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Cardiovascular > Peripheral Vasculature in Health and Disease 1, Arterial Aspects > Flashcards

Peripheral Vasculature in Health and Disease 1, Arterial Aspects Flashcards

1
Q

What are the relative sizes of artery diameter?

A

Large vessels- aorta, great vessels in chest, iliac
Medium- mesenteric, renal, femoral, popliteal, tibial, subclavian, brachial, radial
Small- blood vessels in the hand and foot, the kidneys, the brain, the eye

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2
Q

How does blood reach the peripheries by several routes?

A

Arteries have many anastomoses
Blood can reach target organs by several routes
Collateral circulation can compensate for occlusion of the main system in some circumstances

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3
Q

Describe the starling forces across the capillary bed

A 
Blood pressure (35 mmHg)
Osmotic (25 mmHg)
-Arteriole-
Blood pressure (16 mmHg)
Osmotic (25 mmHg)
-Venule-
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4
Q

What is the arterial pathology when dilated?

A

Aneurysm

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5
Q

What is the arterial pathology when narrowed?

A

Stenosis

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6
Q

What is the arterial pathology when blocked?

A

Occluded

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7
Q

What is the arterial pathology when split?

A

Dissection

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8
Q

What is the arterial pathology when over sensitive?

A

Vasospasm

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9
Q

What is the arterial pathology when inflamed?

A

Vasculitis

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10
Q

Describe aneurysms

A

Definition= 1.5 x the normal diameter
Degenerative aneurysms most common
Inflammatory, mycotic (infective), traumatic can also occur
Connective tissue disease- Marfans, Loeys-Dietz

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11
Q

How can aneurysms be detected?

A

CT Angiogram imaging

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12
Q

How can aneurysms be repaired?

A

Open surgery

Endovascular repair

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13
Q

Describe stenosis

A

Atherosclerosis
20% of UK population aged 55-75 have peripheral arterial disease
5% have symptoms
Cardiovascular risk HIGH

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14
Q

Describe atherosclerosis

A

Lipid deposits
Cholesterol rich plaque
Calcification
Plaque rupture= occlusion

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15
Q

What are the symptoms of stenosis

A

Claudication
Short distance Claudication
Nocturnal pain/ rest pain

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16
Q

What is Claudication?

A

Pain on walking a fixed distance
Worse uphill
Eases rapidly when you stop
Angina of the leg

17
Q

What is the treatment for claudication?

A

Stop smoking
Aspirin
Lipitor tablets

18
Q

What are the symptoms of acute occlusion?

A

The 6 P’s

  • Pain (sudden onset)
  • Pallor
  • Perishing cold
  • Paraesthesia
  • Pulselessness
  • Paralysis
19
Q

What are the symptoms of chronic occlusion?

A
  • Short distance claudication
  • Nocturnal pain
  • Pain at rest
  • Numbness
  • Tissue necrosis
  • Gangrene
20
Q

What is the treatment for occlusion?

A

Stent

Amputation

21
Q

Describe amputation

A
  • Median survival after amputation is 2.25 years
  • 30 day mortality of 17%
  • 30% lose the other leg with 2 years
  • 6000 per year in UK
22
Q

Describe vasospasm

A
  • Over active vasoconstriction
  • Capillary beds shut down
  • Triggers- cold, stress
  • Can have underlying connective tissue disease
23
Q

Describe vasculitis of large vessels

A

Takayasu’s disease- “pulseless disease”

24
Q

Describe vasculitis of medium vessels

A

Giant Cell Arteritis/ Polymyalgia

25
Q

Describe vasculitis of small vessels

A

Lots of polyangiitis conditions usually involving the kidneys

26
Q

What is the treatment for vasculitis?

A

Steroids

Other immunosuppressive agents

27
Q

How are broken arteries caused?

A

Trauma
Self-inflicted
Iatrogenic ( illness caused by medical examination or treatment)

28
Q

What does IV Drug abuse cause?

A

Arterial pseudoaneurysm
collection of blood that forms between the two outer layers of an artery, the tunica media and the tunica adventitia. It is usually caused by a penetrating injury to the vessel, which then bleeds, but forms a space between the above two layers, rather than exiting the vessel.

29
Q

Describe the link between Diabetes and Arterial disease

A
  • Major problem for healthcare systems worldwide
  • Increasing incidence
  • Diabetic patients are 20 times more likely to have an amputation
30
Q

Describe Diabetic Foot

A

-Neuropathic (disease or dysfunction of one or more peripheral nerves, typically causing numbness or weakness)
-Ischaemic
-Infected
-Calcified vessels
-Small vessel arterial disease
Patients can’t see their feet (retinopathy)

31
Q

Describe Charcot Foot

A
  • End-stage diabetic foot changes
  • Neuropathic
  • Warm (greater than 2 degrees than normal, AV shunting)
  • Multiple fractures
  • “Rocker bottom” sole (midfoot collapse)

Cardiovascular (52 decks)

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