Peripheral Arterial Disease 1 Flashcards
What are some risk factors of PAD? 15.
- Diabetic
- Hypertension
- Hyperlipidemia
- Coronary artery disease (CAD)
- Previous history of CVA or MI
- Smoking
- Chronic renal insufficiency
- Age
- Family history
- Male
- Obesity
- Sedentary lifestyle
- Elevated levels of homocysteine
- Excessive levels of C-reactive protein
- History of radiation
What are some physical signs and symptoms of PAD? 8
- Skin changes
- Palpations
- Auscultations
- Limb pressures
- Claudication (intermittent)
- Ischemic rest pain
- Necrosis
- Pseudoclaudication
What are some skin changes seen in PAD? 9
- Pallor
- Rubor
- Dependent Rubor
- Cyanosis
- Temperature
- Nonhealing ischemic ulcers
- Gangrene
- Trophic changes (hair loss, nail thickening, skin thinning)
- Capillary refill time
In terms of PAD what are palpations?
- Pulses graded 0-4
- Aneurysms
In terms of PAD what can Bruits be caused by?
Significant stenosis
In stenosis how many bruits are not heard?
> 90%
In terms of signs and symptoms, what does the difference of limb pressures do?
Difference in limb pressures indicate disease, if there is a >20 mmHg in upper and lower extremity
What is claudication (intermittent)?
Lack of blood supply to a group of muscles
Is claudication reproducible?
Yes
What are common sites of claudication for PAD? 4
- Hip
- Buttock
- Thigh
- Calf
In terms of PAD sites of disease are always where in relation to the muscle group?
Proximal
How does claudication feel like?
Pain that occurs during exercise but subsides at rest
Ischemic rest pain is always an indicator of what?
Advanced multi-segment disease
In terms of ischemic rest pain, pain presents how?
Severe and constant
What does ischemic rest pain affect?
The dorsum of the foot and toes
Early onset of ischemic rest pain occurs when?
Only at night when the limb is not in a dependent position and may be relieved by lowering the foot or mildly exercising
In terms of ischemic rest pain, does rest relieve pain?
NO
What is the most severe symptom of PAD?
Tissue death
What is pseudoclaudication? Can it be reproducible?
- Pain caused by other factors
- No
What is the most common location of atherosclerotic disease?
Femoral artery at the adductor canal?
Atherosclerosis disease may appear how and affect what kind of levels?
- Focal or diffuse
- May affect any level or multiple levels
What are other common sites of Atherosclerosis besides common femoral?
At bifurcations and the popliteal artery
What is the most common cause of embolism?
From plaque breaking loose from the heart or a proximal aneurysm and traveling until it becomes lodged in a smaller vessel
What kind of plaque formation is embolism formed from?
Stenotic plaque formation