Vascular Flashcards
What are the Local complications of AV fistula placement? (6)
1) Bleeding
2) Venous hypertension
3) Aneurysm/pseudoaneurysm/megafistula
4) Infection
5) Neuropathy
6) 1° failure and failure of mature AV fistula
Local problems of AV fistula placement
venous hypertension
Q: What are the 2 causes of extremity swelling?
1) Central vein stenosis
2) Venous valvular incompetence
Local problems of AV fistula placement
venous hypertension
Q: complications of venous hypertension?(3)
1) Skin discoloration
2) Access dysfunction
3) ischemic skin changes
Local problems of AV fistula placement
venous hypertension
Q: Risk factors for developing venous hypertension? (5)
- chronic ipsilateral tunneled catheter
- Previous port placement
- Pacemaker
- Defibrillator placement
- History of ❤️ transplant
Physical Examination
CEAP scoring is used for varicose veins
What does CEAP stand for? (4)
Describe the scoring attributes (7)
C0= N
C1= T
C2= V
C3= O
C4= a.= P
b.= L
C5= H
C6= A
C= Clinical manifestation
E= Etiology
A= Anatomic distribution
P= Pathophysiology
C0= No visible or palpable signs of venous disease
C1= Telangiectasia or reticular veins
C2= Varicose veins
C3= Oedema
C4= a= Pigmentation +/- eczema
b= Lipodermatosclerosis +/- atrophie
blanche
C5= Healed venous leg ulcer
C6= Active venous ulcer
Physical Examination
Inspection of upper limbs (based on lecture notes).
Palpation (3)
Inspection:
Skin color
Tar staining
Gangrene
Ulcer
Arteriovenous fistula
Temperature
Capillary refill time
Thrill or pulsation over AVF
Physical Examination
Pulses of the upper limb: (4)
The brachial pulse is located (medial/lateral) to the bicep tendon in the antecubital fossa.
Radial pulse (1 minute) palpate BOTH hands
Collapsing pulse
Radio-radial delay
Brachial pulse
Medial
Radio-radial delay causes (5)
- Subclavian artery stenosis (compression by cervical rib)
- Aortic dissection
- Coarctation of aorta
- Smokers
- Arteriosclerosis
Physical Examination
Inspection of the lower limbs.
Inspection:
1) scars
2) Missing limbs/toes
3) Trophic changes/nail changes (hair loss etc)
4) Muscle wasting
5) Gangrenous tissue
6) Ulcers
7) Pallor
8) Wiggle toes
9) Dilated veins
10) Discoloration
11) Swelling
Physical Examination
Palpation of the lower limbs (2)
- Temperature (distal to proximal)
- CRT
Physical Examination
Lower limb pulses:
Femoral pulse:
1) Best palpated where?
2) Location of the above point?
3) Radio-femoral delay suggests?
Popliteal pulse:
1) Location?
Posterior tibial pulse:
1) Location?
Dorsalis pedis pulse:
1) Location?
1) Mid-inguinal point
2) Located halfway between ASIS and pubic symphysis
3) Aortic coarctation
1) Inferior region of the popliteal fossa
1) Posterior to medial malleolus of tibia (1/3rd from medial malleolus to calcaneum)
1) Dorsum of foot lateral to extensor hallucis longus
Physical Examination
After Buerger’s test and putting the patient’s leg down quickly to look for hyperemia, you do sensation.
What is done in sensation? (
