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Sharlene and MB's PT party > Cardiovascular- PNS (general and disease) > Flashcards

Cardiovascular- PNS (general and disease) Flashcards

1
Q

Function of arteries and the exceptions

A

Transport blood from areas of high pressure to lower pressures in the body tissues.
The only exceptions are the umbilical vein (in utero) and the pulmonary veins.

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2
Q

What 3 things affect arterial circulation?

A

1- heart pump
2- influenced by elasticity and extensiblity of vessel walls
3- peripheral resistance, amount of blood in body

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3
Q

Arterioles are the primary site for _____ ______

A

vascular resistance

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4
Q

5 points about the anatomy of veins

A 
1- larger capacity
2- thinner walls than arteries
3-greater number
4- one way valves to prevent back flow
5- superficial and deep veins. Deep veins accompany arteries.
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5
Q

What is venous circulation influenced by?

A

1-muscle contraction
2- gravity
3- respiration (increased return with inspiration)
4- compliancy of R heart

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6
Q

What makes up the lymph system?

A

1- lymphatics (superficial, intermediate, and deep)
2- lymph fluid
3- lymph tissue and organs: lymph nodes, tonsils, spleen, thymus, and thoracic duct

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7
Q

Lymphatic contraction occurs by what?

A

1- parasympathetic, sympathetic, and sensory nerve stimulation
2- contraction of adjacent mscles
3- abdominal and thoracic cavity pressure changes during normal breathing
4- mechanical stimulation of dermal tissues
5- volume changes within each lymphatic vessel.

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8
Q

Where are major lymph nodes located?

A 
1- submaximally
2- cervical
3- axillary
4- mesenteric
5- iliac
6- inguinal
7- popliteal
8- cubital
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9
Q

Function of lymph nodes

A

contributes to the immune system- collect cellular debris and bacteria, remove excess fluid/blood waster/bacteria, produce antibodies

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10
Q

List arterial diseases

A

Occlusive Peripheral Arterial Disease (PAD)
Thromboangiitis Obliterans (Buerger’s Disease)
Diabetic Angiopathy
Raynaud’s disease or phenomenon

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11
Q

List venous diseases

A

Varicose veins
Superficial vein thrombophlebitis
Deep vein thrombophlebitis (DVT)
Chronic venous stasis/incompetence

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12
Q

List lymphatic diseases

A

lymphadenopathy

lymphedema

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13
Q

What areas and vessels does PAD affect?

A
  • Its a chronic occlusive disease that affects medium and large sized vessels due to peripheral artherosclerosis
  • primarily affects lower extremities
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14
Q

What other pathologies is PAD associated with?

A

hypertension, hyperlipedemia, CAD, cerebrovascular disease, diabetes, metabolic syndrome (and a Hx of smoking)

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15
Q

Early stage and general symptoms of PAD

A

General: diminshed or absent pulses, skin is pale on elevation and dusky red on dependency
Early: intermittent claudication- pain is burning/searing/aching/tight/crampy and occurs with walking but relieved with rest.

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16
Q

Late stage of PAD

A

pain at rest, muscle atrophy, trophic changes (hair loss, skin and nail changes)

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17
Q

Critical stenosis PAD

A

resting or nocturnal pain, skin ulcers, gangrene

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18
Q

What is Thromboangiitis Obliterans (Buerger’s Disease)?

A

Chronic, inflammatory vascular occlusive disease of small arteries and also veins
Begins distally and progresses proximally in both upper and lower extremities.

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19
Q

Who gets Thromboangiitis Obliterans (Buerger’s Disease) and what are the symptoms?

A

Young adults, largely males, who smoke
Symptoms: paresthesias or pain, cyanotic cold extremity, diminished temp senstations, fatigue, risk of ulceration, gangrene

20
Q

Diabetic angiopathy. Go!

A

1- inappropriate elevation of blood glucose levels and accelerated atherosclerosis
2- Neuropathy is a major complication
3- Neurotrophic ulcers, may lead to gangrene and amputation

21
Q

Everything you know about Raynaud’s Disease

A

1- Episodic spasm of small arteries and arterioles
2- Abnormal vasoconstrictor reflex exacerbated by exposure to cold or emotional stress, tips of fingers develop pallor, cyanosis, numbness and tingling
3- affects largely females
4- occlusive disease is not usually a factor

22
Q

What are varicose veins?

A
  • distended, swollen superficial veins; tortuous in appearance
  • may lead to varicose ulcers
23
Q

What is Superficial vein thrombophlebitis?

A
  • clot formation and acute inflammation in the superficial vein
  • localized pain; usually in the saphenous vein
24
Q

What is Deep vein thrombophlebitis (DVT)?

