Peripheral Vascular Disease Flashcards
note:
Peripheral artery disease is one of the key clinical manifestations of ___ ____. Like other vascular diseases, PAD is frequently ignored misdiagnosed and mistreated, contributing to the development and progression of ___ and ___ disease.
Peripheral artery disease is one of the key clinical manifestations of systemic atherosclerosis. Like other vascular diseases, PAD is frequently ignored misdiagnosed and mistreated, contributing to the development and progression of cerebrovascular and cardiovascular disease.
common PAD risk factors
PAD involves the claudication of many different peripheral vessels that end up causing a multitude of effects including amputation/necrosis or stroke. what is claudiation?
Claudication: Limping. From the Latin claudicare,
which means ‘to limp.’ The Roman emperor
Claudius was so named because he limped,
probably because of a birth defect. • In 1858, Jean Martin Charcot described pain in the
lower extremities resulting from arterial
insufficiency. Intermittent claudication can inhibit
walking, and cause limping due to ischemia of the
lower extremity unilaterally or bilaterally.
Symptoms of claudication can be either ____(10%), or ____ (50%) with 40-60% of people actually having asymptomatic PAD. Outline the difference between the two classes of claudication
classic: discomfort, pain cramping, aching, HEAVINESS. - consistently occurs at a set walking distance, and relieved by rest while standing.
Atypical: exertional but at different distances. requires sitting to relieve. SHARP or LANCINATING PAIN. weakness on exertion.
for hip claudication/limping/heaviness, the ___ or ___ is occluded
for thigh claudication, the ___ is occluded.
for calf claudication, the ___-___ is occluded
for foot claudication, the ___ is occluded.
for hip claudication/limping/heaviness, the AORTA or ILIAC is occluded
for thigh claudication, the FEMORAL is occluded.
for calf claudication, the TIBIO-PERONEAL is occluded
for foot claudication, the PEDAL ARTERY is occluded.
Intermittent Claudication
• Slow progressive •
Critical Limb ischemia
• Limb ___
• End stage of chronic limb ischemia
• causes: ___ or ___
• Acute Limb Ischemia
• Acute Limb Threatening
• Usually __
Intermittent Claudication
• Slow progressive •
Critical Limb ischemia
• Limb Threatening
• End stage of chronic limb ischemia
• Atherosclerotic or thrombotic
• Acute Limb Ischemia
• Acute Limb Threatening
• Usually EMBOLIC
outline questions of the edinburgh questionnaire
inspection and palpation findings of claudication
- Inspection
- Color: white, pink, purple, blue, bright red (rubor),black
- Ulcers or sores
- Shape of foot •
Palpation
• Pulses- compare right and left sides
• Temperature
• Abdomen, popliteal fossa (pulsation-?aneurysms)
• Edema (swelling)
on auscultation of a limb or body part with claudication, you may hear ____
bruits, turbulent flow due to stenosis or fistula. if renal involvement, might hear renal bruits.
Buerger;s test
Positive if pallor develops after limb elevation with
subsequent hyperemia after lowering the limb
Ddx for peripheral artery diseases: 3 main categories
- pain relieved by lumbar flexion
- pain elicited on joint examination
- vascular (nonatherosclerotic)
a diagnostic test for PAD is non-invasive evaluation ankle-brachial index. outline how it happens.
ABI= ankle pressure/brachial pressure
- normal should be over 0.9 and less than 1.3.
ex/ if ABI=0.62 the person might have periphery artery disease
outline how you can differentiate normal, PAD, claudication, critical ischemia using ankle brachial pressure
T/F calcified peripheral vessels will have a very low ABI index
false. if >1.3 ABI, consider calcified vessels.
supervised exercise into pain remains one of the best treatments.
two surgical options for PAD
- bypass
- amputation
