PERIPHERAL VASCULAR DISORDERS Flashcards by michaela gail

Major function of the blood vessels is to supply the tissue with blood, remove wastes, & carry unoxygenated blood back to the heart.

Made up of different blood vessels

vascular system

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function of the vascular system

Circulatory needs of the tissues
Blood flow or movement
Blood pressure regulation
Capillary filtration and reabsorption
Hemodynamic resistance
Peripheral vascular regulating mechanism

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blood clot formation (within); atherosclerosis

Thrombus

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blood clot dislodgement; trauma

Embolism:

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: sudden vasoconstriction; stress, cold, medications

Vasospasm

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: inc. levels of cholesterol & triglyceride w/inflammation resulting to atheroma formation

Atheroma

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: vasoconstriction d/t external pressure; tumors or trauma

Compression

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: inflammation of the vessel walls, which leads to narrowing, weakening, scarring; autoimmune, infections, medications

Vasculitis

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diverted blood flow d/t abnormal blood vessel connections; AVMs or vascular surgeries

Steal syndrome:

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: inc. blood thickness; polycythemia or inc. levels of plasma proteins

Hyperviscosity

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Refers to conditions affecting blood vessels outside of the heart and brain.

Also known as peripheral arterial occlusive disease.

It includes arteries, veins, and the lymphatic system.

Peripheral Vascular Disease

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arterial vs venous

skin

cold, dry, pallor
warm, pigmented

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arterial vs venous

pain

sharp, stabbing, lower feet!
aching, cramping, elevate feet!

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arterial vs venous

ulcers

severely painful, dorsum of foot
moderately painful, medial of ankle

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arterial vs venous

pulse

absent, diminished
present

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arterial vs venous

edema

minimal
moderate to severe

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Caused by a thrombus (clot formation) that obstruct venous flow going back from the heart from the limbs.

Acute Venous Disease

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formation of thrombus which causes inflammation of the vein may occur in either superficial or deep veins.

Thrombophlebitis

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Easily diagnosed; iatrogenic; resulting from IV caustic infusions.

Components are thrombosis and phlebitis

Usually not an emergency; symptoms often resolves in 1-2 weeks.

Superficial Thrombophlebitis

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hallmark s/sx of Superficial Thrombophlebitis

rubor
calor
dolor
hard core like feeling under skin

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A serious medical condition where blood clot forms in one or more of the DVs in the body (arms, pelvis, and lower extremities).

Occurs in bifurcation of the DVs, common among women & major surgeries (pelvic & lower extremities)

Deep Vein Thrombosis

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Deep Vein Thrombosis
hallmark s/sx:

(Virchow’s Triad)
Endothelial Injury
Venous stasis
Hypercoagulability

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Hallmark sign of deep vein thrombosis

homan’s sign

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medical mgmt for acute venous disease

anticoagulants
thrombolytics

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surgical mgmt for acute venous disease

thrombectomy

diagnostics for acute venous disease

venography angiography doppler utz

Refers to the long-term, progressive nature of venous dysfunction. Venous reflux occur d/t damage, weak, or dysfunction valves of the blood vessels pooling blood in the lower extremities. Most common form is varicose veins.

Chronic Venous Disease

true or false - Recurrent DVTs can lead to CVDs.

true

An abnormal dilation of the veins of the lower extremities due to incompetent valves leading to increased venous pooling and venostasis.

Varicose Veins

Varicose Veins hallmark s/sx

Dull aches Muscle cramps Increased fatigue in the lower extremities Ankle edema Feeling of heaviness in the lower extremities

Used to determine the site of valvular incompetence or insufficiency.

(Trendelenburg’s Test)

surgical mgmt for Chronic Venous Disease

Vein stripping & ligation Thermal ablation Sclerotherapy

Occlusion of arteries in the lower extremities Acute or chronic Severe cases presence of ischemic pain relieved by hanging/dangling the affected extremity on a bed or chair

Peripheral Arterial Disease

Objective indicator of arterial disease that allows the examiner to quantify the degree of stenosis of the vessels. With increasing degrees of arterial narrowing, a progressive decrease in systolic pressure distal to the involved sites is noted.

Ankle-Arm/Brachial Index

AA/BI ratio > 1.0 0.95 to 0.50 0.50 to 0.25 0.25 or less

no arterial insufficiency mild to moderate insufficiency pts with ischemic rest pain pts with severe ischemia or tissue loss

This is a controlled exercise test performed on a treadmill to assess claudication. Often, AA/BI are measured before and immediate after the test. In PAD patients, AA/BI will typically drop significantly after exercise d/t the inability of the narrowed arteries to increase blood flow adequately.

