PVD/ PAD Flashcards

1
Q

Alterations in Cardiovascular System

A

Impaired arterial circulation:
- Beurger’s Disease, Raynaud’s Disease, Aneurysm’s, Embolus, Thrombus
Impaired venous circulation:
- Varicose veins, Venous ulcer’s/ Cvi, Thrombus, DVT

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2
Q

PAD - Peripheral Artery Disease

PVD - Peripheral Vascular Disease

A

Arterial Disease

  • Hypertension
  • Arterial thrombus/ embolism
  • Beuger’s Disease
  • Raynaud’s Syndrome
  • Aortic aneurysms
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3
Q

PVD

A

Refers to any abnormality in the arteries or veins outside the heart
Common sites of atheromas in peripheral circulation are abdominal aorta and femoral and iliac arteries

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4
Q

PVD

A

Partial occlusion may impair both muscle activity and sensory function in legs
Total occlusion may result from thrombus obstructing lumen
- breaking off (embolus) obstructing smaller vessels

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5
Q

PVD

A

Loss of blood supply leads to:

  • Necrosis
  • Ulcers
  • Gangrene - bacterial infection of necrotic tissue
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6
Q

PVD: S&S

A

Inc. fatigue and weakness in legs
Intermitten claudication or leg pain d/t muscle ischemia - pain subsides with rest
Sensory impairment - paresthesias; burning, tingling, numbness

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7
Q

PVD: S&S

A

Peripheral pulses - popliteal and pedal weak or absent
Skin changes on feet and legs - marked pallor or cyanosis when elevated and rubor or redness when down
- Skin dry and hairless, toenails thick and hard, feet or lower legs cold

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8
Q

PVD: Diagnostic Tests

A

Doppler studies - ultrasonography
Arteriography
Plethysmography - measures size of limbs and blood volume in organs and tissues

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9
Q

Beurger’s Disease (Thromboangitis Obliterans)

A
Inflammatory condition of med-small peripheral arteries - vascular occlusion. Formation of thrombi filled with inflammatory and immune cells, permanent occlusion and obliteration
Legs and arms
Genetic factors
Usually young men before age 35
Cigarette smoking plays a profound role
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10
Q

Beurger’s Disease: S&S

A
Severe pain, even at rest
Sluggish blood flow
Rubor caused by dilated capillaries and cyanosis
Thin shinny skin
Thickened nails, malformed
Ulceration
Gangrene
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11
Q

Raynaud’s Syndrome

A

Common in young woman
Considered idiopathic (without cause)
Vasospastic condition
- Temporary vasoconstriction - arterioles (small arteries), fingers and toes, usually bilateral
Ethology - unknown, associated with systemic sclerosis, scleroderma, vascularitis, malignancy, chemotherapy, cocaine use, etc.
Exposure to cold and long term vibration

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12
Q

Raynaud’s Syndrome: S&S

A

Temporary ischemia - pallor, numbness, cyanosis - followed by vasodilation, redness and throbbing pain
Triggered by exposure to cold, stress or smoking
- Protect hands from cold
Blue-white-red disease - vasospasm causes fingers to turn blue, then white as blood flow severely limited, red when warm and spasm resolved

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13
Q

Raynaud’s Syndrome: Diagnostic Tests

A

Clinical symptoms for 2 years
Antinuclear antibody titre- autoimmune disorders
Doppler ultrasonography - reduced blood flow
Arteriography - rule out arterial occlusive disease

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14
Q

Aortic Aneurysms

A

A localized dilation of arterial walls
Most common - abdominal or thoracic aorta.. aorta very susceptible due to constant stress
- Different shapes: fusiform or dissecting
- Develops from defect in medial layer
- May eventually rupture causing massive hemorrhage

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15
Q

Aortic Aneurysms: Etiology

A

Dilation or outpouching or a vessel wall or cardiac chamber - involve the layers of the wall - a weakening of a vessel wall

  • Atherosclerosis
  • Trauma (esp. car accidents)
  • Syphillis and other infections
  • Congenital defects
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16
Q

Aortic Aneurysms: S&S

A

Frequently asymptomatic for long periods of time
Thoracic - dysphagia and dyspnea
Abdominal - sometimes detected as palpable, pulsating masses with bruits
Rupture - sometimes moderate - more often - severe bleeding and death
Signs of rupture - severe and indications of shock
Dissection - severe pain, loss of pulses, organ dysfunction

17
Q

Aortic Aneurysms - Diagnostic Tests

A

Radiography - abd. x-ray
Ultrasound - abd.
CT scan

18
Q

Diseases of the Arteries and Veins: Thrombus Formation

A

Blood clot that remains attached to the vessel wall
Risk factors include intimal injury/ inflammation, obstruction of flow, pooling (stasis)
Thromboembolus
Thrombophlebitis
Arterial thrombi
Venous thrombi

19
Q

Diseases of the Arteries and Veins: Embolism

A

Bolus of matter that is circulating in the blood stream

  • Dislodged thrombus
  • Air bubble
  • Amniotic fluid
  • Aggregate of fat
  • Bacteria
  • Cancer cells
  • Foreign substance
20
Q

Diseases of the veins: Varicose Veins

A
A vein in which blood has pooled
Distended, tortuous, and palpable veins
Caused by trauma or gradual venous distention
Risk factors:
- Age
- Female gender
- Family Hx
- Obesity
- Pregnancy
- DVT
- Prior leg injury
21
Q

Diseases of the Veins: Chronic Venous Insufficiency

A

Inadequate venous return over a long period d/t varicose veins or valvular incompetence
Venous stasis ulcers

22
Q

Diseases of the Veins: DVT

A

Obstruction of venous flow leading to increased venous pressure
Factors:
- Triad of Virchow
- - Venous stasis
- - Venous endothelial damage
- - Hypercoagulable states
- Other (cancer, orthopaedic surgery/ trauma, heart failure, immobility)