Pathophysiology - PVD/Amputations Flashcards
test 2
What controls the chemical and gas exchange between blood, interstitial fluid, and lymph?
blood and lymph capillaries
T or F?
High to low pressure arteries, arterioles, capillaries, venules, veins
True
What are arteries job?
To carry rich oxygenated blood AWAY from heart
What are the layers of the integumentary system? (superficial to deep)
epidermis –> dermis –> hypodermis (subcutaneous layer)
What is the epidermis function?
Protect from infection, assist heat regulation
What is the dermis function?
Deals with nerves, lymphatics, and blood vessels
What is the hypodermis function?
Stabilize skin over muscles and organs
*not technically part of the integument
What is the inflammation stage in wound healing?
- temporary repair
- debris and bacteria are attacked
- if interrupted can result in chronic inflammation
What is the maturation/remodeling stage in wound healing?
- granulation tissue is forming
- epithelial cells move to type 1 collagen
- scar tissue matures
T or F?
Oxygen, moisture, and nutrition are all important for wound healing
True
What are the wound characteristics?
location, size, shape, edges, tunneling, base, peri wound area, pain, bacteria quantity
What is would closure’s primary intention?
Healthcare closes wound by bringing edges together
What is wound closures secondary intention?
Heal on its own
What is wound closures tertiary intention?
Tries to heal by secondary intention then closes by primary intention
What is PVD?
A disorder that interferes with arterial and venous blood flow of the extremities
What is arterial insufficiency and ulceration?
Lack of blood flow to region of the body
What can PVD arterial insufficiency and ulceration be related to?
Smoking, cardiac disease, diabetes, hypertension, renal disease, elevated cholesterol & triglycerides, obesity
What is arteriosclerosis?
Thickening, hardening, loss of elasticity of arterial walls
What is atherosclerosis?
Damage of endothelial lining of vessels and formation of lipid deposits resulting in plaque formation
What is arteriosclerosis obliterans?
Intermittent claudication, most likely to lead to ulceration
What is thromboangiitis obliterans (Buerger Disease)?
Inflammation leads to arterial occlusion and tissue ischemia
*found in young men who smoke
What is Raynaud’s disease?
Characterized by pallor and cyanosis of fingers
What is ulceration?
Peripheral sign of a long-standing disease
How is arterial insufficiency and ulceration presented?
Wounds, diabetes, tropic changes, cool skin, pain in legs and feet, decreased pulses
What is venous insufficiency?
Inadequate drainage of venous blood from a body part
What is chronic venous insufficiency (CVI)?
Venous insufficiency over long periods of time
T or F?
Most people with PVD are diagnosed with CVI
True
Where is CVI most common?
Leg ulcers
How is venous insufficiency and ulceration presented?
Swelling, itching, fatigue, aching, skin change, dermis fibrosis, increased skin temp, wounds
What is lymphedema?
Chronic and abnormal accumulation of lymph fluid in the tissue of one or more body regions
What are the two types of lymphedema?
Primary - congenital
Secondary (more common) - injury from one of more lymphatic systems
How is lymphedema presented?
Swelling to distal area that is impaired from the lymph system, fatigue, pressure, numbness, loss of ROM, impaired wound healing
What causes a pressure injury?
Unrelieved pressure to the dermis and underlying vascular structures
How long can the superficial dermis tolerate ischemia?
2-8 hrs
How long can the deeper mm, connective tissue, fat tolerate pressure?
2 hours or less
How are pressure injuries presented?
Blanchable erythema, increased skin temp, superficial abrasion, blister
Where are pressure injuries usually found? (6)
Sacrum, coccyx, greater trochanter, ischial tuberosity, calcaneus, lateral malleous
What is neuropathy?
Any disease that deals with nerves
T or F?
Diabetes is the most common disease with neuropathy
True
How is neuropathy presented?
Ulceration on weight bearing surfaces of foot, anesthetic, sensory neuropathy, motor neuropathy, autonomic neuropathy, dysvascular symptoms
What is the intervention of PVD and wound care?
Coordination, communication, documentation
*select least invasive methods
What is the major cause of LE amputations?
PVD (peripheral vascular disease)
What are other causes of amputations?
MVA, war, GSW, cancer, smoking
What are the most common LE amputations?
Transtibial, transfemoral
Less common LE amputations
hip disarticulations, syme’s (through the ankle jt), toe disarticulation
T or F?
Surgeons try to maintain the greatest bone length and save the joints
True
T or F?
80% of pts with amputations deal with phantom limb pain
True
Where is phantom limb most common?
Upper limb amputations
What are common complications of amputations?
Joint contractures and edema
What is rigid dressing?
- immediate post op prosthesis that is handmade by surgeon and not adjustable
- removable rigid dressing that is plastic and adjustable as limb changes
What is semirigid dressing?
- controls edema
- loosens easily
- unna’s dressing with gauze impregnanted with compounds
- superior to soft dressing
What is soft dressing?
- oldest method
- elastic wrap
- frequent rewrapping
What is the focus on rehab for amputation patients?
Positioning, functional training, balance, gait, limb care, prosthetic training/preparation
