Arterial Disease of the Limbs Flashcards
Pulses of the Limbs
Aorta Common Femoral artery Popliteal artery Posterior tibial Dorsalis Pedis
Risk factors for critical limb ischaemia
Male Age Smoking Hypercholesterolemia Hypertension Diabetes Drug history (anti hypertensive Dx, antiplatelet, diabetes etc.)
Signs of critical limb ischaemia
Ulceration
Hair loss
palor
Critical limb ischaemia investigations
Duplex
CTA/MRA
Digital subtraction angiogram
Causes of acute limb ischaemia
Arterial embolis Thrombus Trauma Dissection Acute aneurysm thrombosis i.e. popliteal
Presentation of acute limb ischaemia
6 Ps Pain Pallor Perishingly cold Paraesthesia = as the nerve dies Paralysis = as the muscle dies Pulseless
Investigations of acute limb ischaemia
ECG
Bloods
Management of acute limb ischaemia
Analgesia
Anticoagulate
Possibly amputation
Pathophysiology of diabetic foot disease
Microvascular peripheral artery disease (stiffening of capillaries, inflammation etc)
Peripheral neuropathy (standing on things without realising)
Mechanical imbalance (pressure points on odd places resulting in tissue damage)
Susceptibility to infection
Management of diabetic foot disease
Prevention (e.g. good footwear, glycaemic control)
Good wound care
Tracking infection: consider systemic antibiotics
Investigate for osteomyelitis, gas gangrene, necrotising fasciitis (fatal)
Revascularisation (limited success as distal disease)
- Distal (rural angioplasty) stent
- Amputation
Management of chronic limb ischaemia
Anti-platelet Statin BP control Smoking cessation Exercise Diabetic control
Types of amputation of lower limbs
Hindquarter Hip disarticulation Above knee Through knee Below knee Symes (don't do anymore) Transmetatarsal Digit
