Peripheral Vasculature

Question 1

What are the 3 venous systems?

Answer 1

superficial, communicating, deep

Question 1

What are some risk factors for arterial disease?

Answer 1

MI, stroke, emboli, smoking, hyperlipidemia–atherosclerotic plaques, h/o cardiac disease htn and reynauds

Question 2

What are historical clues for venous disease?

Answer 2

pain, fatigue, heaviness, extremity or head/neck edema, skin erythema, ulceration, dermatitis

Question 3

What are the 3 aspects of virchow’s triad?

Answer 3

venous stasis, vascular injury, hypercoagulability

Question 4

What are the 8 aspects of inspection for peripheral vascular disease? ( UP Vp Vp PACT )

Answer 4

asymmetry, pigmentation, venous pattern, visable pulsations, capillary refill, trophic changes, ulcers, previous surgery or amputations

Question 5

In virchow’s triad, what are 3 things listed under vascular injury?

Answer 5

indwelling catheter, trauma, surgery

Question 6

In virchow’s triad, what are 4 things listed under venous stasis?

Answer 6

immobility, paralysis, a-fib, LV dysfunction

Question 7

In virchow’s triad, what 3 things are listed under hypercoagubility?

Answer 7

protein C & S deficiency, antithrombin deficiency, malignancy

Question 8

Describe the notable factors of orthostatic edema?

Answer 8

caused from sitting/standing for a long time, pits on pressure, bilateral, no other findings.

Question 9

Descrive the notable factors of lymphedema?

Answer 9

lymphatic obstruction, soft but becomes hard if chronic over time, initially pitting but gets harder and then doesn’t pit, skin thickens over time, feet also have edema, no ulceration or color change

Question 10

What is lipedema?

Answer 10

fat legs, always bilateral because that is how fat works

Question 11

How would you distinguish thick legs caused by chronic venous insufficiency?

Answer 11

it is an obstruction or valvular incompetency or the deep veins, soft and pitting but becomes hard over time, common with skin thickening, ulceration, pigmentation, feet edema as well.

Question 12

How can you tell ulcers are ischemic?

Answer 12

affects the fingers/toes first

Question 13

How can you tell that ulcers are from chronic venous issues?

Answer 13

they develope above the malleolus and typically also have hyperpigmentation

Question 14

How can you tell ulcers are neuropathic?

Answer 14

painless, on pressure points, people might not know they have them

Question 15

What are the 6 P’s of acute ischemia?

Answer 15

pain at rest, pallor, pulseless, poikilothermia, paralysis, paresthesia

Question 16

To summarize, 6 indications of venous insufficiency?

Answer 16

h/o DVT, varicose veins, chronic leg edema, achy legs, stasis dermatitis, stasis ulcers

Question 17

To summarize, 4 indications of chronic ischemia?

Answer 17

Claudication, ulcers, gangrene, erectile dysfunction

Question 18

To summarize, 8 indications of arterial insufficiency?

Answer 18

claudication, rest pain, pulse presence, trophic skin changes, postural changes, cool/pale extremities, ulcers, gangrenous changes

Question 19

Which vein from the leg is commonly grafted for CABG?

Answer 19

the greater saphenous vein

Question 20

What arterial pulses are included in his slides?

Answer 20

radial, brachial, aorta, renal, iliac, femoral, popliteal, posterior tibialis, dorsalis pedis

Question 21

What are the 4 grading levels of pulses?

Answer 21

0 absent -1 barely - 2 normal - 3 brisk, bounding.