Peripheral Vascular Disease Flashcards
What are the 3 tunics of the arterial system from inner to outermost?
- Tunica Intima
- Tunica Media
- Tunica Adventitia
In what type of arteries is BP highest and why?
In muscular smaller arteries because they expand only slightly regardless of the pressure
What is the function of the lymphatic system?
To facilitate movement of wastes, extra fluid, and proteins between the bloodstream and interstitium
What can be defined as hardening of arterial walls?
arteriosclerosis
What can be defined as a common form of arteriosclerosis in which plaques deposit of the endothelial lining?
atherosclerosis
What can be defined as an occlusive arterial disease most prominently affecting peripheral arteries (usually in the LEs), which may lead to absent dorsalis pedis, posterior tibial, and/or popliteal artery pulses?
Arteriosclerosis obliterans
What can be defined as a specific arterial disease with tissue ischemia in young men who smoke?
Thromboangiitis Obliterans (Buerger’s disease)
What can be defined as temporary vasospasm in the arterioles causing cyanosis
that is typically brought on by cold, and leads to pallor, pain, and numbness
Primary Raynaud’s Disease
True or False
Veins cannot contract like arteries because their tunica media is insignificant
True
What are 2 mechanisms by which the movement of blood within the veins is aided?
- muscle pumping
- breathing
What are the 4 pathological types of PVD?
- Arterial occlusive
- Inflammatory
- Vasomotor Disorder
- Venous
What are 2 types of acute arterial occlusive disorders? Explain each…
- emboli: originate in heart and migrate to peripheral vessels where they block blood flow
- thrombi: clot forms around an atherosclerotic lesion which blocks blood flow
Which is more serious, embolus or thrombus?
embolus is a medical emergency and surgery is required ASAP
What are the 5 symptoms of sudden cessation of blood flow? (5 P’s)
- Pain
- Pallor
- Paralysis
- Parasthesia
- Pulselessness
Peripheral arterial disease (atherosclerosis) is a chronic condition which is slow in progression. What usually causes the initial injury to the blood vessel?
HTN or trauma
How can you tell the difference between intermittent and neurological claudication?
If pain persists when riding a bike this is an indication of reduced blood supply rather than neurological origin
Subjectively what will your patients tell you if they have arterial disease?
- experience cramping with walking (intermittent claudication)
- pain is relieved by rest
- have wounds but have no history of trauma
What are the objective findings associated with arterial disease?
- Trophic skin changes (loss of hair growth, abnormal nails, dry skin)
- Cool skin
- Decreased pulses
What are a few medical management options for patients with chronic arterial disease?
- quit smoking
- wound care
- walking programs
What can be defined as inflammation of the vessel wall resulting from immune complex deposition or cell-mediated immune reactions directed against the vessel wall?
Vasculitis
What is the cause of Vasculitis?
Unknown
What is the difference between primary and secondary Raynaud’s?
Primary is due to external factors
Secondary occurs due to another disease such as Buerger;s disease or connective tissue disorders
What can be defined as abnormally dilated veins that are the result of intrinsic vessel wall weakness and chronic valvular insufficiency?
Varicose veins
Varicose veins are _ times more likely to occur in women than in men
3
What are varicosities?
smaller pools of blood in veins
What causes a DVT?
coagulation of blood collected in deep veins due to obstructed flow
How long after a patient receives anticoagulation therapy must you wait to ambulate?
48-72 hours
What are the risk factors for venous disease?
- Aging
- Pregnancy
- Obesity
- Long hours of standing/sitting
- Lack of regular activity
- Family history
Subjectively what will your patients tell you if they have venous disease?
- Aching, heavy legs that is sometimes relieved by elevation
- Wounds may have no history of trauma
What are the objective findings associated with venous disease?
- Swelling present
- Skin changes (hemosiderin staining/deposits of LE, fibrosis of the skin)
- Pulses present
- Wounds with drainage
What causes 70-80% of LE ulcers?
Chronic Venous Insufficiency
What are the symptoms associated with Chronic Venous Insufficiency?
- dilated veins
- leg pain
- edema
- cutaneous changes (stasis dermatitis)
What are 3 possible causes of chronic venous insufficiency?
- Venous occlusion
- Valvular defects
- Problems with muscle pump
What are 3 surgical options for patients with chronic venous insufficiency?
- Angioplasty
- Stenting
- Amputation
Describe primary lymphedema
Hereditary or congenital underdeveloped lymphatic system
Describe secondary lymphedema
Injury to a part of the lymphatic system that leads to blockage
Subjectively what will your patients tell you if they have lymphedema?
- Feelings of fullness and heaviness
- Numbness/tingling
What are the objective findings associated with lymphedema?
- Swelling that is not improved with elevation
- Pitting
- Dermal changes (cysts, hyperkeratosis)
- Decreased ROM
What type of therapy is used to treat lymphedema?
Complete decongestive therapy (CDT)
What are the causes of neuropathy?
Mostly unknown but thought to be indirect and oftentimes linked to glucose damage to other systems
What is Charcot’s Joint?
progressive degeneration of a weight bearing joint, a process marked by bony destruction, bone resorption, and eventual deformity
What are the 3 phases of wound healing?
1) inflammatory phase
2) proliferative phase
3) maturation phase
