LP #109 Vascular Disorders Flashcards
CV disorders divided into?
- disorders that affect mainly the heart (cardio)
- disorders that affect mainly bv’s (vascular)
- affect heart & CO
- BF (tissue perfusion) depends on health of bv’s & adequate BP
- alterations in BF affect large & peripheral bv’s (arterial flow & venous return)
Cardiac disorders
Types of cardiac disorder
- valve dysfxn
- arrhythmia & conduction blocks
- congenital defects
- myocardial dysfxn:
- occlusive (obstructive) disorder, ex. Atherosclerosis
- congestive disorders, ex. Pericarditis
- infections, ex. Picard it is, endocarditis
Vascular disorders means
Vascular dysfxn affecting bv’s & BF
Types of vascular disorders
- changes in bv walls, ex. Arteriosclerosis, & vasculitis
- bv obstruction, ex. D/t thrombi, emboli, vasospasm
- ABN bv dilation, ex. Aneurysms, varicose vv
- compression, ex. Tumours, edema, decubitus ulcers
Affect circulation by damaging bv’s & cause inflammation or vasospasm
Arterial disorders
Examples of arterial disorders include
- atherosclerosis (structural)
- vasculitis/arteritis (inflammatory)
- raynaud’s disease (vasospasm)
- buerger’s disease(inflammatory)
Bv obstruction impairs BF by ?
Narrowing the lumen of bv’s
Causes of bv obstruction
- compression
- vasospasm
- thrombus formation
- embolus
- atherosclerotic plaque
-external sources,ex. Casts
-internal sources, ex. Tumours
?
Compression
Contraction of bv’s tunica media results in vasoconstriction?
Vasospasm
- blood clot attached to bv wall (w/in lumen)
- more common in vv
Thrombus formation
-dislodged thrombi or other foreign substances (ex. Air or fat)
Emboli
- originates in deep vv of legs
- travel to R heart
- lodge in pulmonary vv
Venous emboli
- originate in heart
- may travel to brain, kidneys or lower extremities
Arterial emobli
- aka arterial plaque, plaque or atheroma
- characterized by scar tissue & fatty deposits on intima of bv walls
- often leads to atherosclerosis
Atherosclerotic plaque
- role in plaque formation
- can occlude bv’s & cause hardening of aa
Blood lipids
- lipids wrapped in proteins
- transported in blood to various tissues (ex. Liver, skeletal m & adipose tissue)
- 2 of 4 types are: LDL & HDL
Lipoproteins
- bad cholesterol
- carriers of cholesterol
- tend to deposit excessive lipids on arterial walls
LDL ( low density lipoproteins)
- good cholesterol
- remove & dispose cholesterol from blood
HDL (high density lipoproteins)
- N bv’s are relatively clear of plaques & blood lows freely
- elevated (hyperlipidemia): increase LDL & trigycerides; plaques tend to form at increase rate
LDL/HDL ratios
2 terms describe hardening of aa
Arteriosclerosis
Atherosclerosis
General term describing the hardening (sclerosis) of aa
Arteriosclerosis
Form of arteriosclerosis specifically d/t plaque
Atherosclerosis
Atherosclerosis insidious onset:
- accumulation of lipids (fatty streaks) on arterial walls
- fibrous atherosclerosis plaques begin to form
Atherosclerosis commonly affected
- aorta
- coronary aa
- large aa supplying brain
Atherosclerosis risk factors include
- increase BP
- environmental
- lifestyle
- buildup of various substances released by platelets & blood plasma lipids
- stimulate smooth m proliferation
Smooth m proliferation
- collagen, lipids, smooth m & cellular debris accumulate- form plaque on bv wall
- repeated injury causes decrease elasticity of arterial bv, adds to original plaque
- slowly occludes bv lumen
Atherosclerotic plaque formation
-largest research suggests inflammation plays role in formation & dislodging of plaques
Inflammation
Major contributor to heart disease & strokes
Atherosclerosis
Venous disorders related to & include
Related to:
- venous stasis
- increase P in venous bv’s
Includes:
- varicose veins
- venous thromboses (thrombophlebitis)
- dilated veins (lower extremities)
- more common in elderly -females > males
- prolonged dilation of bv walls d/t increase P
Varicose veins
Factors increase P include:
- prolonged standing
- incompetent (regurgitant) valves
S/S of varicose veins
- venous insufficiency
- progressive limb heaviness
- achiness & congestion in legs
- edema in legs (lower legs & ankles)
- impaired tissue nutrition
- thrombus lodged in v & accompanying inflammation
- develop in deep or superficial vv
- more common in lower limbs
- DVT tend to dislodge & travel in blood as emboli
- can lodge in heart, lungs or brain
- lead to MI, pulmonary failure or CVA
Venous thromboses (thrombophlebitis)
Venous thromboses (thrombophlebitis) S/S
- pn, swelling & m tenderness at thrombus site
- arterial pulses- weak or absent
- affected limb may appear pale
- fever & general malaise
- increase WBC count
Venous thromboses (thrombophlebitis) risk factors
- conditions that promote blood stasis
- conditions that are susceptible to blood clots
- injury to bv walls
- minimally invasive endovascular surgery
- removes atherosclerosis from blood vessels
Atherectomy
Endovascular procedure to widen narrowed/ obstructed vessels, typically to treat arterial atherosclerosis
Angioplasty
