Peripheral Vascular Disease Flashcards
Vascular vs arterial
vascular = capacitance
arterial = resistor
Muscular wall thinner in vein
Varicose veins defintion
pooling of blood causing venous distention leading to enlargement and twisting
typically occurs in lower leg
Venous insufficiency
Tx for varicose veins
pressure gradient stockings
surgery
injection
avoid prolonged standing
Thrombophlebitis def
inflammation of a vein with thrombosis (clotting)
Causes of thrombophlebitis\
s/s
Tx
varied
redness and pain
dec dependent position, elevation, pain meds
DVT
Thrombosis of deep vein, most commonly in legs
Risk factors for DVT
immobilization, paralysis
Administration of estrogen
s/p surgery
trauma
Clinical presentation of DVT
pain tenderness edema inc temp of body part palpable vein
Dx of DVT
history and clinical findings non-invasive test of vascular system venography radionuclide studies Homans sign - validity issues
Wells CLinical Decision Rule
-2 to 0 = low probability (3%)
1-2 = moderate (17%)
3 or moe = high (75%)
Tx for DVT
hospoitiliation rest, elevation Anticoagulatants (SQ low molecular weigth) Maintain INR 2-3 Want to prevent pulm embolism
Bicycle test
differentiate btw vascular claudication and neurogenic claudication
patient cycle with spine first extended and then flexed
Vascular - time to onset of symp is the same
Neurogenic - time to onset if shortened in extended position
Chronic venous insufficiency define
venous valvular incompetence leading to impaired venous function
Venous hypertension
Clinical presentation of chronic venous insuff
edema
venous dilation
skin pigmentation change
skin ulceration
Arterioclerosis
thickening and stiffening of arterial walls
Most common cause of death in western world
Significant cause is smoking
Pathology of arteriosclerosis
development of atheroma dont develop uniformly throughout Increas platelt adhesiveness Advanced lesions can calcify Necrosis, ulceration can occur
Clinical Periheral presentation of arteriosclerossi
many are asymptomatic until major event occurs
Interment claudication
pain in muscle due to lack of oxygen
s/s arteriosclerosis
gradual onset progressve buits rest distribution pattern skin changes Shiny,thin absent hair deformed or slow growing nails ulceration on weight bearing areas
Dx of arteriosclerosis
pat and fam history appearance of extremities pulses auscultation bicycle test Ankle brachial index transcutaneous oxygen pressure arteriogram
Ankle Brachial index
highest ankle doppler pressure over the highest brachial doppler pressure
Normal is 0.9-1.1
below is arterial insuff
above is arterial calcification
Special tests - arteriosclerosis
claudification time rubor of dep venous filling time trendelenburg sensory testing
Tx and prognosis Arteriocsc
medication (anticoag) dietary changes cessation of smoking surgery exercise
Aneurysm
weakening of the arterial wall localized dilation of artery
Etiology of aneyr
congenital, trauma, infection, rypture potential is biggest problem
