Flashcards in General Deck (15)
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1
usually refers to
chronic atherosclerotic occlusive disease of large and medium arteries, primarily of the legs
2
epidemiology
common
elderly
men
risk factors same as for CAD
3
Atherosclerotic luminal narrowing decreases blood flow...
in inverse proportion to length of stenosis and blood viscosity
in proportion to radius to the fourth power
**Poiseuille's eqn.
4
What is important in determining the amount of blood flow?
radius of the lumen
5
if radius is reduced to half, flow is....
reduced to 1/16
6
Symptoms
intermittent claudication
7
intermittent claudication
pain brought on by exercise, relieved by rest
8
Where is the pain most common?
calf muscles when disease in femoral or popliteal arteries (the usual site) causes it
9
What are indicators of severe disease?
pain at rest
ulcers
10
Signs
diminished or lost distal pulses
brits
pallor or cyanosis
skin atrophy muscle atrophy
ulcerations
necrosis (gangrene)
11
bruits
swishing sounds auscultated over lesions with turbulent flow
12
Diagnosis
made by Hx and physical exam!!!
13
Physical exam useful for diagnosis
measure BP in arm and lower leg w/ pt supine...
if ratio ("ankle/brachial ratio") is <.9, no further diagnostic tests are necessary
14
First line treatment
exercise (esp walking)
--helps develop collaterals
cilostazol (vasodilates)
penoxifylline (decreases blood viscosity)
angioplasty
surgery (bypass, amputation)
15