Peripheral Vascular Diseases Flashcards
What is occlusive peripheral arterial disease (PAD)? What conditions is this typically associated with? (2)
Chronic, occlusive arterial disease of medium and large sized vessels, the result of peripheral atherosclerosis.
Associated the hypertension and hyperlipidemia
What is the primary results of peripheral vascular disease?
Diminished blood supply to affected extremities with pulses decreased or absent.
What happens to the color of the extremities in elevated versus dependent positions in patients with peripheral vascular disease (PAD)?
Elevated = pale Dependent = Dusky red
What does a patient in the early stages of peripheral vascular disease exhibit?
Intermittent claudication
Pain described as burning, aching, and cramping
Occurs regularly and predictably with walking and is alleviated by rest.
List 3 symptoms of late stage peripheral vascular disease.
- Pain at rest
- Muscle atrophy
- Trophic changes (hair loss, skin and nail changes)
List 3 symptoms exhibited by patients with critical stenosis PAD.
- Resting or nocturnal pain
- Skin ulcers
- Gangrene
What is thromboangiitis obliterans (Buerger’s disease)? Who does it typically affect?
- Chronic, inflammatory vascular occlusive disease of small arteries and veins
- Beings distally and progresses proximally in both UEs and LEs
- Occurs commonly in young adults, largely males, who smoke
List 6 signs and symptoms associated with thromboangiitis obliterans (Buerger’s disease).
- Pain or paresthesia
- Cyanotic cold extremity
- Diminished temperature sensation
- Fatigue
- Risk for ulceration
- Gangrene
What is diabetic angiopathy? What is a major complication of this condition?
Inappropriate elevation of blood glucose levels and accelerated atherosclerosis
Neuropathy is a major complication
What is Raynaud’s disease? Symptoms? Who does it typically affect?
- Episodic spasm of small arteries and arterioles
- Abnormal vasoconstrictor reflex exacerbated by exposure to cold or emotional stress; tips of fingers develop pallor, cyanosis, numbness and tingling
- Affects largely females
What are varicose veins?
Distended, swollen superficial veins
What is a venous thromboembolism?
The formation of a blood clot in a deep vein that can lead to complications including DVT, pulmonary embolism, or post thrombotic syndrome.
What is deep vein thrombophlebitis (DVT)?
Clot formation and acute inflammation in a deep vein
- Progressive inflammation with tenderness to palpation
- Dull ache, tightness or pain in calf
- Swelling, warmth, redness or discoloration in the LE
What standardized risk assessment measure should be used to assess for DVTs?
Wells Criteria score for DVT
How are DVTs typically treated? (2)
- Anticoagulation therapy (low molecular weight heparin)
2. Graded compression stockings
Low molecular weight heparin is contraindicated in patients with _____.
High risk for bleeding
List 5 signs of a pulmonary embolism.
- Abrupt chest pain
- Abrupt dyspnea
- Diaphoresis
- Cough
- Apprehension
What is chronic post thrombotic syndrome? List 5 signs and symptoms associated with this condition.
Combination of clinical signs and symptoms that persist after a LE DVT
- Pain
- Intractable edema
- Limb heaviness
- Skin pigmentation changes
- Leg ulcers
What is chronic venous stasis/incompetence?
Venous valvular insufficiency from fibroelastic degeneration of valve tissue, venous dilation.
Describe the 3 classification of chronic venous stasis/incompetence.
Grade I = mild aching, minimal edema, dilated superficial veins
Grade II = increased edema, multiple dilated veins, changes in skin pigmentation
Grade III = venous claudication, severe edema, cutaneous ulceration
What type of positioning should be encouraged in patients with chronic venous sufficiency?
Extremity elevation, minimum of 18 cm above heart.
Encourage patients to elevate leg as much as possible and avoid the dependent position
List 5 contraindications to compression therapy.
- ABI < 0.8 in the involved extremity
- signs of active infection or cellulitis
- Systemic arterial pressure < 80 mmHg
- Advanced peripheral neuropathy
- Uncontrolled CHF
What exercises are the most effective for increasing blood flow in patients with peripheral arterial disease?
Resistive calf exercises
