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Clinical Medicine - OT > Week 10 - Peripheral Vascular Disease and Amputations > Flashcards

Week 10 - Peripheral Vascular Disease and Amputations Flashcards

1
Q

What is peripheral arterial disease (PVD)?

A

A circulatory condition in which narrowed blood vessels reduce blood flow to the limbs.

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2
Q

What are risk factors of PVD?

A

Smoking, older age, diabetes, high cholesterol, high blood pressure, heart disease and stroke.

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3
Q

What is the major cause of death of people with PVD?

A

Coronary heart disease

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4
Q

What is PVD also known as?

A

Arteriosclerosis obliterans
Arterial insufficiency of the legs
Claudication
Intermittent claudication

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5
Q

What caused PVD?

A

Fatty deposits or plaques build up along the walls of the arteries carrying blood to the arms and legs

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6
Q

What are the symptoms of PVD?

A
  • Reduced hair growth
  • Cramps
  • Colour changes in skin
  • Sores on legs and feet that do not heal promptly
  • Burning or aching in the feet at rest
  • Intermittent claudication
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7
Q

What is intermittent claudication?

A

Intermittent pain affecting the calf, and less commonly the thigh and buttock, that is induced by exercise and relieved by rest.

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8
Q

What is claudication?

A

Pain, commonly in the legs, caused by too little blood flow, usually during exercise. Often indicates peripheral artery disease.

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9
Q

How is PVD diagnosed?

A 
Physical examination
Comparing ankle blood pressure with the BP of the arm (Ankle Brachial Index)
Angiography
Magnetic resonance angiography
CTA
Blood tests
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10
Q

How is PVD treated?

A 
Quit smoking
Exercise regularly
Eat healthy diet
Medications
Vascular surgery and angioplasty
Amputation
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11
Q

What are medications used for in PVD?

A

To reduce blood viscosity
Destroy platelets causing blockage
Lower Cholesterol

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12
Q

What is the prognosis of PAD?

A

If diagnosed early, most cases of PAD will respond to lifestyle treatments

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13
Q

What are the complications of PAD?

A 
Tissue death - amputation
Impotence
Pain
Reduced mobility
Wounds
Infections
Heart attack
Stroke
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14
Q

What are the 4 causes of upper limb amputation?

A

Trauma - 60%
Neoplasm (tumour) - 13%
Vascular - 6%
Infection - 5%

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15
Q

What are the 4 causes of lower limb amputation?

A

Vascular - 70-85%
Trauma - 22-24%
Neoplasm - 4-4.5%
Congenital - 26 per 100,000 infants

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16
Q

What is the highest cause of upper limb amputation?

A

Trauma

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17
Q

What is the highest cause of lower limb amputations?

A

Vascular

18
Q

What is a partial foot amputation?

A

Distal to ankle joint

19
Q

What is a transtarsal amputation?

A

Through the tarsus or foot bones

20
Q

What is an amputation at the ankle joint called?

A

Ankle disarticulation

21
Q

What is a Syme’s amputation?

A

Amputation at the ankle joint with the fatty heel pad retained for cushioning

22
Q

What is an amputation between the knee joint and ankle joint called?

A

Trans-tibial amputation

23
Q

What is a knee disarticulation?

A

An amputation at the knee joint

24
Q

What is a trans-femoral amputation?

A

An amputation between the knee and the hip

25
Q

What is an amputation at the hip leaving the pelvis intact called?

A

Hip disarticulation

26
Q

What is a trans-pelvic amputation?

A

Amputation of the lower limb together with all or part of hemipelvis

27
Q

What is a fingers or partial hand amputation?

A

Distal to the wrist joint

28
Q

What is wrist disarticulation?

A

Amputation at the wrist joint

29
Q

What is an amputation between the elbow and wrist joint called?

A

A trans-radial amputation

30
Q

What is an elbow disarticulation?

A

Amputation at the elbow

31
Q

What is a trans-humeral amputation?

A

Amputation between the elbow and shoulder joint

32
Q

What is an amputation at the shoulder joint called?

A

Shoulder disarticulation

33
Q

What is a forequarter amputation?

A

An amputation at the scapulo-thoracic & sternoclavicular joints

34
Q

What are the primary impairments of amputation?

A

Loss of part of a limb
Loss of part or all of support ambulation
Motor loss
Sensory loss - light touch, pressure and proprioception

35
Q

What are secondary impairments/co-morbidities of amputation?

A 
Contractures
Weakness
Deconditioning
Pain - surgical, scar, phantom, musculoskeletal
Other foot compromised by PVD
36
Q

What is preoperative care for amputation?

A

Psychological preparation
Increase strength and flexibility
Increase cardiovascular fitness
Management of pain

37
Q

What is immediate post-op care for amputation?

A

Care of wound

Residual limb care – bandaging to shape the residual limb for prosthesis

38
Q

What is mirror box?

A

Mirror therapy or mirror visual feedback is a therapy for pain or disability that affects one side of the patient more than the other side.

39
Q

How do you prepare amputations for prosthesis?

A

Residual limb care – Pressure sock 24 hours/day (‐shower time)

  • Care of scar area
  • massage and mobilise scar area, desensitisation

Strength, flexibility and fitness specific to prosthetic use

Interim prosthesis

  • Don & Doff socks & prosthesis
  • Standing in prosthesis, gait training, functional retraining
  • Adjustments/modification of prosthesis

Psychological support

40
Q

What are 2 types of lower limb prosthesis?

A

Above the knee and foot prosthesis

41
Q

What are 3 types of upper limb prosthesis?

A

Cosmetic/passive
Mechanical (cable controlled)
Myoelectric

Clinical Medicine - OT (35 decks)

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