Vascular disease 1&2 Flashcards
what is the most common classification for PAD
Rutherford. Stage 0-6. Asymptomatic>Degree of Claudication>Rest pain>Degree of tissue loss
risk of MI, stroke, death is shown by a high or low ABI?
Low
changes in skeletal muscle histology in PAD
decrease in muscle, increase in adipocytes and inflammatory cells. Denervation
What are the three biggest risk factors for vascular disease
smoking, diabetes, htn
what drug do we use for claudication
cilostazol
what are the four etiologies of mesenteric ischemia
embolic, thrombotic, nonocclusive, venous thrombosis
where does an embolism lodge and what tissue is affected
In SMA distal to middle colic artery. Still get flow to proximal jejunum and transverse colon
where do embolisms causing mesenteric ischemia originate
usually from heart
where do we see thrombi in mesenteric ischemia
at the origin of the SMA. Affects entire bowel
where does a venous thrombosis originate and what does it cause
superior mesenteric vein, inferior mesenteric vein, portal vein. Causes edema and hemorrage. Almost always in hypercoagulable patients
presentation of acute mesenteric ischemia
sudden things: pain, nausea, vomiting, diarrhea
presentation of chronic mesenteric ischemia
post prandial pain, weight loss, food fear
presentation of Nonocclusive and venous thrombosis
slower course. Usually hospitalized, critically ill patients
where does plaque tend to build up?
bifurcations, as in carotid artery, especially along the lateral wall
how does a carotid duplex evaluate stenosis
by the velocity of the blood
how can you tell the external from the internal carotid
the external has branches
In what layer does blood accumulate in aortic dissection
the media
what are the calssifications of Ao dissection. Who is more likely to have each class?
A-ascending:younger
B-descending:older (60-70)
Men, Blacks, connective tissue disorders
what happens to each of the vascular layers in Ao dissection
Medial degeneration
Intimal thickening-fibrosis,calcification,FA deposits
Adventitial fibrosis-obstruction of vasa vasorum
what are some sequela of a Type A dissection
Ao regurg, coronary vessel occlusion, tamponade
sequela of type b dissection
ischemia of intestine, kidneys, spinal cord, lower extremities
what is the mortality of Ao dissection
about 1% per hour
what is considered an aneurysm
a widening of at least 50%
what are the three central themes of AAA
inflammation
disruption of conn. tissue and loss of elastin
medial thinning
