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CardioPulmoaryPT1 > Vascular Pathology: Exam 1 > Flashcards

Vascular Pathology: Exam 1 Flashcards

1
Q

Types of vascular pathos

4

A
  1. arterial
  2. inflammatory
  3. venous
  4. vasomotor
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2
Q

Types of Vascular pathos

Arterial

A
  • Acute
    • arterial embolism
  • PAD/Chronic
    • ​arteriosclerosis/PAD
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3
Q

Types of vascular pathos

Inflammatory

A
  • Thromboangitis obliterans
    • Buerger’s dis.
  • vasculitis
  • Chilblains
    • Covid toes
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4
Q

Types of vascular pathos

Venous Disorders

A
  • Chronic venous insuff.
  • DVT
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5
Q

types of vascular pathos

Vasomotor disorders

A
  • Raynaud’s
  • CRPS
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6
Q

Inflammatory disorders

Buergers/Thromboangiitis obliterans

arterial ****

A
  • vasculitis affecting intima of periph blood vessels
  • Pathophys
    • ​inflamm in intima + sm thrombus/platelet accum.
  • Causes
    • ​heavy smoking
    • unknown, but heavy inflamm markers
      • homocysteine, SED, ESR
    • age >40
  • Dx
    • ​biopsy
    • Rubor of dependency
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7
Q

Buerger’s Dis.

Sequelae

A

necrosis

can lead to amputation

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8
Q

Buerger’s Dis

Symptoms/Tx

A
  • Symptoms
    • cool extremities
    • pain
    • ulcers of digits
    • intermitt claud
  • Tx
    • grade ex. to avoid claud
      • work below claud threshold
    • encourage to quit smoking
      • initial cause
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9
Q

Inflammatory disorders:

Vasculitis

A
  • inflamm blood vessels
  • acute OR chronic
  • Sx’s
    • sudden or dev over time of pain/throb
  • PT involve:
    • pain relief
    • prevent LOF
    • wound care
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10
Q

Venous Disorders:

Chronic venous stasis/insuff.

A
  • == inad. venous return over long pd of time
  • pathophys:
    • ​damaged valves w/in veins==decd venous return
      • chronic venous stasis (stuck)
  • Causes
    • ​DVT
    • idiopathic
    • trauma to pelvic floor
    • varicose veins (females)
    • neoplastic obstruct of pelvic veins—cancer
    • CHF
  • Dx
    • ​venous trendelenberg
      • if leg elevated is blood return better?
    • rule out lymphedema
    • ABI
      • rules OUT PAD
      • rules IN CVS
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11
Q

Venous Disorders:

CVS sequelae

A
  • chronic venous ulcers
  • inad. cellular O2
  • prone to infection
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12
Q

Venous disorders:

CVS Sx’s and Tx

A
  • Sx’s—> very comfortable w/ leg elevated
    • edema
    • pulses ALWAYS norm
    • pain in dep. pos
    • hemosiderin staining—- HgB stains
    • varicose veins
    • wet wounds–uneven borders
  • Tx
    • compression devices
      • ​MAKE SURE THEY HAVE NORMAL AA PERFUSION ****
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13
Q

Pitting Edema Scale

A
  • 1+: barely perceptible depression
    • ​2mm
  • 2+: easily ID’d depression
    • ​4mm
    • skin rebounds <15s
  • 3+: easily ID’d depression
    • ​6mm
    • skin rebounds 15-30s
  • 4+: easily ID’d depression
    • ​8mm
      • skin rebounds >30s
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14
Q

Venous disorders:

DVT

ACUTE!!!

