Peripheral vascular diseases

Question 1

what is the patho behind peripheral vascular disease?

Answer 1

lower extremity atherosclerosis causes ischemia of whatever is below it.
this causes reduced muscle fibers, impaired mitochondrial function, muscle damage and degeneration, and impaired peripheral nerve function.
overall this leads to mobility problems, reduced strength, and pain

Question 2

what are the risk factors for PVD?

Answer 2

smoking
diabetes
high cholesterol
heart disease
stroke
> 50

Question 3

what are the common causes of PVD?

Answer 3

atherosclerosis
thrombi
inflammation
vasospasms (from Raynaud’s or other autoimmune things)

Question 4

what is thromboangitis obliterans?

Answer 4

an inflammatory condition of the arteries which was formerly known as Berger’s disease - this is more likely in smokers and leads to permanent occlusion of peripheral arteries.

Question 5

what are the clinical manifestations of peripheral artery disease?

Answer 5

pain in whatever the affected region is (buttock, calf)
numbness / burning
heaviness
intermittent claudication (pain caused by little blood flow during exercise)
unhealing wounds
diminished sensation
shiny skin
thick toenails
loss of leg hair
diminished pulses
elevation pallow
cyanosis
reactive hyperemia / dependent rubor
erectile dysfunction

Question 6

what is intermittent claudication, what does it look like?

Answer 6

pain, commonly in legs, caused by too little blood flow, usually during exercise
constant pain precipitated by a certain level of exercise
stops with rest
common with walking
pain depends on the site of plaque build up and presence of collateral circulation or not

Question 7

what is the most common site of PAD?

Answer 7

femoral artery

Question 8

what are the 5 P’s of PAD?

Answer 8

pain
pulselessness
palpable coolness
paresthesia
paresis (weakness)

Question 9

what is used to diagnose PVD?

Answer 9

ankle-brachial index (ABI)

Question 10

what is a normal ABI?

Answer 10

> 1

Question 11

what is an acceptable ABI?

Answer 11

0.9-1.0

Question 12

what ABI indicates some arterial damage, what is the recommendation?

Answer 12

0.8-0.9 - treat risk factors to avoid progression

Question 13

what ABI indicates moderate arterial damage, what is the recommendation?

Answer 13

0.5-0.8 - see vascular spec

Question 14

what ABI indicates severe arterial damage, what is the recommendation?

Answer 14

< 0.5 - see vascular spec

Question 15

what is the pain like for arterial ulcers?

Answer 15

intermittent, claudication pain

Question 16

what is the edema like for arterial ulcers?

Answer 16

none

Question 17

what are the pulses like for arterial ulcers?

Answer 17

weak or no pulses

Question 18

what is the drainage like for arterial ulcers?

Answer 18

no drainage

Question 19

what are the sores like for arterial ulcers?

Answer 19

smooth and round

Question 20

what is the pain like for venous ulcers?

Answer 20

dull, achy pain

Question 21

what is edema like for venous ulcers?

Answer 21

lower leg edema

Question 22

what are the pulses like for venous ulcers?

Answer 22

present

Question 23

is there drainage present with venous ulcers?

Answer 23

yes

Question 24

what are the sores like for venous ulcers?

Answer 24

irregular borders

Question 25

what is the typical location of arterial ulcers?

Answer 25

toes and feet

Question 26

what is the typical location of venous ulcers?

Answer 26

ankles

Question 27

PVD or PAD: pain that worsens during walking / activity and subsides with rest?

Answer 27

PAD

Question 28

PVD or PAD: pain worsens when standing and improves when leg is elevated or activity?

Answer 28

PVD

Question 29

what is chronic venous insuffiency?

Answer 29

the most common form of functional (no physical injury to the vessel) PVD.
a condition that occurs when the venous wall / valves in leg veins are not working
this causes blood to pool

Question 30

what are symptoms of chronic venous insufficiency?

Answer 30

lower extremity edema
achy / tiredness in the legs
leathery skin
stasis ulcers (usually on ankles)
flaking / itching
new varicose veins (not everyone that has this has CVI)