Brainscape's Knowledge GenomeTM

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


See full index

Cardiovascular system > Lecture 15- Peripheral arterial and venous disease > Flashcards

Lecture 15- Peripheral arterial and venous disease Flashcards

1
Q

lower limb venous anatomy- the venous system is divided into

A

superificial and deep veins

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

movemetn of blood from superifical to deep veins via

A

perforating viens with valves

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

deep veins found

A

underneath deep fascia with major arteries

x

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

Superficial veins found

A

subcutaneous tissue

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

name the superidical veins of the leg

A

short and long sapehnous

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

names the deep veins of the leg

A

external iliac –> femoral

femoral –> deep femoral or popliteal

popliteal –> anterior tibial/ posterior tibial/ peroneal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

what is known as the peripheral heart

A

calf muscle pump

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

calf muscle pump

A

Is the motive force enhancing return of venous blood from the lower extremity to the heart. It causes displacement of venous blood in both vertical and horizontal directions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

which are the main muscles which contribute to the calf muscle pump

A

soleus and gastrocnemois contirbute to pushing the blood against gravity back towards the heart

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

outline actions of the calf muscle pump

A
  1. When the valves are open –>blood pushed through to deep veins via the pressure contracting muscle puts on the veins–> then valves close to prevent retrograde movement
  2. Perforating valves open again allowing filling from the superficial veins
  3. Venous pressure in the foot reduced during exercise
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Peripheral venous disease

A

Venous diseases usually occur as people age

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

a common vein pathology

A

varicose veins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

varicose veins

A

Tortured, twisted or dilated veins

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

what happens to valves in varicose veins

A

infective and blood movement is slowed or reversed

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

which vein is commonly affected by varicose veins

A

saphenous

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

In healthy veins

A
  • Normally venous blood from the legs flows upwards through superficial veins which eventually flow into deeper veins
  • Blood flow is assisted by valves in veins which allow blood to move up towards the heart and prevent blood from flowing back down
  • Ensures venous blood only flows in one direction
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

In varicose veins

A
  • If veins become dilated due to the weakening of the walls of the vein, the leaflets of the valves are pulled apart
  • This lets blood leak back through the valve by the downward pull of gravity (retrograde flow)
  • Causes a build-up of blood, increased pressure on the valves upstream of the faulty valve, casing further retrograde flow through overwhelmed valves
  • Cycle continues and causes blood to pool in the lower leg, forming varicose veins
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

causes of varicose veins

A

Pregnancy

Older age

Obesity

Occupation that involves a lot of standing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q
A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Symptoms of varicose veins

A
  • Leg feels heavy
  • Tense
  • Itchy
  • Veins can be seen and look bump
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

complications of varicose veins

A
  • haemorrhage
  • thrombophlebitis
  • venous hypertension
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Haemorrhage

A
  • Wall of varicose veins are thin and bulge from the skin making them more susceptible to damage through trauma
  • Emergency treatment for this is to raise the leg to a level higher than the heart
  • Helps venous blood drain from leg and apply pressure to the blood
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Thrombophlebitis

A

Inflammation of a vein caused by formation of a small clot

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

which do clots form as a result of varicose veins

A

Clot forms due to stasis of blood within varicose vein

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

thrombophlebitis symptoms

A

inflammation can cause pain and swelling

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

why can thrombophlebitis stain skin brown

A
  • Thrombophlebitis can lead to RBC to leak from affected vein into surrounding tissue
  • Macrophages then breakdown and oxidise the cells
  • Oxidation of iron in haemoglobin: Fe2+ –> Fe3+
  • Fe3+ stains skin brown
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

how can varicose veins cause venous hypertension

A

The incompetence of the valves in varicose veins means that venous blood struggles to flow. This results in blood pooling at the bottom of the vein, building up the pressure in the vein which causes venous hypertension.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

another cause of venous hypertension

A

calf-muscle pump failure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

how can calf pump failure cause venous hypertension

A

The calf muscles play an important part in forcing blood up the deep veins in the calf. Failure of these muscles to contract, for example as a result of immobility or shuffling gait, results in building up of blood in the veins under higher pressure.

30
Q

Venous hypertension is associated with complications such as:

A
  • oedema
  • varicose eczema
  • lipodermatosclerosis
  • venous ulceration
  • deep vein thrombosis (DVT)
31
Q

oedema caused by varicose veins

A

he blood in the varicose veins is under high pressure and so fluid leaks into the interstitium causing oedema.

32
Q

Varicose eczema

A

fluid leaks from the vein under the high pressure, causing inflammation, which can cause eczema of the overlying skin.

*These patients are susceptible to developing ulcers*

Symptoms

Chronic, itchy, tight and painful

Develops around hard nodular areas like the medial malleolus

33
Q

Lipodermatosclerosis as a result of varicose veins

A

inflammation and hardening of the subcutaneous fat due to the inflammation caused by the varicose veins.

*Hard to touch

34
Q

Venous ulceration as a result of varicose veins

A

– fluid leaks from the vein causing swelling and damage to the skin, eventually resulting in an ulcer.

35
Q

deep vein thrombosis and varicose veins

A

The blood flow in varicose veins is stagnant. Due to stasis of blood it can then clot in the deep veins of the leg.