Treadmill Test for Intermittent Claudication

a non-invasive imaging test that uses sound waves to create images of arteries and measure the speed and direction of blood flow

Arterial Duplex Ultrasonography

pharmacologic mgmt Peripheral Arterial Disease

Pentoxifylline (Trental) Cilostazol (Pletaal)

Reduction of blood viscosity and increase RBC flexibility. Pain relief, wound healing, and ulcer management.

Pentoxifylline (Trental)

Promotes vasodilation and inhibits platelet aggregation (decreased blood clot) Contraindication: Heart Failures

Cilostazol (Pletaal)

surgical mgmt Peripheral Arterial Disease

Vascular Grafting Endarterectomy

Also known as Raynaud’s phenomenon/syndrome. Characterized by episodes of vasospasm d/t vasospastic or obstructive nature, which temporarily cease blood flow to the fingers or toes. Triggered cold temperatures or stress.

Raynaud’s Disease

type of RD; most common form. Begins at 30 and is more common in women.

primary

type of RD: less common but more serious. Develops as a symptom of an underlying condition, medication use, or exposures. Typically manifest later in life (40 years old and above)

secondary

reynaud's s/sx;

Numbness Tingling and burning pain as palmar color changes Hallmark signs: Pallor, Cyanosis, and Rubor

reynaud's medical mgmt

Calcium Channel Blockers - nifedipine (relaxes small BV) vasodilators - viagra, prozac

Also known as Thromboangiitis Obliterans (TAO) Characterized by inflammation and thrombosis that leads to obliteration of the blood vessels. BD are exclusively associated with smoking, chewing tobacco, and vaping. Most common in men at around 45 years old, heavy smoker. Idiopathic. However, believed to be an autoimmune vasculitis d/t occlusion of the distal vessels.

Buerger’s Disease

pain in buergers

Claudication Rest Pain Neuropathic Pain

skin changes in buerger

Pallor Paresthesia Non-healing ulcers Gangrene

medications buergers

Analgesics Vasodilators Anticoagulants

An irreversible, abnormal, vasodilation, localized bulge in the wall of a blood vessel. Develops d/t blood vessel weakening d/t: Atherosclerosis Hypertension Genetic factors e.g., Marfan syndrome Infection Trauma Aging

Aneurysm

A localized, sac-like bulge on only one side of the blood vessel wall, often with a distinct "neck." Commonly found in the brain (cerebral or "berry" aneurysms).

Saccular Aneurysm

A uniform, spindle-shaped bulge that involves the entire circumference of the blood vessel. Typically seen in the aorta (e.g., abdominal aortic aneurysms).

Fusiform Aneurysm

A tear in the inner layer of an artery wall, allowing blood to flow between the layers, creating a "false lumen." (Technically not a true aneurysm). Most commonly affects the aorta. A medical emergency.

Dissecting Aneurysm (Aortic Dissection)

A hematoma (collection of blood) outside the arterial wall that is contained by surrounding tissues, connected to the arterial lumen. Does not involve all layers of the arterial wall. Often results from trauma, medical procedures (e.g., catheterization), or infection.

Pseudoaneurysm (False Aneurysm)

Occurs in the abdominal section of the aorta, usually below the renal arteries. Most common type of aortic aneurysm.

Abdominal Aortic Aneurysm

Occurs in the chest portion of the aorta (ascending, arch, or descending aorta).

Thoracic Aortic Aneurysm

Occur in arteries supplying the brain, most often at branching points. Commonly found at the base of the brain (Circle of Willis).

Cerebral (Brain) Aneurysms

Occur in arteries other than the aorta or those in the brain.

Peripheral Aneurysms

Occurs behind the knee. Most common peripheral aneurysm.

Popliteal Artery Aneurysm

Occurs in the groin.

Femoral Artery Aneurysm

Occurs in the artery supplying the spleen. Most common visceral artery aneurysm.

Splenic Artery Aneurysm

Occurs in the artery supplying the kidney.

Renal Artery Aneurysm

deep constant pain in the abdomen, side or back, a pulsating sensation near the navel.

Abdominal Aortic Aneurysm

back pain, hoarseness, dysphagia, SOB or chest pain.

Thoracic Aortic Aneurysm

“thunderclap” headache, stiff neck, n/v, blurred vision, photosensitivity, loss of consciousness

Cerebral (Brain) Aneurysms

pulsating lump, pain, numbness, tingling or coldness in the limb.

Peripheral Aneurysms

aneurysm complications

Rupture Shock Thromboembolism Compression

PERIPHERAL VASCULAR DISORDERS Flashcards

(68 cards)