peripheral arterial disease Flashcards
chronic venous insufficiency
incompetent venous valves blood remains in veins and then you get dilated. and increased venous hydrostatic pressure (edema)
signs of chronic venous insufficiency
hemosiderin- stasis dermatitis: medial mallelous: improves with decreased venous hydrostatic pressure
what are the complications of chronic venous insufficiency
venous ulcer- proximal to ankle
vircow triad
venous stasis, endothelial damage, hypercoaguability
homan sign
dorsiflex the foot, pain in the calf
complication of the DVT
pulmonary embolus
migratory superficial thromboplhebitis
superifical venous thrombus- classically associated with malignancy, recurring with multiple sites. hypercoagubility.
Which are the veins affected in peripheral venous disease
great saphenous
small saphenous
both are superficial
factors that improve peripheral venous disease
leg elevation, ambulation, and compression stockings.
venous ulcer pain improves and worsens with what?
exertion - improves
rest- worst
where do venous ulcers appear
above the lateral and medial alleoli
complication of chronic venous insufficiency
venous ulcer- increased venous hydrostatic pressure forces leukocytes into the interstitial tissue which leads to free radical formation and capillary damage
Which are the arteries affected in PAD?
Femoral Artery, politeal artery, anterior/posterior tibial and fibular arteries.
What is the pathophysiology for PAD?
smoking, artherosclerosis, decreased arterial perdusion.
What are the signs of peripheral arterial disease?
worse with exertion, improves with rest. weakned pulses (femoral, posterior tibial, dorsalis pedis)
What is the treatment for peripheral artery disease?
cilostazol (inhibit PDE3) which inhibits plt aggregation.
definitive management: PCI
arterial ulcer
pressure points, lateral malleolus. distal gangrene
Leriche syndrome
bilateral hip and thigh claudication, erectile dysfunction, diminished femoral pulses.
ankle brachial index
systolic ankle BP/ systolic brachial BP- whats the threshold for peripheral artery disease
<0.9. <0.4= severe
1.4 = calcifications, mockenberg sclerosis
how do you improve symptoms in peripheral artery disease
lowering the legs will increase arterial perfusion
neuropathic ulcer- where are they found
plantar surface of the foot.
diminished S1 reflex