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CVS1 > Peripheral Arteries > Flashcards

Peripheral Arteries Flashcards

1
Q

What are the lower imb veins divided into

A

Superficial and deep

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2
Q

What are the deep veins

A

Rewatch

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3
Q

Where is the long saphenous vein

A

Remember, the one constant vein in the body is the long saphenous vein anterior to the medial malleolus

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4
Q

—

A

-

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5
Q

What are varicose veins

A

Varicose veins are tortuous, twisted, or lengthened veins

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6
Q

Describe the pathophysiology of varicose veins

A

The vein wall is inherently weak in varicose veins,
which leads to dilatation and separation of valve
cusps so that they become incompetent

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7
Q

Hat are the symptoms of varicose veins

A

Heaviness, tension, aching, itching

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8
Q

What are the complications of varicose veins

A

Results from the vein itself
Haemorrhage
• Thrombophlebitis

Result from the venous hypertension 
• Oedema
• Skin pigmentation
• Varicose eczema
• Lipodermatosclerosis
• Venous ulceration
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9
Q

What is venous thrombophlebitis

A

Venous thrombosis produces an inflammatory response, including PA I N
Big dilated varicose veins, can get thrombosis, very painful

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10
Q

What is haemosiderin staining

A

Ferrous to ferric iron

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11
Q

Describe varicose eczema

A

Affects primarily lower limb, can spread elsewhere

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12
Q

What is lipodermatosclerosis

A

Hard - fat has become thickened and hardened

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13
Q

What does venous hypertension result to

A

It is venous hypertension that leads to venous ulceration - very painful
Venous hypertension is a result of calf muscle pump failure

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14
Q

Describe ethe causes of calf muscle pump failure

A
  • ‘Failure’ of calf muscle contraction - immobility, obesity, reduced hip, knee and/or ankle movement
  • Deep vein incompetence
  • Volume overload - superficial vein incompetence
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15
Q

What is the retrograde circuit

A

-

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16
Q

Describe the oathophysioogy of thrombosis

A
  • Virchow’s triad
  • Changes in the lining of the vessel wall
  • Changes in the flow of blood
  • Changes in the constituents of blood
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17
Q

What is the biggest cause o f arterial thrombosis

A

Changing in lining f the vessel wall eg atheroma

18
Q

What is the most common cause of venous thrombosis

A

Changes n the flow of blood - stasis leads to venous thrombosis

19
Q

Why does stasis lead to venous thrombosis

A

In reality it is usually stasis plus another ‘provocateur’ – surgery (trauma), oral contraceptive pill, dehydration, cancer

Arterial thrombosis in response to bleeding involves platelets, extrinsic and then intrinsic pathways. Arterial thrombi are platelet rich

20
Q

Descrie venous thrombosis

A

Venous thrombosis does not involve platelets in
a major way, initially the intrinsic pathway is
involved and then the extrinsic. Venous thrombi
are fibrin rich

21
Q

Whee does deep venous thrombosis begin and what does it produce

A 
• Most commonly begins in the deep calf veins • Produces an inflammatory response
– Calor
– Dolor
– Functio laesa
– Rubor
– Tumor
22
Q

What are the clinical features of DVT

A
  • Symptoms
  • Pain, cannot walk
  • Swelling
  • Blue-red skin discolouration
  • Signs
  • Calf tenderness
  • Muscle induration
  • Skin warmth
  • Skin discolouration
  • Distended, warm superficial veins
  • Oedema
  • Pyrexia
23
Q

Wat is the association between DVT and surgery

A

• Immobility prior to surgery • No calf muscle pump during surgery • Immobility after surgery • Surgery is trauma. The body’s response trauma includes
a ‘prothrombotic state’
The dreaded, often fatal consequence of DVT is pulmonary embolism

24
Q

How can peripheral arterial disease be classified

A

Acute, chronic

25
Q

What is collateral circulation

A

Develops in response to a stenosis , bypasses the occlusion to supply myocardium

26
Q

What is acute lib ischaemia

A

• The limb goes from a normal blood supply to greatly impaired blood supply over a period of minutes. No chance for collateral vessel development (which takes
weeks/months)
• Commonest causes are embolism (from heart or abdominal aortic aneurysm) and trauma
• Sudden onset
• If not reversed within 6 hours the limb cannot be recovered and if not amputated the patient will die (hyperkalemia due to dead tissue releasing intracellular potassium)

27
Q

What are the symptoms of acute ischaemia

A

• Pain • Paralysis • Paraesthesia • Pallor • Perishing cold • Pulseless

28
Q

What is chronic peripheral arterial disease

A

• Intermittent claudication (equivalent to stable angina)
• Critical ischaemia
– Rest pain (equivalent to unstable angina)
– Ulceration/gangrene (equivalent to myocardial infarction)

29
Q

Wha is the definition of claudication

A

Pain in the muscles of the lower limb elicited by walking / exercise

30
Q

What are the features of claudication

A

• The calf muscles are most frequently affected,
although more proximal muscles may be affected
• Pain relieved rapidly by stopping exercise for a few
minutes, even whilst standing up

31
Q

Where is the femoral pulse felt

A

The femoral pulse is felt at the mid inguinal point

- between pubic symphysis and smth iliac spine??

32
Q

Where is the popliteal pulse felt ?

A

Popliteal pulse is deep in the popliteal fossa and difficult to feel

33
Q

Where is the dorsalis pedis pulse felt?

A

Dorsalis pedis pulse felt just lateral to extensor hallucis longus tendon

34
Q

Where is the posterior tibial pulse felt

A

Posterior tibial pulse felt behind medial malleolus

35
Q

What are the symptoms of aortoilica occlusion

A
  • Bilateral buttock, thigh and calf claudication
  • Absent lower limb pulses
  • Rare
36
Q

What are the symptoms of common iliac occlusion

A

Right buttock, thigh and calf claudication
• Absent right lower limb pulses
• Not so common

37
Q

What are the symptoms of common femoral or ext iliac occlusion

A

• Right thigh and calf claudication • Absent right lower limb pulses • Not so common

38
Q

What are the symptoms of superficial femoral artery occlusion>

A
  • Right calf claudication
  • Femoral pulse present, absent popliteal and pedal pulses
  • By far the commonest finding in patients with claudication
39
Q

What is critical ischaemia

A
  • Rest pain (equivalent to unstable angina)

* Ulceration/gangrene (equivalent to myocardial infarction)

40
Q

What is rest pain

A

• Pain in the FOOT that comes on when the patient goes to bed and is relieved by hanging the foot out of the bed
• The ischaemia is so severe that at rest the foot skin, muscles, bones are ischaemic at rest. This means that
there is not enough oxygen to provide for the cells basic metabolic requirements
• If left untreated then will progress to:

CVS1 (20 decks)

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