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Cardiopulmonary PT > Peripheral vascular dysfunction and other contributors to cardiac dysfunction > Flashcards

Peripheral vascular dysfunction and other contributors to cardiac dysfunction Flashcards

1
Q

Metabolic syndrome, dysmetabolic syndrome or syndrome X

A
  • a cluster of conditions that occur together increasing risk of heart disease, stroke and type 2 diabetes
  • the presence of at least three of the diagnoses in an individual confirms the condition of metabolic syndrome
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2
Q

What combinations of conditions are incluced in metabolic syndrome

A
  • visceral obesity
  • insulin resistance
  • hTN
  • high triglycerides
  • low HDL cholesterol
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3
Q

Microvascular complications of diabetes

A
  • eye: damage to eye blood vessels = retinopathy, cataracts and glaucoma
  • kidney: damage to small blood vessels overworks kidneys resulting in nephropathy
  • neuropathy: damages PNS
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4
Q

Macrovascular complications of diabetes

A
  • brain: increase risk of CVA/TIA
  • Heart: increase risk of CAD
  • Extremities: PVD
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5
Q

Complications of body weight

A
  • impaired fasting glucose
  • metabolic syndrome
  • HTN
  • dyslipidemia
  • early plaques and CAD
  • psychosocial issues
  • higher risk of DVT/PE
  • undiagnosed sleep apnea/restrictive lung disease
  • higher risk of cardiac arrhythmias/sudden death
  • susceptible to pressure wounds and skin infections
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6
Q

Peripheral Arterial disease

A
  • angina of the LE
  • ischemia to LE tissue
  • pain is referred to as intermittent claudication
  • pain occurs with activity initially is relieved by rest
  • benefit from exercise esp. walking to tolerance
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7
Q

Ischemia Pain scales

A
  • higher number equates to increased more debilitating pain
  • intermittent claudication rating scale 0-4
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8
Q

PAD walking program

A
  • warm up
  • then walk at a speed that elicits mild symptoms within 3-5 minutes
  • continue walking until pain is moderate, rest until resolved and then walk again
  • Goal = 30+ minutes of walking to assist with development of collateral circulation in LE’s
  • walk into the 2/3 level of pain
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9
Q

Ankle brachial index

A
  • BP in ankle compared to brachial artery
  • less BP in LE (low ABI) = likely PAD/arterial insufficient
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10
Q

Progression of Arterial insufficiency

A
  1. painful walking (intermittent claudication)
  2. elevated foot develops increased pallor (lose the assistance from gravity)
  3. venous filling delayed following foot elevation
  4. redness of distal limb (depended rubor)
  5. death of tissue (gangrene)
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11
Q

Carotid artery blockage treatment

A
  • large % of blockage = can do carotid endarterectomy
  • plaque is removed and incision repaired with stitches
  • can also get carotid artery stenting = plaque removed and stent put in
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12
Q

Renal stenosis

A
  • a blockage of the renal artery
  • this artery can also be stented
  • kidney will atrophy and can increase fluid in the body if the kidney is not filtering it out
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13
Q

Abdominal aortic aneurysm

A
  • dilation/buldging of the artery wall
  • can be caused by HTN and atherosclerosis
  • triple A
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14
Q

Aortic dissection

A
  • a serious condition which a tear occurs in the inner layer of the aorta
  • blood rushes through the tear, causing the inner and middle layers to split
  • mostly seen in males over 60 years old
  • symptoms mimic and MI but often experience back pain
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15
Q

Aortic rupture

A
  • disection requires immediate treatment
  • can lead to aortic rupture which is through the entire vessel
  • significant back pain
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16
Q

Open repair vs endovascular aneurysm repair

A
  • the point of entry for endovascular repair is via the femoral artery to insert a stent (the stent gives structure and strength)
  • the open repair will be a graft that is usually synthetic
17
Q