A
  • Clot formation and acute inflammation in a deep vein
  • Usually occurs in LE, associated with venous stasis (bed rest, lack of leg exercise), hyperactivity of blood coagulation and vascular trauma; early ambulation is prophylactic
25
Q

Signs and Symptoms of Deep vein thrombophlebitis (DVT)

A
  • may be asymptomatic early
  • progressive inflammation with tenderness to palpation
  • dull ache, tightness, or pain in calf
  • swelling
  • warmth
  • skin discoloration
  • venous distention
26
Q

Pulmonary emobolism

A
  • DVT may precipitate PE
    S/S- chest pain and dyspnea, diaphoresis, cough, apprehension
  • Go to ED, life threatning
27
Q

Diagnose DVT

A
  • Use Well’s criteria

- According to Therapy Ed do NOT use Homan’s (article cited in book)

28
Q

Medical management of DVT

A
  • anticoagulation therapy (ex: heparin)
  • thrombolytic agents (ex: streptokinase)
    -ambulation and mobility encouraged after 1 dose of low molecular weight heparin
  • ## compression stockings with pressure gradient of 30-40mm Hg can assist w/ pain and reduce risk of post-thrombolytic syndrome
29
Q

What is Chronic venous stasis/incompetence

A

Venous valvular insufficiency: from fibroelastic degeneration of valve tissue, venous dilation

30
Q

Grades for Chronic venous stasis/incompetence

A

Classification
Grade I: mild aching, minimal edema, dilated superficial veins
Grade II: increased edema, multiple dilated veins, changes in skin pigmentation
Grade III: venous claudication, severe edema, cutaneous ulceration

31
Q

Differential Diagnosis- arterial vs.venous vs. lymph: Etiology

A

Arterial: artherosclerosis thrombosis, emboli, inflammatory process
Venous: thrombophlebitis, trauma, vein obstruction (clot), vein incompetence
Lymphatic: primary lymphedema, secondary lymphadema

32
Q

Differential Diagnosis- arterial vs.venous vs. lymph: Pain

A

Arterial: severe muscle ischemia/intermittent claudication, rest pain indicates severe involvement, muscle fatigue/cramping/numbness, parathesias over time

Venous: min-mod steady pain, aching pain in LE w/ prolonged standing or sitting (dependent position), superficial pain along vein

Lymphatic: heaviness, tightness, aching, or discomfort

33
Q

Differential Diagnosis- arterial vs.venous vs. lymph: Location of pain

A

Arterial: usually calf, lower leg, or dorsum of foot
Venous: muscle compartment tenderness
Lymphatic: edematous limb

34
Q

Differential Diagnosis- arterial vs.venous vs. lymph: Vascular

A

Arterial: decreased or absent pulses, pallor of fore foot on elevation, dependent rubor

Venous: venous dilation or varicosity, edema- mod -sev especially after prolonged dependency

Lymphatic: rare complications unless severe and untreated edema

35
Q

Differential Diagnosis- arterial vs.venous vs. lymph: Skin Changes

A

Arterial: pale, shiny, dry, loss of hair, nail changes, coolness of extremity

Venous: hemosiderin deposition-dark/cyanotic/thickened/brown skin, lipodermatosclerosis-fibrosing of subcutaneous tissue, may lead to stasis dermatitis , cellulitis

Lymphatic: cutaneous fibrosis, may lead to cellulitis, lymphangitis

36
Q

Differential Diagnosis- arterial vs.venous vs. lymph: Acute

A

Arterial: distal pain, paresthetic, pale, pulseless, sudden onset

Venous: calf pain, aching, edema, muscle tenderness, 50% asymptomatic

Lymphatic: rarely acute, usually progressive over time except with changes in pressure to limb altering flow (repeated blood pressure measurements, airplane flights)

37
Q

Differential Diagnosis- arterial vs.venous vs. lymph: Ulceration

A

Arterial: may develop in toes, feet, or areas of trauma, pale or yellow to black eschar, gangrene may develop, regular in shape and may appear punched out.

Venous: may develop at sides of ankles- especially medial malleolus along the course of veins, gangrene absent, painful, shallow, exudative, granulation tissue in the base, irregular borders.

Lymphatic: unusual

38
Q

Differential Diagnosis: Risk factors for arterial

A
  • over age 60
  • smoking
  • diabetes
  • slightly more prevalent in men
  • dyslipedemia
  • hypertension
  • hyperhomocysteinemia (abnormally high level of homocysteine in the blood)
  • African American
39
Q

Differential Diagnosis: Risk factors for venous

A
  • venous hypertension
  • varicose veins
  • inheritated trait
  • female
  • age
  • increased BMI
  • sedentary lifestyle/prolonged sitting
  • ligamentous laxity
40
Q

Differential Diagnosis: Risk factors for lymphatic

A
  • lymphadenectomy
  • radiation treatment
  • inflammatory arthritis
  • obesity
41
Q

What is lymphadenopathy?

A

enlargement of nodes, with or without tenderness

42
Q

What is acute lymphangitis?

A

acute bacterial infection spreading throughout lymph system

usually streptococcal

43
Q

What is lymphedema in general and the causes of it?

A

Chronic disorder w/ excessive accumulation of fluid due to obstruction of lymphatics or removal of lymph nodes.

Causes swelling of soft tissues in UE and LE.

Results from mechanical insufficiency of the lymphatic system.

44
Q

What is primary lymphedema?

A

congenital condition with abnormal lymph node or lymph vessel formation (hypoplasia or hyperplasia)

45
Q

What is secondary lymphedema?

A

acquired due to injury of one or more parts of the lymphatic system. Possible causes:

  • surgery such as radical mastectomy, femoropopliteal bypass, lymph node removal
  • tumors, trauma, or infection affecting the lymph vessels
  • radiation therapy with fibrosis of tissues
  • chronic venous insufficiency
  • in tropical r subtropical areas, filariasis (nematode worm larvae in the lymphatic system)

Sharlene and MB's PT party (35 decks)

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