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Med > PVD > Flashcards

PVD Flashcards

1
Q

Three layers in blood vessels:

A

Tunica intima
Tunica media
Tunica externa

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2
Q
  • forms a friction-reducing lining
  • Endothelium
A

Tunica intima

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3
Q
  • Smooth muscle and elastic tissue
  • Controlled by sympathetic nervous system
A

Tunica media

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4
Q
  • forms protective outermost covering
  • Mostly fibrous connective tissue
  • Supports and protects the vessel
A

Tunica externa

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5
Q

have a heavier, stronger, stretchier tunica media than to withstand changes in pressure

A

Arteries

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6
Q
  • have a thinner tunica media and operate under low pressure
  • also have valves to prevent backflow of blood
  • Lumen is larger
  • Skeletal muscle “milks” blood here toward the heart
A

Veins

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7
Q
  • Only one cell layer thick
  • Allow for exchanges between blood and tissue
A

Capillaries

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8
Q

Form networks that consist of:
- A vascular shunt
- True capillaries

A

capillary beds

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9
Q

Blood flow through a capillary bed is known as

A

microcirculation

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10
Q

A permanent localized
dilation of an artery,
which enlarges the artery
to at least 2 times its
normal diameter

A

ANEURYSM

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11
Q

diffuse dilation affecting the entire circumference of the artery

A

Fusiform

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12
Q

an outpouching affecting
only a distinct portion of the artery

A

Saccular

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13
Q

what specific anatomic sites
is aneurysm most common?

A

abdominal aorta.

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14
Q

Aneurysm forms when
the ____ of the artery is
weakened, producing a
stretching effect in the
inner layer (T. intima) and
outer layers (T. adventitia)
of the artery

A

middle layer (T.
media)

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15
Q

most common cause of all
aneurysm with hypertension & cigarette smoking
being contributing factors

A

Atherosclerosis

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16
Q

signs of rupturing AAA

A
  • hypotension
  • diaphoresis
  • mental obtundation,
  • oliguria
  • dysrhythmias
  • S/S of hypovolemic shock
    DIAGNOSTI
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17
Q

reveals “eggshell” appearance in cases of AAA

A

X-ray

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18
Q

Standard tool that determines the size and location or aneurysm

A

CT scan

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19
Q

Nonsurgical management of aneurysm:

A
  • frequent CT scanning
  • maintenance of BP
  • treated with
    anti-hypertensive agent
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20
Q

surgical management of aneurysm:

A

Abdominal Aortic Aneurysm
Resection

Goal: to secure a
stable aortic integrity & tissue
perfusion throughout the
body

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21
Q

excision of aneurysm from the abdominal aorta to prevent or repair the rupture

A

Abdominal Aortic Aneurysm
Resection

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22
Q

Disorders that alter the natural flow of blood
through the arteries & veins of the peripheral
circulation

A

PERIPHERAL VASCULAR DISEASE

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23
Q

most frequently affected are the lower
extremities

A

PERIPHERAL VASCULAR DISEASE

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24
Q

AORTIC BRANCHES:

A
  • Ascending Aorta
  • Aortic Arch
  • Thoracic Arch
  • Abdominal Aorta
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25
Q

noninvasive technique that provides accurate diagnosis, as well as information about the size & location of AAA

A

Ultrasonography

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26
Q

Pain: Intermittent claudication

A

Arterial insufficiency

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27
Q

Pain: aching, cramping

A

Venous insufficiency

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28
Q

Pulse: diminished or absent

A

Arterial insufficiency

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29
Q

Pulse: present, assessment may be difficult due to edema

A

Venous insufficiency

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30
Q

Skin: dependent rubor

A

Arterial insufficiency

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31
Q

Skin: increased pigmentation in the gaiter area

A

Venous insufficiency

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32
Q

Location: tip of toes, heels (pressure areas)

A

Arterial insufficiency

33
Q

Location: medial malleolus, lateral malleolus, anterior tibial areas

A

Venous insufficiency

34
Q

Depth: deep, may affect the joint

A

Arterial insufficiency

35
Q

depth: superficial

A

Venous insufficiency

36
Q

Shape: circular

A

Arterial insufficiency

37
Q

Shape irregular

A

Venous insufficiency

38
Q

Ulcer base: pale to black, dry gangrene

A

Arterial insufficiency

39
Q

Ulcer base: granulation tissue

A

Venous insufficiency

40
Q

Leg edema: minimal

A

Arterial insufficiency

41
Q

Leg edema: moderate to severe

A

Venous insufficiency

42
Q

Thickening or hardening of
the arterial wall

A

Arteriosclerosis

43
Q

A type of arteriosclerosis that involves
the formation of plaque within the arterial wall

A

Atherosclerosis

44
Q

involves the distal end of the aorta & the common, internal, external iliac arteries (located above the inguinal ligament)

A

INFLOW OBSTRUCTION

45
Q

involves femoral, popliteal & tibial arteries (below the superficial femoral artery)

A

OUTFLOW OBSTRUCTION

46
Q
  • Most common cause
  • Risk factor includes hypertension, hyperlipedimia, DM, CIGARETTE SMOKING, obesity & familial predisposition
A

