Cardiovascular (peripheral vessels) Flashcards
(25 cards)
Varicose Veins causes and risk factors
Causes: Trauma to saphenous veins-damage to one or more valves
Blood not being moved back up - gravity pulling it down
Risk factors:
Age, female, family hx, obesity, DVT, previous leg injury
Chronic Venous Insufficiency
Caused by:
Valvular incompetence
Obesity
poor venous return longterm
Venous hypertension, circulatory stasis, tissue hypoxia
Untreated varicose veins lead to chronic venous insufficiency
Symptoms:
Edema to lower extremities
Hyperpigmentation of skin on feet and ankles
Tx: Elevate legs, compression stockings, physical exercise
Thrombus
Occurs more in veins than arteries due to lower pressure
Thromboembolus: Venous more than arterial, DVT - deep vein thrombosis
Causes
Venous stasis - immobility, age, HF
Venous endothelial damage - trauma- IV meds
Hypercoagulable states - inherited disorders, pregnancy, oral contraceptives, HRT
Ortho surgery
Most thrombi dissolve without tx
Persistent obstruction: chronic venous insufficiency (causes blood to collect in vein)
Signs: Leg pain, red skin, warmth
Thrombus vs thromboembolus
Thrombus: Blood clot attached to vessel wall
Thromboembolus: Detached thrombus
Thrombus in veins causes
Venous stasis
Immobility
age
heart failure
venous endothelial damage
hypercoaguable states
Primary hypertension
Most common
No underlying cause. Hypertension is the main issue
Secondary Hypertension
Caused by Underlying disease (frequently involves kidneys)
Meds can cause hypertension
Fixing disease resolves BP
Causes of acute hypotension
(lower than 90/60)
•Pregnancy (increased demand for blood from fetus)
•Blood loss
•Impaired circulation from heart attack
•Shock
•severe dehydration
•Anaphylaxis
•Sepsis
Orthostatic hypotension
Decrease in Systolic by 20
Or
Decrease in diastolic by 10
After standing
True aneurysm
Affects all 3 layers of arterial walll
Dissecting aneurysm
Splits vessel wall along length of vessel
False aneurysm
extra vascular hematoma
Most common aneurysm areas
Thoracic or abdominal area
AAA or TAA
Ascending aorta vs descending aorta
Increased pressure in these vessels compared to other areas of body
Thoracic aneurysm symptoms
Dysphagia
Dyspnea
Bulge affects surrounding tissue
Embolism
Obstruction of vessels by embolus:
•Dislodged thrombus
•Bolus of aur
•Ambiotic fluid
•Fat
•Bacteria
•Cancer cells
•Foreign body
Pulmonary emboli originate from venous side
Arterial emboli originate in left ventricle (After MI, valvular disease, endocarditis, dysrhythmia)
Bolus of air: IV, chest trauma
Fat: Trauma of long bones
Beurger’s Disease
Associated with smoking
Formation of thrombi in peripheral arteries. Overtime the thrombi become organized and fibrotic.
Permanent occlusion of vessels
Symptoms: Pain, tenderness, sluggish blood flow, rubor (redness) of skin due to dilated capillaries under skin, thin and shiny skin, nails thick and deformed.
Dx: <45 years, smoker, peripheral ischemia
Raynaud phenomenon/disease
Is a primary disease. Vasospastic disorder with unknown origin
Attacks or vasospasm in small arteries and arterioles of fingers (less common in toes)
Secondary disease when associated with lupus.
Arteriosclerosis
Thickening of artery walls
Atherosclerosis
Build of up plaques of lipid material on artery walls.
Systemic issue. Never develops in just one area.
ATHEROsclerosis is a type of ARTERIOsclerosis
Leading cause of coronary artery disease and cerobrovascular disease
Peripheral Artery Disease
Atherosclerotic disease of arteries in limbs.
Linked to diabetes and smoking.
Intermittent claudication: Normally pain free; but there is pain with ambulation. Will stop if ambulation stops. Due to vessels unable to handle increased blood flow that is required by body
Gradual: Pain with ambulation, can be gradual, walking more than 50 steps, climbing stairs. Pain stops when ambulation stops.
Acute: Thrombus development over atherosclerotic lesion causing complete blood flow obstruction, leading to severe pain, loss of pulses, skin change
Venous vs Arterial Ulcer
Venous: On lower leg. typically between knee and ankle. Large, shallow wounds with inflamed base. Irregular and uneven borders. Moist or weepy. Surrounding skin shiny, tight, discoloured (deep pink to red), and warm to touch.
Arterial: Occur on angles, heels, toes, feet.
Are small, deep, round, look like hole punches. Have well-defined borders. Pale/very light pink
BP for hypertension
Systolic >140
Diastolic >90
Sympathetic Nervous System (SNS) - Primary Hypertension
Stress
Epinephrine/norepinephrine
•Beta 1: increased HR/contraction
•Alpha 1: Peripheral Vasoconstriction
•Increase ADH: Kidneys release less water, retain sodium/water
Complicated Hypertension
Uncontrolled hypertension >180/120
Causes tissue damage to heart (left ventricular hypertrophy), angina, heart failure
Renal complications
Cerebrovascular: stroke, TIA, aneurysm, dementia
