Systemic Conditions Flashcards
- Peripheral Artery Disease (PAD) = ?
- Symptoms = ?
- PAD is a narrowing of peripheral arteries, leading to reduced blood flow, commonly affecting lower extremities.
- Symptoms: Pain in buttocks, hips, thighs, calves, and feet due to obstruction of different arteries.
What are the common signs of PAD?
Intermittent claudication, hair loss, shiny skin, diminished pulses, and cool skin.
What is the Claudication Pain Grading Scale?
It categorizes pain from minimal discomfort
- 1 = Initial discomfort or pain, but only minimal levels
- 2 = Moderate discomfort or pain from which the patient’s attention can be diverted
- 3 = Intense pain from which the patient’s attention cannot be diverted
- 4 = Excruciating and unbearable pain
What is intermittent claudication?
It is pain caused by inadequate blood flow during exercise, relieved by rest.
How does exercise benefit patients with PAD?
Exercise improves symptoms by increasing capillary density and promoting angiogenesis.
What is Chronic Venous Insufficiency (CVI)?
CVI is a condition where veins fail to adequately return blood to the heart, leading to swelling and skin changes.
What are the symptoms of CVI?
Swelling, pain in dependent positions, and skin discoloration (hemosiderin staining).
What is the treatment approach for CVI?
- exercise
- compression therapy
- elevation of limbs
What are the differences between arterial and venous wounds?
- Arterial wounds are dry with punched-out appearance
- Venous wounds are wet with irregular borders
What is the purpose of the ABI (Ankle-Brachial Index) test?
- It measures blood pressure differences between the arms and legs to diagnose PAD.
- If an ABI (SBP of ankle/SBP of arm) is 0.90 or less, it is considered abnormal.
What are Wells Criteria used for?
To assess the probability of DVT in patients with symptoms like swelling and pain.
What are the signs and symptoms of a PE and DVT?
- PE: Shortness of breath, anxiety, pleuritic chest pain, and tachycardia.
- DVT: Pain, ipsilateral swelling, palpable cord, warmth, redness
What is the importance of compression therapy in venous disease?
To prevent venous stasis and promote blood flow.
What is the treatment approach for DVT?
- early mobilization
- compression therapy
- anticoagulation medications.
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How does rubor of dependency help in assessing arterial insufficiency?
- It measures the color change in a foot to indicate arterial insufficiency.
- Rubor of Dependency: Observe color of both feet in supine (or in sitting).
- In supine, elevate one leg for 60 sec. Observe foot color: light pink is normal; chalky white or painful means arterial insufficiency.
- Then lower to dependent position and time the color return compared to the color of the non-elevated foot.
- Observe foot color: Light pink is normal; chalky white or painful means arterial insufficiency.
- Then lower to dependent position and time the color return compared to the color of the non-elevated foot.
- Normal = pink in < 15 sec.
- Abnormal > 20-30 sec + bright red (histamine response) =Arterial compromise
What is the typical patient presentation with PAD pain?
Pain increases with walking and decreases with rest; worsens with elevation.
What is venous stasis ulcer and what are its characteristics?
A venous ulcer caused by poor venous return, characterized by wet, red, and irregular borders.
What are the pharmacological treatments for DVT and VTE?
Anticoagulants like Heparin, Lovenox, and Warfarin are common treatments.
What precautions should be taken when mobilizing a patient on anticoagulants?
Monitor INR levels; avoid mobilization if INR < 2 or > 5.
- INR
- < 2 than no mobility
- 2-5 = mobility
- > 5 you should check with the physician.
What are the secondary effects of systemic cardiovascular diseases on renal systems?
They may lead to renal insufficiency and failure due to poor circulation.
How does aerobic and anaerobic training benefit PAD patients?
Improved blood flow, oxygen consumption, and pain tolerance.
What is an aortic aneurysm?
A permanent dilation of the aortic wall, increasing the risk of rupture.
What are the implications for PT when treating patients with aortic aneurysms?
Monitor blood pressure and avoid Valsalva maneuvers; promote regular moderate exercise.
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What is the role of physical therapy in treating PAD?
- improving circulation
- improving walking endurance
- reducing claudication
What is a transient ischemic attack (TIA)?
A temporary blockage of blood flow to the brain that resolves within 24 hours.
How does diabetes impact cardiovascular health?
Diabetes accelerates atherosclerosis, increasing the risk for CAD and stroke.
What are the PT implications for patients with carotid or vertebral disease?
Monitor vital signs closely, especially blood pressure, during activities.
What is the significance of elevated ABI in PAD diagnosis?
An ABI <0.9 indicates PAD, with lower blood pressure in legs than arms.
How does venous insufficiency typically present in lower extremities?
- swelling
- pain relief with elevation
- hemosiderin staining
What are the risk factors for chronic venous insufficiency (CVI)?
Age, female gender, history of DVT, and prolonged standing.
What is the role of exercise in managing venous insufficiency?
Exercise helps pump blood back to the heart, reducing venous stasis.
What is the relationship between DVT and pulmonary embolism (PE)?
A DVT can dislodge and cause a PE, blocking pulmonary arteries.
How does atherosclerosis contribute to systemic conditions like PAD and CAD?
Atherosclerosis narrows arteries, reducing blood flow and increasing the risk of ischemia.
What are the characteristics of venous wounds?
Wet, irregular, and beefy red in appearance, often found on the lower leg.
What is the purpose of the Wells Prediction Model for VTE?
To predict the risk of lower extremity DVT based on symptoms and risk factors.
How is claudication pain assessed during treadmill testing?
Claudication is assessed by noting the distance walked before pain begins and intensifies.
What are the main treatment goals for patients with PAD?
Reducing pain, improving walking ability, and enhancing overall circulation.
What role does physical therapy play in managing DVT?
Mobilization reduces the risk of clot formation and improves circulation.
What is the clinical presentation of arterial wounds?
Dry, punched-out appearance, often on the toes or lateral leg.
What are the main risk factors for venous thromboembolism (VTE)?
History of immobility, surgery, trauma, and cancer.
How do peripheral pulses indicate PAD or DVT?
Weak or absent peripheral pulses indicate PAD, while bounding pulses suggest DVT.
What are the primary interventions for preventing chronic complications in venous disease?
Compression therapy, exercise, and patient education on prevention.
What are the implications of PAD pain increasing with elevation?
PAD pain worsens with elevation as blood struggles to reach the extremities.
How does angiogenesis improve with exercise in PAD patients?
Exercise induces angiogenesis, increasing capillary density and oxygen supply.
