Pathophysiology Continued Flashcards
6 stages of plaque formation
- Intimal damage
- Platelet aggregation
- Release of PDGF
- Proliferation of smooth muscle
- Formation of connective tissue matrix
- Deposition of lipids and other materials
True of False: plaque has to be severe to cause acute occlusion.
False- Plaques do not have to be severe to cause acute occlusion.
What methods are used to diagnose arterial disease?
- History and physical
- Noninvasive studies
- Angiography
- MRA
- CT
What are some ways to treat arterial disease?
- Medical therapy (exercise, medication)
- Endovascular therapy (stenting, ablation)
- Endarterectomy
- Bypass
- Amputation (most common in diabetics)
- New age medicine
Most common site of atherosclerotic build up?
SFA mid to distal thigh in adductor canal.
Why is treating DVT important?
DVT can cause PE
How many people die each year from PE?
200,000
__% of PEs come from leg clots.
90%
What are the Sx’s of DVT?
Swelling, aching, and the best clinical indication: acute unilateral edema.
If a Pt has bilateral edema do you still expect for them to have DVT?
No- DVT usually presents as unilateral edema. Bilateral edema can suggest CHF.
What do you expect with full blown DVT?
Usually all major veins of entire leg are filled with clots: femoral to popliteal to calf.
What percentage of calf thrombus propagate proximally if untreated?
15-20%
Risk factors of DVT
- cancer
- surgery
- bedrest
- pregnancy
- infection
- trauma
- obesity
- CHF
- age
- dehydration
All risk factors of DVT are related to ____ ____.
Virchow’s triad
Who was Virchow?
A german physician and pioneer
What term did Virchow coin?
Thrombus
Virchow discovered the cause of ____ ____. He also fought for better social conditions in order to combat disease.
He discovered the cause of pulmonary embolus.
What is Virchow’s triad?
- Stasis
- Hypercoagulability
- Vessel-wall injury
Blood is in a constant state of ____ and ____ clotting.
In constant state of clotting and not clotting.
Where does clot usually begin?
In soleal sinuses and/or valve cusps.
Once there is thrombus, the body ____ it over weeks and months
The body lyses it.
When the body lyses a clot there is some degree of valve damage. This leads to what?
deep vein insufficiency
What are methods used to diagnose DVT?
- clinical
- noninvasive study
- venography
What are the treatments used for DVT?
Heparinizing for a week- then 3-6 months on coumadin. You can also lyse the clot with tPA, but it is not useful after clot has formed completely.
What is CVI and what causes it?
Chronic venous insufficiency, caused by venous hypertension.
What are the Sx’s of CVI?
- chronic edema
- stasis pigmentation changes
- lipodermatosclerosis
- stasis ulcer
How do you test and treat CVI?
Testing: -PPG -APG -duplex/color flow -descending venography Treatment: -foam & ablation
What is an aneurysm?
weakening and bulging of arterial walls.
True aneurysm
involves bulging of all 3 walls.
False aneurysm
may only be bulging of 1 layer.
Pseudoaneurysm
artery doesn’t close completely causing blood to escape into the tissue.
Who’s law proves that large vessels are most susceptible to aneurysm?
Law of La Place
What is a hematoma?
blood clot in tissue
What is Raynaud’s syndrome, and who is most likely to have it?
abnormal sympathetic response to cold or emotion; young females.
What are the triphasic color changes of Raynaud’s?
- Pallor (white)
- Cyanosis (blue)
- Rubor (red)
What is thoracic outlet syndrome?
compression at the superior thoracic outlet resulting from excess pressure placed on a neurovascular bundle.
What type of thoracic outlet syndrome is most common?
Nuerogenic
What is Buerger’s disease, and who is most likely to have it?
Small clots in the digits; young male smokers.
What is an arteriovenous fistula?
abnormal communication between artery and vein, has very low resistance.