ATHEROSCLEROSIS

47
Q

discomfort in the lower back, buttocks or thighs

A

Inflow disease

48
Q

burning or cramping in the calves, ankles, feet & toes

A

Outflow disease

49
Q
  • Intermittent claudication
  • Rest Pain
  • Loss of hair on the lower calf, ankle & foot;
  • dry, scaly, dusky, pale or mottled skin
  • thickened toenails
  • Cold extremity & cyanotic
  • pallor occurs when
    the extremity is elevated
  • Diminished or absent distant peripheral pulses
A

PERIPHERAL ARTERIAL DISEASE

50
Q

PERIPHERAL ARTERIAL DISEASE DIAGNOSTIC ASSESSMENT:

A
  • Arteriography
  • Segmental Systolic BP measurements
  • Ankle-Brachial Index (<0.9)
  • Exercise Tolerance Testing
51
Q

medications to PERIPHERAL ARTERIAL DISEASE:

A

Pentoxifylline (Trental)
Aspirin

52
Q

PERIPHERAL ARTERIAL DISEASE SURGICAL INTERVENTIONS:

A
  • Percutaneous Transluminal Angioplasty (PTA)
  • Laser-Assisted Angioplasty
  • Bypass procedures
53
Q
  • Reserved for clients with smaller occlusions in the distal superficial femoral, proximal popliteal & common iliac arteries
  • Heat from the laser vaporizes the arteriosclerotic plaque to open the occluded or stenosed artery
A

Laser-Assisted Angioplasty

54
Q
  • grafts preferred are saphenous vein, cephalic or basilic arm veins, synthetic materials such as polytetrafluoroethylene, GoreTex & Dacron
A

Bypass procedures;

55
Q

recurring inflammation of the intermediate and small arteries and veins of the lower and upper extremities

A

BUERGER’S DISEASE
(THROMBOANGIITIS
OBLITERANS)

56
Q
  • Pain
  • Instep claudication
  • Aggravated by emotional
    disturbances, nicotine or chilling
  • Sensitivity to cold
  • Dependent rubor
  • Absent or diminished radial or ulnar pulses
  • Digital ulceration and gangrene
A

BUERGER’S DISEASE

57
Q

NURSING INTERVENTIONS IN BUERGER’S DISEASE:

A
  • Complete abstinence from tobacco
  • Avoid to extreme cold
58
Q

Caused by vasospasm of the arterioles and arteries of the upper & lower extremities

A

RAYNAUD’S DISEASE

59
Q
  • blanching of the extremities occurs followed by cyanosis
  • Numbness, coldness, pain. swelling
  • ulcers may also be present
A

RAYNAUD’S PHENOMENON

60
Q

management in raynauld’s disease:

A

● Calcium Channel Blockers – potent vasodilator
● Nifedipine – first choice
● Sympathectomy

61
Q

first choice medication for raynaulds disease

A

Nifedipine

62
Q
  • Calf or groin
    tenderness & pain
  • unilateral swelling
    of the leg
  • Localized edema in
    one extremity may
    suggest
    thrombophlebitis
A

DEEP VEIN THROMBOSIS

63
Q

DO NOT MASSAGE THE AFFECTED
EXTREMITY!!!

A

DEEP VEIN THROMBOSIS

64
Q

management for DEEP VEIN THROMBOSIS:

A

Rest – supportive therapy; bed rest & elevation of
the extremity

65
Q

Drug therapy for deep vein thrombosis:

A

anticoagulant

66
Q
  • prevent formation of other clots & prevent enlargement of the existing clot.
  • discontinued if there is severe
  • heparin-induced thrombocytopenia & thrombosis (due to platelet aggregation)
  • SE: Bleeding
A

UNFRACTIONATED HEPARIN Therapy

67
Q
  • Works in the liver to inhibit synthesis of the four vitamin K-dependent clotting factors
  • Takes 3-4 days before it can exert therapeutic anticoagulation
A

WARFARIN Therapy

68
Q
  • recombinant tissue plasminogen activator, Alteplase, Reteplase
  • effective in dissolving clots or preventing new clots
  • serious complication: intracerebral bleeding
A

THROMBOLYTIC Therapy

69
Q

Antidote for heparin

A

Protamine sulfate

70
Q

Dilated tortuous veins

A

VARICOSE VEINS

71
Q

COMMON AFFECTED SITES in varicose veins:

A

saphenous leg veins (lack support from
surrounding muscles)
● also occurs in
- Rectum : Hemorrhoids
- Esophagus : Esophageal varices

72
Q

ASSESSMENT OF VARICOSE VEINS:

A
  • Legs feel heavy & tired
  • Leg veins look distended & tortuous seen under the skin as dark blue or purple,
    snakelike elevations
  • Feet, ankles, legs may appear swollen
73
Q

VARICOSE VEINS STAGES:

A
  1. Reticular or spider veins
  2. Varicose veins or venous nodes
  3. Edema of the lower legs
  4. Varicose eczema or trophic ulcer
74
Q

MILD VARICOSE VEINS
MANAGEMENT:

A
  • exercise (walking, swimming)
  • losing weight
  • wearing elastic support stockings
  • avoidance of prolonged sitting & standing
75
Q

SEVERE VARICOSE VEINS
MANAGEMENT:

A
  • Vein ligation
  • Vein stripping
  • Sclerotherapy
76
Q

veins are tied off above & below the area of incompetent valves,
but the dysfunctional vein remains

A

Vein ligation

77
Q

ligated veins are severed & removed

A

Vein stripping

78
Q

Injection of chemical in the varicose veins to scar and close it

A

Sclerotherapy

Med (40 decks)

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