Peripheral Arterial And Venous Disease

Question 1

How does blood drain through the viens?

Answer 1

From superficial to deep veins via perforating veins

Question 2

What are the two main junctions between deep and superficial veins in the legs?

Answer 2

Short saphenous vein- to popliteal

Long saphernous vein- femoral

Question 3

What is the role of the calf muscle pump?

Answer 3

Aids pushing blood back against gravity
Valves close to prevent retrograde flow

When contract muscles close of poerforating veins to prevent back flow to supeprficial

Question 4

What are causes of peripheral vascular disease?

Answer 4

Varicous veins
Chronic venous insufficiency - venous hypertension
Venous hypertension and calf muscle pump failure- DTV

Question 5

What are varicose veins?

Answer 5

Ineffective valves, blood movement slow or reversed

Walls of veins wekened- varicosities develop and valve cusps separate

Question 6

What are the symptoms of Varicose veins?

Answer 6

Along affected veins;

• heaviness and aching, cramps, throbbing
• ankle swelling
• varicose eczema
• haemorrhage
• Superficial vein thrombophelbitis (clot in vein)

Question 7

What is chronic venous insufficiency?

Answer 7

More advanced venous disease

Reflux or obstruction leads to venous hypertension (blood pooling)

Question 8

What are signs of Chronic Venous Insufficiency?

Answer 8

Lipodermatosclerosis (thickening of fat- skin harder)

Haemosiderin staining

Venous ulceration (hard to heal as lack blood flow)

Eczema- chronic and itchy

Question 9

Types of peripheral thrombosis/

Answer 9

Arterial- caused by atheroma
-platelet rich

Venous-caused by stasis and another factor
-little platelet content

Question 10

What is DVT?

Answer 10

Deep vein thrombosis
-clotting of blood in deep veins

Inflamation, calf tenderness, unexplained pyrexia, asymmerty

Can be fatal -pulmonary embolism

Question 11

What is acute limb ischaemia?

Answer 11

Occlusion of arteries to limbs with no collateral circulation

(Trauma and embolism causes)

Question 12

What are the 6 Ps of acute limb ischaemia?

Answer 12

Pain 
Pallor 
Perishing with cold 
Pulseless 
Paraesthesia 
Paralysis 

Compair both legs to identify

Question 13

What is chronic peripheral arterial disease?

Answer 13

Immermittent claudication (cramping with exercise) of the lower limb

Pain goes away with rest

Question 14

What causes chronic peripheral arterial disease?

Answer 14

Atherosclerosis

Question 15

What is critial limb ischaemia?

Answer 15

Progression of chronic peripheral vascular disease

Pain at rest- blood supple poor at rest (like unstable angina)

Leads to ulceration and angina

Question 16

Where would you feel the feromal pulse?

Answer 16

Mid ingual point midway between anterior superoir iliac spine and pubic symphysis

Question 17

Where would you feel the Popliteal pulse?

Answer 17

Deep in popiteal fossa

Question 18

Where would you feel the dorsalis pedis pulse?

Answer 18

Lateral to extensor hallucis longus tendon

Question 19

Where would you feel the tibial pulse?

Answer 19

Just behind the medial malleolus

Question 20

What is the Ankle- brachial pressure index?

Answer 20

Compares the bp in arm (bracial artery) to bp in ankle (tibial artery)

Get a ratio

Question 21

What is the Ankle- brachial pressure index used for?

Answer 21

Early diagnostics of peroperal artery disease

Less than 0.8 suggests disease

Question 22

What is a doppler ultrasonography used to measure?

Answer 22

Real time blood flow and velocity

Shows the apparent change in frequency of sound

Question 23

How does a dopper ultrasonography work?

Answer 23

Sound is produced from moving blood, this is detected and computed into flow direction and velocity (colours)

Velosity increases through stenosis- measure through a doppler

Question 24

How is a dopper ultrasonography useful?

Answer 24

Estimates the flow and velocity of blood

• in heart
• in distal vessels (atheroma- stenosis- turbulance)