pvd

Question 1

PVD

Answer 1

umbrella term for several circulatory diseases
PAD = only arteries
CAD
cerebral artery disease

Question 2

PVD: patho

Answer 2

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

Question 3

PVD: rf

Answer 3

smoking, DM, high chol, heart disease, stroke, >50

Question 4

PVD: etiology

Answer 4

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

Question 5

PVD: cm

Answer 5

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

Question 6

intermittent claudication

Answer 6

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

Question 7

PAD: femoral artery

Answer 7

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

Question 8

PAD: 5 P’s

Answer 8

pain (IC)
pulselessness
palpable coolness
paresthesias
paresis (weakness of extremity)

Question 9

PVD: dx

Answer 9

ankle brachial index
compared BP in arm v leg
normal >1, ankle > brachial
severe PAD = 0.5

Question 10

PVD: arterial v venous

Answer 10

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

Question 11

PVD: chronic venous insufficiency

Answer 11

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

Question 12

PVD: non pharm tm

Answer 12

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

Question 13

PVD: pharm tm

Answer 13

antiplt (aspirin, clopidogrel)
anticoag (warfarin, apixaban)
thrombolytics
lipid lowering agents (statins)
antihtn
agents that increase blood supply to extremities