Session 8- Peripheral venous and arterial disease Flashcards
In what direction does blood move in veins in the lower limb?
superficial to deep
how do the calf muscles act like a pump
soleus and gastrocemius muscles contribute to pushing blood against gravity back towards the heart
valves open-> blood pushed through to deep veins -> valves close to prevent retrogade movement
varicose veins
valves ineffective and blood movement is slow or even
reversed
saphenous are common site of pathology
walls of veins weaken- varicosities develop and valve cusps separate becoming incompetent
veins become tortuous and twisted
symptomatic presentation of peripheral venous disease
heaviness
aching
muscle cramps
throbbing
signs of peripheral venous disease
along the affected vein
- leg cramps
- ankle swelling
- variscose eczema
- haemorrhage
superficial vein thrombophlebitis
inflammatory processes resulting from a clot in vein
- painful erythematous
- follows varicose veins
- increase risk of deep vein thrombosis
lipodermatosclerosis
inflammation and thickening of fat layer under skin
haemosiderin staining
browny oedemy
RBC leak and macrophages injest them and release oxidative products which stain
what is chronic venous insufficiency
more advanced disease reflex and or obstruction -> venous hypertension can lead -lipodermatosclerosis -haemosiderin staining -venous ulceration
venous eczema and ulceration
chronic, itchy red and swollen
tight and can lead to lipodermatosclerosis
ulcer chronic painful, often develop around hard nodular areas like medial malleolus- as a result of venous hypertension
why does the calf muscle pump fail
when not in use- used in plantarflexion when walking
who is at risk of calf muscle pump failure
immobile
obese
injured
superficial vein incompetence
superficial to deep becomes deep to superficial
calf muscle pump overloads
how do you treat calf muscle pump failure
ligation and vein stripping
deep vein incompetence
retrograde flow- system overload
what causes arterial thrombosis
artheroma
what does a arterial thrombosis consist of
platelet rich
activated platelets aggregate and form a plaque
what does a venous thrombosis consist of
low flow and little platelet content- fibrin rich
what causes a venous thrombosis
stasis and usually another factor
- trauma
- medication
- dehydration
- chemotherapy
- inflammatory conditions
- pregnancy
what is DVT
deep vein thrombsosis
-clotting of blood in a deep vein- commonly calf - impaired venous return and hypercoagulablity
asymmetry, tenderness, warmth, distended, visible superficial veins
pyrexia
raised body temp
wells test
pre test probability forms part of diagnosis- all suspected DVT patients
what is the adaptive response to stenosis of a major vessel over a period of months or years
collateral circulation
acute limb ischaemia
occurs in minutes to days- no collateral circulation can develop in this time
