PVD Flashcards
PVD
Peripheral vascular disease
Umbrella term for arteries and Venus diseases
patho of PVD
atherosclerosis in extremities
Ischemia reperfusion
Reduced myofibers, impaired, peripheral nerve function, muscle damage, degeneration
Impaired oxygen consumption
Increase the rate of mobility loss
risk factors for PVD
Smoking
Diabetes, high cholesterol
Heart disease
Stroke
>50
cause of PVD
Most common – atherosclerosis
Thrombus – clotting
Inflammation of arteries– thromboangitis obliterans
Vasospasm – raynauds disease
s/sx PAD
due to local tissue, ischemia an appearance in extremities
calf, buttock pain – numbness, burning, heaviness, intermittent claudication
Wounds that won’t heal
Decreased sensation in extremities
round, smooth sores on toes and feet
Black eschar
what are trophic skin changes in PAD?
Shiny and thick skin, toenails
Loss of leg hair
Decreased pulses
Pallor, cyanosis
Reactive hyperemia/dependent Rubor
Erectile dysfunction
intermittent claudication
Consistent pain precipitated by a consistent level of exercise
Cramping, Angina of lower extremities
T/F intermittent claudication does not stop with rest
False
what is intermittent claudication caused by?
Ischemic tissue
Arterial flow obstruction
where is a common site of PAD?
Femoral artery
5 P’s of PAD
Pain– intermittent claudication
Pulselessness
Palpable, coolness
Paresthesias
Paresis – weakness
dx of PAD
ankle brachial index
Compare blood pressure in leg versus arm
Severe – 0.5 ratio.
s/sx PVD
dull, achy pain
Lower leg edema
Pulse and drainage present
Sores with a regular borders on ankles
Redskin
Yellow slough
chronic venous insufficiency
Occurs when venous wall and/or valves in leg veins are not working effectively
venous stasis
Blood pools or collects in veins
s/sx chronic venous insufficiency
Lower extremity edema
Achyness, tiredness
Leathery looking skin – dark, hard
Stasis ulcers on ankles
Flaky, itchy skin
New varicose veins
valve disease types
wear and tear
Calcification
pannus
Endocarditis – inflammation infection
Thrombus – clot
stenosis valve
Very hard, tight, stiff
Hard for blood to get through
regurgitation valve
Very loose, blood flows backward and increases pressures
aortic stenosis triad
Chest pain
SOB
Lightheaded
endocarditis
Vegetation of valves – infective mass
Septic emboli
Can cause pulmonary occlusion
risk factors for endocarditis
Prosthetic valve
Pacemaker
IV drug abuse
causative agents for endocarditis
Strep viridans
Staph aureus
Staph epidermidis
Contaminated needle, dirty skin
s/sx endocarditis
fever, chills
Anorexia, weight loss
Heart murmur
Myalgias, arthralgias
Ischemia in extremities, spleen, kidney, bowel, brain
septic emboli can cause stroke
Neuro sx– meningitis, seizures, and cephalopathy, abscess of brain
septic emboli
Infected blood clots
Travel to heart
adhere to damaged endothelial tissue
attract white blood cells and platelet’s
release cytokines and coags
patho of septic emboli
simulation of coags– fibrin deposition– develop vegetation
Vegetations found in valve, leaflets, cannibalize into circulation
Carried by bloodstream – infection/ischemia in tissue
s/sx septic emboli
Petechiae – non-blanchable
Splinter hemorrhage
Janeway lesions
olsers nodes
roth spots
Splinter hemorrhage
Linear streaks and nails
Janeway lesions
Red, swollen, nontender on palms and soles
olsers nodes
Subcutaneous nodules on fingertip pads
roth spots
Oval retinal hemorrhage with pale center
why are drug users involved with septic emboli?
Veins are portals of entry with drug use
duke criteria of infectious endocarditis
Two Major
One major, three minor
Five Minor.
Treatment for infectious endocarditis
antibiotics – blood culture to treat specific bacteria
4 to 10 weeks, lengthy hospital stay
PICC line used