Venous insufficiency

A
  • due to not have muscular walls veins need valves
  • if the valve doesn’t close properly = back flow
18
Q

Venous insufficiency: varicose veins vs chronic venous insufficiency

A
  • varicose veins = bulging veins
  • chronic: leg swelling –> skin color and texture changes –> venous ulcers
19
Q

hemosiderin staining

A
  • related to venous insufficiency
  • brown color
  • extra pressure causes RBCs to be pushed out of the circulation and die
  • the color comes from the Fe
20
Q

What is a DVT

A
  • a blood lot that forms in a deep vein of the leg or pelvis either partially or totally blocking the flow of blood
  • pt can have stasis/poor valves = stagnate blood
  • hypercoaguabilty
  • endothelial trauma
    have one of the three/combination
21
Q

What is pulmonary embolism caused by

A
  • caused when
    1. DVT or part of it breaks off from the vein
    2. the break away clot travels through the bloodstream, too the heart and migrates towards the lung
    3. the clot blocks a vessel in the lungs interrupting blood supply
22
Q

S&S of DVT

A
  • swelling
  • pain or redness
  • warmth
  • red or discolored skin
    not all people with DVT have symptoms
23
Q

S&S of PE

A
  • unexplained SOB
  • chest pain and or palpitations
  • anxiety and or sweating
  • cough (may be blood tinged)
  • fatigued and/or fainting
24
Q

What diagnostic test DVT/PE

A
  • blood test for PE = D-dimer
  • wells prediction rule for DVT
  • Wells production rule for PE
25
Q

Pulmonary embolism and Heart failure

A
  • Dependent on the size and the location of the embolism
  • tissue death of pulmonary cells
  • increase pulmonary artery pressure
  • increase stress on the right side of the heart
  • if large enough to block a significant amount of blood volume can impact V/Q and creates deadspace
26
Q

Treatments for hypercoaguability/PE

A
  • thrombolytic meds
  • anticoags
  • oxygen
  • embolectomy
  • insertion of IVC filter
27
Q

IVC filter

A
  • go in through femoral artery
  • will be inserted in the vena cave to catch clots
  • typically will be removed once the co-agulation condition is under control
28
Q

May-thurner syndrome

A
  • iliac vein compression
  • an anomaly where the right iliac artery compresses the left iliac vein against the spine
  • blood is not flowing freely
29
Q

Renal insufficiency/kidney failure effects what systems

A
  • hematlogic
  • cardiovascular
  • metabolic
  • neurologic
  • musculoskeletal
30
Q

Treatment for renal insufficiency/kidney failure

A
  • dialysis
  • transplant
31
Q

Kidney failure

A
  • Acute renal failure
  • chronic renal failure (end stage renal disease)
  • stage 1-5
  • typically don’t know until stage 3
32
Q

hemodialysis

A
  • uses dialysis machine to filter blood external to the body
  • access is gained via: central venous catheter, AV fistula. AV graft
33
Q

Peritoneal dialysis

A
  • uses the peritoneum within the abdominal cavity as the membrane through which toxins are exchanged with the blood
  • access via intrabdominal catheter
34
Q

AV fistula

A
  • used for hemodialysis
  • connects an artery/vein
35
Q

AV graft hemodialysis

A
  • under the skin to connect the artery and vein
  • material self seals
  • don’t take BP/put pressure in this arm
36
Q

How does hemodialysis work

A
  • uses a lower concentration of toxins then in the blood to get them to move out of the blood into the machine
  • people typically will gain weight between dialysis
  • dry weight = weight after dialysis
37
Q

Peritoneal dialysis (how it works)

A
  • Waste products cross the semipermeable membrane into the peritoneal space
  • typically used at home
38
Q

Kidney transplant

A
  • types of donors: living, deceased, paired
  • typically added to around the hip area of the abdominal cavity
  • other kidney atrophies

Cardiopulmonary PT (25 decks)

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