Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Yr 3 Cardiovascular > Venous and arterial Ulcers > Flashcards

Venous and arterial Ulcers Flashcards

1
Q

What are the key steps to taking an ulcers history?

A

Asking about the symptoms experienced (onset, progression, and severity)
Identifying risk factors, such as immobility and a history of deep vein thrombosis
Examining the wound (site, edge, size, depth, wound bed, and look for signs of infection)
Examining both legs (for oedema, varicose veins, venous skin changes, peripheral neuropathy and reduced ankle mobility)
Assessing for other causes of ulceration and/or delayed wound healing
Measuring the ankle-brachial pressure index in both legs to exclude arterial insufficiency

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is an arterial ulcer?

A

Arterial ulcers, also known as ischemic or arterial insufficiency ulcers, stem from inadequate blood supply to the extremities.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is the main cause of an arterial ulcer?

A

Atherosclerosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Where do arterial tend tooccur?

A

Lower extremities near the end-arteries
1. Toes
2. Heels
3. lateral malleolus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What pain is experienced typically in an arterial ulcer.

A
  1. severe resting pain due to ischaemia
  2. Painful, especially at night
  3. Pain worse when elevated
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

How do arterial ulcers typically appear?

A
  1. Pale
  2. Dry
  3. Gangrenous
  4. Cool surrounding skin
  5. Sharply defined
  6. Have a deep punched out appearance
  7. Loss of hair on surrounding skin
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are the pulses like in the effected area of an arterial ulcer?

A

Diminished or absent pulses, especially in the affected limb, are a hallmark sign.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What 3 investigations are used to investigate arterial ulcers?

A
  1. Doppler Ultrasound
  2. ABPI (<0.8 = arterial insufficiency)
  3. Angiography
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what is the epidemiology of arterial ulcers?

A
  • ELDERLY
  • men
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

what is the aetiology of arterial ulcers?

A
  • atherosclerosis > peripheral arterial disease > inadequate blood supply to the distal extremities
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

what are the differentia diagnosis of arterial ulcers?

A

-diabetic ulcers

  • vasculitis ulcers
  • malignant ulcers
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

what is the management of arterial ulcers?

A
  • treat the underlying cause
  • improving arterial circulation via lifestyle changes eg smoking cessation, weight loss, supervised group exercise for collateral blood supply
  • medications = clopidogerol, atorvastatin , BP and DM control
  • angioplasty or bypass surgery when severe
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is contradicted is arterial ulcers are present?

A

Compression bandaging and anti-embolism stockings as this could further reduce distal blood flow

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What type of ulcer is likely to be found on the ankle and calf?

A

Venous

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What type of ulcer is likely to be found in areas of pressure?

A

diabetic ulcer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What type of ulcer is likely to be found on the lateral foot and lower leg?

A

Arterial

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Define ‘ulcer’:

A

excavation of the surface of an organ or tissue that is produced by sloughing of inflammatory necrotic tissue

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is the most common type of lower limb ulcer?

A

Venous

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Name 5 types of lower limb ulcer:

A

1) arterial
2) venous
3) pyoderma gangrenosum
4) neuropathic
5) pressure

20
Q

What is the most common cause of arterial ulcers?

A

peripheral vascular disease

21
Q

What is the main cause of venous ulcers?

A

venous hypertension - high pressures in the veins of the legs makes healing difficult after a minor injury

22
Q

Where are venous ulcers most commonly found?

A

medial malleolus (and lateral)

23
Q

Describe the appearance of venous ulcers:

A

superficial with ill-defined boarders and may produce exudate

24
Q

What is chronic venous insufficiency?

A

refers to functional changes that may occur in the lower extremities due to persistent elevation of venous pressures. This most commonly results from venous reflux due to faulty valve function developing as a long-term sequelae of deep vein thrombosis or varicose veins

25
Q

How does chronic venous insufficiency lead to venous ulcers?

A

esulting in increased venous pressure and impaired tissue oxygenation, triggering inflammation and tissue damage

26
Q

What is the pain like in a venous ulcer?

A
  1. Aching or heaviness in affected limb.
  2. Pain worsens with prolong standing
  3. Pain improves with leg elevation
27
Q

Name 5 findings that may be associated with venous ulcers:

A
  1. Varicose veins
  2. Lipodermatoaschlerosis
  3. venous flare
  4. Atrophie blanche
  5. varicose eczema
28
Q

What is lipodermatosclerosis?

A

hardening/ scarring of skin and fat

29
Q

What is venous flare?

A

spindly veins on the ankles and calf

30
Q

What 3 investigations are used in venous ulcers?

A
  1. Doppler ultrasound
  2. Venous duplex ultrasound
  3. Venous pressure measurement
31
Q

epidemiology of venous ulcers?

A
  • ELDERLY
  • middle-aged females
32
Q

what are the clinical features of venous ulcers?

A
  • gaiter area (medial)
  • large and shallow
  • sloping edges
  • bleed or ooze
  • associated with features of chronic venous insufficiency eg haemosiderin deposits, lipoderatosclerosis and firm oedema
33
Q

what are the differential diagnosis for venous ulcers?

A
  • diabetic ulcers
  • vasculitic ulcers
  • malignant ulcers
34
Q

what is the management of venous ulcers?

A
  • treating the underlying cause
  • compression stockings to reduce venous hypertension
  • promote wound healing
  • surgical intervention for severe cases
35
Q

What is pyoderma gangrenosum?

A

neutrophilic dermatitis associated with IBD that leads to small red bumps that turns into painful ulcers

36
Q

What are neuropathic ulcers?

A

an ulcer caused by peripheral neuropathy e.g. diabetic neuropathy or trauma

37
Q

Where are neuropathic ulcers typically found?

A

feet

38
Q

Give two potential treatments for venous ulcers:

A

1) compression therapy
2) pentoxifylline

39
Q

How do neuropathic ulcers usually present?

A

Variable size and depth. Surrounding skin may be warm, dry, and calloused.
Typically occur in numb skin

40
Q

What is the pain like in neuropathic ulcers?

A

These ulcers are often painless due to sensory neuropathy. Patients may not notice the ulcer until it becomes severe.

41
Q

What pulses can be felt in neuropathic ulcers?

A

Pulses are usually present and normal in neuropathic ulcers, although they can be absent if there is concomitant arterial insufficiency.

42
Q

What investigations are used for neuropathic ulcers?

A

Primarily clinical
X-ray may be used to rule out osteomyelitis

43
Q

What is the management of neuropathic ulcers?

A

Wound care is crucial to maintain a moist wound environment with appropriate dressings. Tissue viability nurses can support with dressing choice, and these patients may also be seen in a dedicated foot clinic.
Glycaemic control and optimisation of diabetes management should be reviewed in these patients to slow the progression of neuropathy

44
Q

Describe compression therapy as a treatment for venous ulcers:

A

2/3 bandages are layered with orthopaedic wadding plus wound contact dressing

45
Q

What type of drug is pentoxifylline?

A

Methylxanthine

46
Q

Describe how pentoxifylline can help treat venous ulcers:

A

it increases microvascular blood flow to enhance oxygenation of ischaemic tissue and aid healing

Yr 3 Cardiovascular (28 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions