PVD

Question 1

what does PVD effect?

Answer 1

mostly arteries but also impacts veins and lymph vessels

Question 2

2 forms of PVD?

Answer 2

acute arterial occlusion

atherosclerotic occlusive disease

Question 3

what is an acute arterial occlusion?

Answer 3

acute onset! quick and without warning
-d/t thrombus or embolus
thrombus= clot that forms and stays in vessels
embolus= clot moves and lodges at new site

Question 4

manifestations of acute arterial occlusion?

Answer 4

7 P's! 
Pain
Pistol shot
Pallor
Polar (cold, decreased blood flow)
Pulselessness
Paralysis (l/o function)
Paresthesia (abnormal sensations)

Question 5

diagnosis of acute arterial occlusion?

Answer 5

physical exam

blood flow assessment (doppler or angiogram)

Question 6

treatment of acute arterial occlusion?

Answer 6

surgery (less invasive first though)
thrombolytics- break down thrombus/clot
anticoagulants- prevent further coagulation

Question 7

what is atherosclerotic occlusive disease?

Answer 7

most common
change in vessels (like atherosclerosis)
usually in lower extremities- popliteal and femoral (large vessels)
gradual development
MOST common in ELDERY and DIABETES MELLITUS
perfusion impeded—> ischemia—> tissue damage
inadequate venous return–> venous and lymphatic stasis—> wastes accumulate—> srs complications

Question 8

compensation for atherosclerotic occlusive disease?

Answer 8

• VASODILATION
• Anarobic metabolism—> increase lactic acid
• COLLATERALIZATION (vessels form around clotted vessel—> aka angiogenesis)

Question 9

manifestations of atherosclerotic occlusive disease?

Answer 9

• intermittent claudication= compromised vessel when person begins to walk—> vessels cannot meet demand for oxygen, ischemia—> ischemic pain
• w/ advanced PVD= l/o function, atrophy of subq tissue, shiny skin

Question 10

diagnosis of atherosclerotic occlusive disease?

Answer 10

physical exam (signs of ischemia) alone can not diagnose!
blood flow assessments (doppler, ultrasound--> CT, MRI, angiogram if needed)

Question 11

treatment for atherosclerotic occlusive disease?

Answer 11

-NO clot so different from acute
-ADDRESS symptoms
-DECREASE risk of atherosclerosis, stroke, MI
if NO treatment: decreased perfusion will lead to ischemia—> necrosis—> ulceration and gangrene—> amputation, acidosis