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Vascular Surgery > Peripheral Arterial Disease > Flashcards

Peripheral Arterial Disease Flashcards

1
Q

What is Peripheral Arterial Disease?

A

Narrowing of the arteries supplying the limbs and periphery, reducing blood supply

Leads to symptoms of claudication

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2
Q

What are the symptoms of claudication?

A

Pain
Cramping
Parasthesia

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3
Q

What is intermittent claudication?

A

Symptom of ischaemia in a limb

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4
Q

When does intermittent claudication occur?

A

During exertion

Relieved by rest

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5
Q

What is experienced in intermittent claudication?

A

Crampy, achy pain in the calf, thigh or buttocks

Associated with muscle fatigue when walking

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6
Q

What is critical limb ischaemia?

A

End-stage of peripheral arterial disease

Inadequate supply of blood to a limb at rest

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7
Q

What are the features of critical limb ischaemia?

A

Pain at rest

Non-healing ulcers

Gangrene

SIGNIFICANT RISK OF LIMB LOSS

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8
Q

What is acute limb ischaemia?

A

Rapid onset of ischaemia in a limb

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9
Q

Why does acute limb ischaemia occur?

A

Thrombus blocks the arterial supply to the distal limb

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10
Q

What is ischaemia?

A

Inadequate oxygen supply to the tissues due to reduced blood supply

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11
Q

What is necrosis?

A

Death of tissue

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12
Q

What is gangrene?

A

Death of the tissue due to inadequate blood supply

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13
Q

What is atherosclerosis?

A

Atheromas (deposits in the artery walls) harden causing stiffening of the blood vessels

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14
Q

What vessels are affected by atherosclerosis?

A

Medium and large arteries

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15
Q

What causes atherosclerosis?

A

Caused by chronic inflammation and activation of the immune system in the artery walll

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16
Q

What happens in atherosclerosis?

A

Lipids deposited in the artery wall

Followed by development of atheromatous plaques

17
Q

What can atheromatous plaques cause?

A
  • Stiffening of artery walls leading to hypertension
  • Stenosis leading to reduced blood flow
  • Plaque rupture resulting in a thrombus that can block distal vessels causing ischaemia
18
Q

What are 3 non-modifiable risk factors of atherosclerosis?

A

Old age
Family history
Male

19
Q

What are some modifiable risk factors of atherosclerosis?

A

Smoking
Alcohol
Diet
Sedentary lifestyle
Obesity
Poor sleep
Stress

20
Q

What co-morbidities increase the risk of atherosclerosis?

A

Diabetes
Hypertension
CKD
Inflammatory conditions
Atypical antipsychotic medications

21
Q

What can atherosclerosis lead to?

A

Angina
MI
TIA
Stroke
Peripheral arterial disease
Chronic mesenteric ischaemia

22
Q

What are the 6 Ps of critical limb ischaemia?

A

Pain
Pallor
Parasthesia
Pulseless
Paralysis
Perishingly cold

23
Q

What type of pain does critical limb ischaemia typically cause?

A

Burning pain

24
Q

When is crticial limb ischaemia worse?

A

Worse at night when leg is raised as gravity no longer pulls blood into foot

25
Q

What is leriche syndrome?

A

Occlusion in the distal aorta or proximal iliac artery

26
Q

What is the clinical triad of Leriche syndrome?

A

Thigh/buttock claudication
Absent femoral pulses
Male impotence

27
Q

What is xanthomata?

A

Yellow cholesterol deposits on the skin

28
Q

What can a hand-held doppler be used for?

A

Assessing pulses when difficult to palpate

29
Q

What is Buerger’s test?

A

Used to assess peripheral arterial disease in the leg

  1. Lay patient supine
  2. Lift patient’s legs at 45 degress to hip
  3. Hold for 1-2 minutes looking for pallor
  4. Sit patient up with legs over side of the bed
30
Q

What does pallor suggest in buerger’s test?

A

Arterial supply not adequate enough to overcome gravity suggesting peripheral arterial disease

31
Q

What is Buerger’s angle?

A

Angle at which leg is pale

32
Q

How do patients with peripheral arterial disease differ to normal patients in Buerger’s test?

A

Normal patient’s legs remain pink colour

in PAD, blue initially as the ischaemic tissue deoxygenates the blood

Dark red after a short time due to vasodilation in response to waste products of anaerobic respiration
(rubor)

Vascular Surgery (10 decks)

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