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Cardiopulmonary > Vascular Conditions > Flashcards

Vascular Conditions Flashcards

1
Q

Carotid Artery Disease

A
  • Atheroclerosis of the carotid arteries
  • Can cause a stroke
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2
Q

Do we still get blood supply to our brain if out carotid artery is blocked?

A

Yes, from the verterbral arteries in the circle of willis!

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3
Q

Risk Factors for Carotid Artery Disease

A
  • Diabetes (4x more likely to develop carotid disease)
  • Smoking
  • Physical Inactivity
  • High Lipids
  • Obesity
  • HTN
  • Age
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4
Q

If an individual has diabetes, what should we auscultate?

A

BOTH coronary and carotid for coronary cladification

If positive, hear bruits - whooshing sound

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5
Q

Clinical Manifestations of Carotid Artery Disease

A
  • Early Stages
    – Typically, no signs or symptoms until complications develop
  • Bruits
    – Not all patients with carotid artery disease displaybruits
    – Common site (within 2 cm of internal carotid)
  • Transient Ischemic Attack
    – May be the first sign of carotid artery disease
    — May have all the signs and symptoms of a stroke, but will go away in 24 hours
    — Weakness, changes in vision, unilateral facial droop, anddifficulty with speaking or walking
  • Stroke
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6
Q

Diagnostic Assessment - Carotid Artery Disease

A
  • Most common test is a Carotid Doppler evaluation which shows carotid blood flow
    – Indicated when bruits are heard
    – Duplex ultrasonography is emerging as a very accurate tool
    – Directly visualizes plaque, stenosis, and narrowing of arteries
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7
Q

Complications - Carotid Artery Disease

A
  • Increased risk for coronary artherosclerosis and MI
  • Placques can rupture (Increased risk of TIA and CVA)
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8
Q

What signs do you look for if you suspect someone is having a stroke?

A

Act FAST.
Face - Does it look uneven?
Arm - One arm hanging down?
Speech - Slurred?
Time - Call 911 NOW!

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9
Q

Deep Vein Thrombosis - Def

A

Development of a clot in a deep vein of the LE’s or pelvis

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10
Q

Pulmonary Embolism - Def

A

Blood clot that moved from a DVT to the pulmonary arteriole tree.

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11
Q

Rates of DVT increase sharply after ____

A

age 45

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12
Q

Risk Factors of DVT and PE

A
  • Anything that can cause Hypercoagulation, Venous stasis, Endothelial Injury
  • Inheriting blood-clotting disorder
  • Prolonged bed-rest (ex. Long hospital stay, paralysis)
  • Prolonged sitting positions, such as when driving or flying. (Hours)
  • Injury/surgery to veins in pelvis/LE’s
  • Pregnancy (increases pressure in the veins of pelvis and LE’s (pregnancy in combination with any other risk factors especially increases the risk)
  • Risk can continue for up to 6 weeks postpartum)
  • Oral contraceptives or hormone replacement therapy (increases clotting factors in blood)
  • Overweight or Obesity (increases pressure in veins of pelvis and LE’s)
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13
Q

PE - Clinical Manifestations

A
  • SUDDEN onset of dyspnea
  • Pleuritic chest pain
  • Cough; pleural rub sound
  • JVD; increased S2 sound at pulmonic valve
  • Tachycardia, Tachypnea (shallow)
  • Hemoptysis may occur

Unilateral, sudden onset of dyspnea and chest pain

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14
Q

DVT - Clinical Manifestations

A
  • Swelling
  • Redness and Warm in Leg
  • Pain with AROM
  • “Cramping”
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15
Q

DVT vs Cellulitis

A

Can’r necessarily know without a doppler BUT…
Cellulitis: Injury or trauma, redness and warmth
DVT: Occlusion of blood to an area of the deep veins typically seen in the legs

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16
Q

Homan’s Sign

A
  • Calf is squeezed while foot is DF with force; Positive test if they have increased pain
  • Not accurate; Use a doppler!
  • Looking for DVT
17
Q

PE - Diagnostic

A
  • Confirmed by pulmonary angiogram, CT, MRI, or surgery
  • Doppler ultrasonography
  • Can be as effective as 91% accurate when used together
18
Q

Complications - Blood Clot (DVT) travels to lung (PE)

A
  • If Cross Sectional Area (CSA) is decreased by more than 50%, pressure to maintain pulmonary blood flow increases, resulting in pulmonary hypertension = possible R ventricular failure
  • Death
19
Q

Peripheral Artery Disease

A
  • Also known as Artherosclerotic Occlusive Disease (AOD)
  • Common Circulatory Problem
  • Ischemia of extremities results in intermittent claudification
20
Q

Why are 50% of individuals with PAD asymptomatic?

A
  • Diabetic/Sensory Loss
  • Not working past the workload; Physically Inactive (oxygen demand is not met resulting in symptoms)
21
Q

PAD - Clinical Manifestations

A
  • Presents as painful cramping affecting primarily the lower extremities
  • Can progress from intermittent with activity into pain at rest
  • LE:
    – Numbness/Weakness
    – Decreased Temp
    – Sores will not heal
    – Change in color
    – Hair loss/slower hair growth
    – Slower growth of toenails
    – Weak pulse
22
Q

Diagnostic - PAD

A

ABI (primary):
- Positive (mild/moderate): 0.41-.90,Severe: <.40
- Exercise ABI: used for patients who experience claudication, yet have a normal ABI value

23
Q

Complications - PAD

A

Critical Limb Ischemia
- Full occlusion of several arteries in the extremities
- 5 P’s (Pain (extreme), Pallor, Paralysis, Parathesia and Pulselessness)
- Tissue Necrosis -> Limb loss

24
Q

Pulmonary Hypertension - Def

A
  • Affecting the arteries of lungs
  • R side of the heart
  • Can be a progressive, fatal condition
  • Can result in heart failure
25
Q

Pulmonary HTN risk increases with

A

age

26
Q

Pulmonary HTN - Pathogenesis

A
  • Arteries leading to lungs become hard and narrow
  • ↑PVR (pulmonary vascular resistance)
  • ↑workload for RV
  • Resulting in RV hypertrophy can lead to R heart dysfunctionand failure (Higher pressures on the R side of the heart can lead to tissue breakdown.
27
Q

Pulmonary HTN - RF

A
  • Having ONE or more of the following:
  • Obesity
  • Family history
  • Illegal drugs (cocaine)
  • Appetite suppressant medications (Fen-Phen); now off market
28
Q

Pulmonary HTN - Clinical Manifestations

A
  • Chest pain
  • Dyspnea during normal routine
29
Q

Pulmonary HTN - Diagnostic

A
  • Defined by mPAP and↑PVR
  • mPAP > 25 mmHg
30
Q

Pulmonary HTN - Complications

A

Right Sided Enlargement and Heart Failure (Cor Pulmonae)
– RV becomes enlarged, does more work
– Compensates by thickening walls & enlarging chambers
Blood Clots
– arteries of the lungs
Bleeding
– Into the lungs; cough up blood

Cardiopulmonary (21 decks)

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