CVS - Peripheral Arterial and Venous Disease Flashcards Preview

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Flashcards in CVS - Peripheral Arterial and Venous Disease Deck (35)
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1
Q

Does doppler of peripheral vessels give flow?

A

No it gives velocity and direction

Can infer flow

2
Q

Which way is flow in veins in the leg?

A

Superficial to deep

3
Q

What are the veins called that flow goes from superficial to deep?

A

Perforators

4
Q

What is the one constant vein in the body? Where might you find it e.g. for venupuncture

A

Long saphenous vein?

Anterior to medial malleolus

5
Q

Is the short saphenous and long saphenous deep or superficial

A

Superficial

6
Q

How does blood flow from superficial to deep and up the leg?

A

When calves relaxed - blood pulled from superficial into deep.

When calves contract blood pushed towards heart

7
Q

How much does the calf pump reduce during exercise?

A

80%

8
Q

What is a varicose vein?

A

Tortuous twisted or lengthened veins

9
Q

What is the pathophys of varicose veins?

A

Vein wall is WEAK

Leads to dilation and separation of valves –> valved become incompetent

10
Q

What are four symptoms of varicose veins?

A

Heaviness
Aching
Itching
Tension

11
Q

What is itching in skin mediate by?

A

Nearly always histamine

12
Q

What are the complications of venous insufficiency (7)?

A

Vein - Haemorrhage, thrombophlebitis

Venous hypertension - oedema, pigmentation (haemosiderin), varicose eczema, lipodermatosclerosis (hard fat), venous ulceration

13
Q

Why do you get haemosiderin skin pigmentation in venous insufficiency?

A

Increased capillary permeability –> RBCs leak out

14
Q

Does venous thrombosis cause pain

A

Yes due to inflame response

15
Q

What in particular leads to venous ulceration?

A

Venous hypertension from calf muscle pump failure

16
Q

What are causes of calf muscle pump failure?

A

Immobility
Obesity
Superficial vein incompetence (retrograde flow)
Deep vein incompetence
Reduces hip/knee/ankle movement e.g. in fracture?

17
Q

What is virchows triad

A

Changes in vessel wall
Changes in blood flow
Changes in coagulability

18
Q

Which of the virchows is most relevant for arterial vs venous thrombosis?

A

Arterial - Vessel wall

Venous - flow of blood (stasis)

19
Q

Stasis + what = venous thrombosis?

A

E.g. surgery, contraceptive pill, dehydration, cancer

20
Q

What is the difference in thrombi components/pathways (intrinsic extrinsic) of arterial vs venous thrombi?

A

Arterial - platelets and both pathways

Venous - Fibrin intrinsic initially then both

21
Q

Does DVT produce an inflamm response? What are the signs?

A

Yes

Calor
Dolor
Function Laesa
Rubor
Tumor
22
Q

What are the signs/symptoms of DVT

A

Pain
Swelling
Blue-red skin colouration

Calf tenderness
Muscle induration
Skin warmth
Skin discolouration
Distended warm superficial veins
Oedema
Pyrexia
23
Q

What about surgery predisposes you to DVT?

A

Immobility

Hypercoaguable due to trauma of surgery

24
Q

Most common cause of acute limb ischaemia?

A

Emboli from heart, AAA or trauma

25
Q

How long have you got to reverse acute limb ischaemia?

A

6 hours

26
Q

What are the 6 Ps of acute limb ischaemia?

A
Pain
Pallor
Pulseless
Paralysis
Perishing cold
Paraesthesia
27
Q

What does a fixed mottled legs represent?

A

Patchy cyanosis –> Irreversible iscahemia –> amputate

28
Q

Why do you need to amputate?

A

Because K+ builds up and if leg reperfused will go to heart and cause cardiac arrest

29
Q

Where is most common cause of PVD causing claudication?

A

Superficial femoral artery

30
Q

Where is most common place to feel pain in claudication?

A

Calf

31
Q

Where might you feel a pulse to assess if there is one in PVD (4)?

A

Femoral
Popliteal
Dorsalis Pedis - just lateral to extensor hallucis longus
Posterior tibial - just behind medial malleolus

32
Q

What artery would you expect to see occlude if having buttock claudication?

A

Internal iliac

33
Q

Superficial femoral artery occlusion - where would you feel pulse/not feel pulse/ feel claudication?

A

Claudication - calf
Pulse in femoral artery present
Pulse in popliteal and pedal pulses

34
Q

What is rest pain? Why at night (3)?

A

Pain in foot at night at rest

Night because: decreased gravity lying down, decreased cardiac output at night, warmed foot=metabolic needs

35
Q

Why would you get ulcers over tibia in particular?

A

Blood supply isn’t great there anyway