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SYSTEMIC TREATMENTS > Peripheral Arterial Diseases > Flashcards

Peripheral Arterial Diseases Flashcards

1
Q

What are the 3 main PAD we learned about?

A
  1. Arteriosclerosis obliterans (ASO)
  2. Buerger’s Disease (thromboangiitis)
  3. Raynaud’s disease
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2
Q

What is arteriosclerosis obliterans?

A

a proliferation of INTIMA which causes complete obliteration of the lumen of the artery.

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3
Q

What is the most common occlusive PAD?

A

ASO - arteriosclerosis obliterans (95% of PAD cases)

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4
Q

What are 2 ways to treat ASO?

A
  1. preventative skin care (avoid minor injuries)

2. exercise to increase collateral circulation and improve function

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5
Q

What are 3 main symptoms of ASO?

A
  1. bilat & progressive intermittent claudication
  2. muscle weakness/fatigue
  3. diabetic neuropathy
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6
Q

What happens to ASO symptoms with rest?

A

Sx should usually be relieved by rest (pain at rest = more severe cases)

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7
Q

What are 6 risk factors of ASO?

A
  1. elderly
  2. DM
  3. smoking
  4. HTN
  5. hyperlipidemia
  6. obesity
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8
Q

What is intermittent claudication a sign of?

A

Atherosclerosis, d/t plaque build up in arteries of legs , causing blockages = not enough BF while exercising, resulting in calf pain.

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9
Q

Buerger’s Disease:

A

inflammatory reaction of the arteries (sm/med) of the hands and feet to nicotine (aka thromboangiitis)

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10
Q

What is Buerger’s disease a rare form of?

A

vasculitis

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11
Q

How does Buerger’s and ASO differ?

A

ASO is caused by plaque build up and BD is caused by an arterial inflammatory response.

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12
Q

What group in BD common in?

A

men under 40 and heavy smokers

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13
Q

What is often the first symptoms of Buerger’s disease (BD)?

A

intermittent claudication in the arch of the foot or palm of the hand

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14
Q

What are 7 SSx of Buerger’s Disease?

A
  1. blood clot formation (tibial, radial or entire neurovascular bundle)
  2. Pain at rest
  3. edema
  4. cold sensitivity
  5. rubor from dilated capillaries
  6. cyanosis
  7. thin, shiny, hairless skin (trophic change) from chronic ischemia
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15
Q

Are BD SSx bilateral and constant?

A

No, they are episodic and segmental (appears differently and in asymmetrical anatomic locations)

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16
Q

The treatment for BD is very similar to the tx for what other PAD?

A

Raynaud’s - goal is to increase circulation to hand/foot.

17
Q

What does ARTS stand for?

A

A: absent pulse (or absent hair, shiny cool legs)
R: round, red sores (blood pooling)
T: toes & feet pale (black “eschar”)
S: sharp calf pain (intermittent claudication)

18
Q

What is PAD?

A

insufficient tissue perfusion - narrowing or occlusion of aorta or peripheral branches

19
Q

What are 3 pathologies to consider if a pulse is markedly dimished in arms?

A
  1. Buerger’s disease (thromboangiitis obliterans)
  2. scleroderma
  3. cervical rib placement
20
Q

What are 2 pulses to palpate in the upper extremity if arterial insufficiency is suspected?

A
  1. ulnar

2. brachial

21
Q

What are the 6 P’s of PAD?

A
  1. Pain
  2. Paralysis
  3. Pulseless
  4. Perishing cold
  5. Pallor
  6. Paresthesia
22
Q

What are 6 symptoms of PAD, overall?

A
  1. intermittent claudication
  2. diminished or absent pulse
  3. painful ulcers
  4. elevated pallor / dependent rubor
  5. cool skin (ischemia)
  6. impotence - iliac a. claudication
23
Q

What are 5 causes of PAD?

A
  1. atherosclerosis
  2. blood clots
  3. DM
  4. infection (syphilis and salmonella)
  5. high cholesterol/HTN
24
Q

What are 4 ways to diagnose PAD?

A
  1. clinical
  2. bruits
  3. doppler ultrasound
  4. abnormal sound from turbulent BF
25
Q

What are 3 treatment routes for Raynaud’s SYNDROME/PHENOMENON?

A
  1. treat the underlying conditions
  2. use of vasodilators (calcium channel blockers)
  3. avoid compromising tissues (cold stress).
26
Q

What gender and age range is Raynaud’s most common in?

A

women

18-30 years old.

27
Q

What is the vascular abnormality present with Raynaud’s?

A

normally, endothelium produces substance to keep vessels dilated, with Raynaud’s there is a deficiency (nitric oxide) causing vascular spasm and the area becomes white from lack of blood flow.

28
Q

What are 3 things a client with Raynaud’s can experience when blood flow comes back to the area of vasospasm?

A
  1. fingers are often red and painful
  2. fingers may swell and throb
  3. ends of fingers may be numb.
29
Q

Define neural abnormality:

A

repeated periods of stress where the NE or noradrenaline are released at the nerve endings = spams (occurs after vascular abnormality)

30
Q

Define floating substances:

A

clots can form due to increased activation of the clotting system and the spams; platelet activity occurs (occurs after neural abnormality)

31
Q

What are 2 triggers of Raynaud’s?

A
  1. cold

2. emotional stress

32
Q

What are 7 signs and symptoms of Raynauds?

A
  1. color changes in fingers or toes
  2. sensory Sx (numbness)
  3. brittle nails
  4. ulcers - tissue health affected
  5. decreased pulse
  6. thicken skin on finger tips (tissue dystrophy in affected digits)
  7. slight swelling (may indicate obstruction)
33
Q

What are 5 underlying pathologies Raynaud’s PHENOMENON is secondary to?

A
  1. arteriosclerosis
  2. occlusive PAD
  3. SLE
  4. TOS
  5. RA
34
Q

Should you treat the extremities during a Raynaud’s flare up?

A

NOPE, treatment of extremities is CI’d during attacks

35
Q

What are the 8 C’s of things to avoid for someone with Raynaud’s?

A
  1. careful with hot temps
  2. cautious with foot trauma
  3. constriction
  4. cross leg
  5. constrictive clothing
  6. cigarettes
  7. caffeine
  8. cold temps
36
Q

What are 7 special tests to consider with Raynaud’s disease?

A
  1. AROM or mild RROM
  2. check pulse and BP
  3. skin integrity check
  4. MMT on weak or atrophies mm.
  5. Capillary refill test
  6. Allen’s test
  7. Leg raise -IF feet affected.
37
Q

What are 5 goals to consider with PAD treatment?

A
  1. decrease BP
  2. improve collateral circulation
  3. increase vasodilation
  4. prevent joint contracture and mm atrophy (A& RROM to extremities)
  5. decreased intermittent claudication (vasodilation by reflex heating)
38
Q

What are 5 CI’s and Precautions for abdominal Tx with someone with Raynauds?

A
  1. no cold on affected tissues, extreme heat should be avoided
  2. caution with stim or painful techniques (SNS firing may trigger attack)
  3. NO deep techniques on affected tissue is tissue health is shit
  4. avoid limb elevation (dependent position is best)
  5. contact doctor regarding risk of thrombus or gangrene.

SYSTEMIC TREATMENTS (7 decks)

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