pvd Flashcards
PVD
umbrella term for several circulatory diseases
PAD = only arteries
CAD
cerebral artery disease
PVD: patho
r/t atherosclerosis processes in extremities
vessels become thick and harden, fill with lipid laden macrophages w/n aterial or venous walls and form plaques -> ischemia bc decreased perfusion -> pain, mobility loss
PVD: rf
smoking, DM, high chol, heart disease, stroke, >50
PVD: etiology
atherosclerosis - most common
thrombus
inflam -> thromboangitis obliterans (bergers - autoimmune) which is an inflam condition of arteries
vasospasm -> raynaud’s (temp sensitivity, vasoconstrict in peripheral arteries) or autoimmune
PVD: cm
d/t local tissue ischemia and appear in extremities
pain -> calf, butt, numb/burn, heavy, intermittent claudication
wounds wont heal
decreased sensation in extremities -> nerves have decreased perfusion
trophic skin changes -> shiny, thick toenails, loss of leg hair, decreased pulses, elevation pallor, cyanosis, reactive hyperemia (dependent rubor - legs get red when they hang), ED
intermittent claudication
consistent pain precipitated by consistent level of exercise, cramping
cease with rest, caused by ischemic tissue
pain depends on site of plaque buildup and collateral circulation
cramping pain of LE or butt caused by arterial flow obstruction
pt describes walking a certain distance when pain starts
angina of LE
PAD: femoral artery
most common site
atherosclerosis
decreased circ: pain (intermittent claudication), decreased pusle, coolness of leg, pallor of leg, loss of sensation in foot
ischemia of muscle in lower leg, cellular hypoxia
PAD: 5 P’s
pain (IC)
pulselessness
palpable coolness
paresthesias
paresis (weakness of extremity)
PVD: dx
ankle brachial index
compared BP in arm v leg
normal >1, ankle > brachial
severe PAD = 0.5
PVD: arterial v venous
arterial: IC pain, no edema, no pulse/weak, no drainage, round smooth sores, black eschar, sores on toes and feet
venous: dull achy pain, lower leg edema, pulse present, drainage, sores with irregular boarders, yellow slough or ruddy skin, sores on ankles
PVD: chronic venous insufficiency
condition when venous wall and/or valves in leg veins arent working effectively
blood pools/collects -> venous stasis
chronic
cm: LE edema, achiness or tiredness in legs, leathery looking skin, stasis ulcers, flake or itching skin, new varicose veins
PVD: non pharm tm
decrease rf: dont smoke, increase physical activity to build collateral circulation and decrease atherosclerosis, lose weight, decrease stress to decrease inflam, control MD and htn
treat occlusion: bypasses, balloon stent, stent
PVD: pharm tm
antiplt (aspirin, clopidogrel)
anticoag (warfarin, apixaban)
thrombolytics
lipid lowering agents (statins)
antihtn
agents that increase blood supply to extremities