A
  • S/S—> UNILATERAL
    • ​PAIN
    • ipsilat. edema— only DVT leg
    • palpable cords
    • redness
    • leg warmth
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15
Q

Venous disorders: DVT

risk factors

A
  • immobility
  • trauma/endothelial injury
  • lifestyle
  • hypercoagulation
  • other
    • family hx/genetics
    • diabetes
    • prior DVT
    • Beurger’s
    • idiopath
    • >60yo
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16
Q

PT and PREVENTION OF DVT

A
  • EARLY mobility—-aerobic act.
  • Compression therapy
    • TEDs
17
Q

Wells Score

Dx of DVT

A

2 pts or more== DVT likely

Fewer than 2 pts== DVT unlikely

18
Q

DVT

Dx Tests

A
  • Wells Criteria Prediction Rules
    • If >2 on Wells
      • ​D-dimer
        • ​(+) if elevated
          • >400-500
        • (-) if NORMAL
          • <400
      • Venous Duplex Dopplers
        • ​US veins

​

19
Q

PT implications:

UnDx’d high sus DVT

A
  • Our fear…
    • dislodge clot if move them
  • limtd research
  • facility protocol
  • Wells, D-dimer, Homan’s
  • obtain clearance from MD
20
Q

Med Mgmt DVT

Anticoagulants or “Blood thinners”

A
  • Heparin
  • Warfarin
  • Function:
    • ​inhibit synthesis of clotting factors
  • Contraindications:
    • ​actively bleeding and high fall risk
21
Q

IVC filter and DVT

A

used for higher risk bleeding or lg wound

22
Q

PT implications DVT:

Once Dx and med tx initiated

A
  • check lab vals to ensure pt therapeutic
  • TREAT BALANCE TO LOWER RISK OF FALLS***
  • Educate on protective measures to prevent falls
  • Ambulation helps DEC sx’s of DVT and risk of PE
  • wound care
    • ​careful!!!
    • clearance before debridement
23
Q

Labs: MD det’d Therapeutic Lvl

PT (prothrombin time) for warfarin (coumadin)

A
  • norm== 11-15s
  • anticoag. therapeutic lvl== 1.5-2.5x normal
    • 15-37s
    • if >38s
      • ​INCd risk hemorrhaging
    • if >88s
      • ​HIGH risk hemorrhaging
        • ​only do ADL/safety check
24
Q

Labs: MD det’d Therapeutic lvl

aPTT

activated partial thromboplastin time for Heparin

A
  • norm== 20-35
  • anticoag. therap. lvl== 2.25x normal
    • 60-110s
  • if >110s
    • ​INCd risk hemorrhaging
  • NO agreed aPTT apon lvl for high risk hemorrhaging
25
Q

Labs: MD det’d Therapeutic lvl

INR

International Ratio

A
  • for Warfarin (coumadin)
  • Normal== 1
  • anticoag. therapeutic lvl: 2-3.5
  • if >3.6
    • ​INCd risk hemorrhaging
  • if >5
    • ​HIGH risk hemorrhaging
26
Q

Labs: MD det’d Therapeutic lvls

Plt

platelets

A

Normal: 150,000-400,000/mm3

27
Q

EARLY ambulation in mgmt of PE, DVT, both

A

early amb associated w/

  • LOWER incidence of new PE
  • LESS progress of dx’d DVT
  • DECd mortality
28
Q

Phys act in pts w/ DVT

A
  • early walking exercise:
    • is safe w/ acute DVT
    • reduces acute sx’s AND chronic sx’s
    • help to prevent/improve postthrombotic syndrome
29
Q

LE DVT

once meds therapeutic lvls or accept. time pd been reached post admin……

A

Mobilization should begin!!!

  • although risks assoc’d w/ mobilization….
    • risk of INACTIVITY is greater!!!!
30
Q

Vasomotor disorders:

Raynaud’s Syndrome====

A

VASOSPASMS

  • Pathophys:
    • ​vasospasm of vessel’s in pts digits aggravated by cold temps——DEC vascular supply
  • Causes:
    • ​unknown
    • women
  • sequelae
    • ​remains static
  • Dx Tests
    • ​descript of sx’s
  • Sx’s
    • ​white/cyanotic digits in cold
    • Hyperemia when initially return to warm temps/recirculation
  • Tx
    • ​wear gloves
    • aquatic tx
      • warm pools
31
Q
A

CardioPulmoaryPT1 (12 decks)

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