36
Q

thrombosis

A

Arterial and venous thrombus precepted by different pathophysiology

37
Q

common cause of arterial thrombosis

A

by fair most common cause is atehroma

Platelet rich –> activated –> aggregated –> plug hole

38
Q

venous thrombosis

A
  • Low flow and little platelet component- fibrin rich.
  • Stasis and usually another factor:
  • Trauma
  • Combined Oral Contraceptive Pill
  • Dehydration
  • Chemotherapy
  • Inflammatory conditions
  • Pregnancy
39
Q

risk factors for DVT

A
  • No calf muscle pump
  • Before surgery
  • After surgery
  • Trauma
  • Malignancy
  • Pregnancy
40
Q

symptoms of DVT

A

Symptoms

Pain

Tenderness and swelling of the leg (usually calf)

Distended and warm veins

Muscle induration

Oedema and pyrexia.

41
Q

complications of DVT

A

A DVT can potentially embolise. If part of the thrombus breaks off and travels in the circulation as an embolus, it can travel up to the pulmonary circulation and lodge to cause a pulmonary embolism

42
Q

differential diagnosis of DVT

A

Soft tissue trauma

Cellulitis

Lymphatic obstruction

43
Q

diagnosis of DVT uses a

A

wells score pre-test probability

44
Q

what vastly decreases DVT surgery

A

prophylaxis e.g. anticoagulants

45
Q

what is promoted soon after surgery

A

mobility

46
Q

alternative routes of blood vessels

A
  • Collateral blood vessels are small capillary-like branches of an artery that form over time in response to narrowed coronary arteries. The collaterals “bypass” the area of narrowing and help to restore blood flow.
  • Can also be a physiological design e.g. When we flex or bend a joint (knee, shoulder, hip)
47
Q

Chronic peripheral arterial disease and intermittent claudication of the lower limb cause

A

Caused by artery stenosis in some vessels of the legs

48
Q

Intermittent claudication

A
  • pain and cramping in the muscle of the leg when walking or exercising due to the reduced oxygen delivery to the muscles
49
Q

management of Chronic peripheral arterial disease and intermittent claudication of the lower limb

A

Exercise

Smoking cessation

Antiplatelet drugs

Angioplasty

By pass graft

50
Q

pathology of claudication

A
  • By far most common presentation is atheromaà atherosclerosis of the superficial femoral artery
  • Present with calf claudication
    *
51
Q

if untreated claudication will become

A

critial ischaemia

52
Q

acute limb ischamia

A

Arteries can become stenosed (narrowed) due to atherosclerosisà this reduces blood through the artery

this can be foolowed by full occluison of an artery

53
Q

Sudden occlusion of an artery occurs due to….

A
  • embolus
    • E.g. AAA
  • Atherosclerosis
  • Clot formation in the heart in atrial fibrillation

Very serious and needs to be treated quickly to avoid damage to the limb

54
Q

signs and symptoms of acute limb ischaemia

A

(6 Ps)

  • Pain
  • Paralysis
  • Paraesthesia
  • Pallor
  • Perishingly cold to touch
  • Pulseless
55
Q

what will a limb with acute limb ischaemia look like

A

Initially affected limb will be white as the perfusion to the tissues is severely reduced. After a few hours the deoxygenated blood in the limb causes it to become cyanotic- blue tinge to the skin which blanches when pressure is applied. As ischaemia progresses- skin becomes mottled and no longer blanches.

–>calls for amputation

56
Q

critical ischameia

A

When stenosis of the vessels are so severe the patient experiences pain in the legs at rest

57
Q

symptoms of cirtical ischaemia

A

Heavy and tight pain in the leg

Only relived at night if they hang their legs off the bed- increases blood flow to calf

58
Q

complication of critical ischaemia

A
  • ulceration and gangrene of the leg
59
Q

how is the stenosis located

A

Carried out by checking for pulses in that limb.

60
Q

The main leg pulses from proximal to distal are:

A
  • Femoral – mid inguinal point.
  • Popliteal – deep in the popliteal fossa.
  • Dorsalis pedis – lateral to the extensor hallucis longus tendon.
  • Posterior tibial – behind the medial malleolus.
61
Q

Patients symptoms and pulses will be different depending on

A

where the stenosis is

62
Q

Aortoiliac stenosis:

A
  • Bilateral buttock, thigh and calf claudication
  • All lower limb pulses are absent
63
Q

Common iliac artery stenosis:

A

Unilateral buttock, thigh and calf claudication

Unilateral (one-sided) absent lower limb pulses

64
Q

Common femoral artery stenosis:

A
  • Unilateral thigh and calf claudication
  • Unilateral absent lower limb pulses
65
Q

Superficial femoral artery stenosis:

A
  • Unilateral calf claudication
  • Femoral pulse present, but popliteal and pedal pulses absent
  • MOST COMMON SITE OF ARTERY STENOSIS
66
Q

where is the most common site of artery stenosis

A

superifical femoral artery stenosis

67
Q

what can be used to measure real-time flow and velocity

A

Doppler ultrasonography

68
Q

dopplet ultrasonopraphy is useful for recording flow and velocity in

A

the heart and distal vesseols

69
Q

doppler US in the heart

A

part of echocardiogram (heart failure, valve disease etc)

70
Q

doppler US in the distal vessels

A

legs when diagnosing peripheral arterial disease atheroma à stenosis à flow and velocity changes

71
Q

Ankle-brachial pressure index (ABPI)

A
  • Measurement of blood pressure in brachial, dorsalis pedis and posterior tibial arteries.
  • Divided ankle systolic by brachial systolic
72
Q

ABPI ……….. indicates peripheral artery disease

A

<0.9

Cardiovascular system (30 decks)

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