peripheral vascular disease Flashcards
PVD
umbrella term used to describe several circulatory diseases
only called PAD when arteries are involved
pathophysiology of PVD
related to atherosclerosis processes in the extremities
lower ext. atherosclerosis
ischemia reperfusion of calf skeletal muscle
reduced myofibers in calf muscle, impaired mitochondria, muscle damage, impaired peripheral nerve function
impaired oxygenation
reduced leg strength
poor 6 min walk
increased rates of mobility loss
risk factors for PVD
smoking, high cholesterol, stroke, diabetes, heart disease, increased age >50
causes of PVD
atherosclerosis- most common cause
thrombus
inflammation- thromboangitis
vasospasm- Raynaud’s disease or an autoimmune disease
clinical manifestations of PVD
dull achy pain in legs lower leg edema pulse present drainage sores with irregular borders yellow slough or ruddy skin thick toenails sore on ankles tired/heavy legs pain WORSENS when standing and IMPROVES with elevation and activity
what is intermittent claudication?
cramping pain of lower extremity or buttock caused by atrial flow obstruction
STOPS WITH REST
caused by ischemic tissue
pain depends on site of plaque build up, collateral circulation
common site for PAD
femoral artery
causes of PAD
lack of circulation pain decreased pulse coolness of leg pallor of leg loss of sensation in foot ischemia of muscle in lower leg, cellular hypoxia
5 p’s of PVD
pain (intermittent caludication) pulselessness palpable coolness parasthesias paresis (weakness of extremity)
how do you diagnose PVD
ankle-brachial index
ankle-brachial index (ABI)
comparison of blood pressure in leg vs. arm
normal ratio is greater than 1
normal= ankle pressure is greater than brachial pressure
a ABI of 1-1.4
normal
a ABI of 0.9-1.0
acceptable
a ABI of 0.8-0.9
some arterial disease
treat risk factors
a ABI of 0.5-0.8
moderate arterial disease, refer to vascular specialist
