When does partial limb ischaemia occur?
when collateral arteries exist eg in patients who already have arterial disease
What does fixed mottling mean?
skin is dying
Ruddy red/pinkness in a foot might be what?
sunset foot - not good
If muscle is tender, what does this mean?
muscle is dying
won’t recover
What can happen if myoglobin is released?
renal failure - better to amputate
