Lecture 19- Peripheral Arterial And Venous Disease Flashcards
Where do superficial and deep veins run?
Superficial in subcutaneous tissue and deep underneath the deep fascia with major arteries.
Superficial connected to deep veins through perforating veins
What vein runs in front of medial malleolus and can be located here?
Long saphenous
Which muscles act as calf muscle pump?
Soles and gastrocnemius
Peripheral venous disease?
Varicose veins where valves ineffective. Blood movement slow or reversed. Get distension and swelling. Venous pressure is increased and walls of vein weaken. Veins tend to be torturous and twisted
Symptoms of varicose veins?
Throbbing, aching, heaviness and muscle cramps along the affected veins
What can occur as a result of varicose veins?
Haemorrhage- in shower standing and warmth vasodilation
Skin pigmentation due to RBC leakage and rust formation
Lipodermatosclerosis
Venous ulceration and oedema
Thrombophlebitis
What is thrombophlebitis?
Inflammatory process resulting in clot forming in vein
Venous eczema?
Chronic, itchy, red and swollen and tight
Can lead to lipidermatosclerosis
Result of venous hypertension
Venous ulceration?
Result of venous hypertension
Often develops around modular areas
Treating venous hypertension and calf muscle pump failure?
Increase mobility etc
Can cut perforating vein to prevent backflow from deep veins
Arterial thrombosis cause?
Usually atheroma
Venous thrombosis cause?
Usually stasis with one other precipitating factor such as trauma, surgery, smoking, dehydration, inflammatory conditions
Identifying a DVT?
Swollen with oedema Pyrexia Tender Warmth Distended
Peripheral arterial disease chronic and acute?
Chronic can allow collateral arteries to develop around the obstructed artery
Acute doesn’t allow this to happen
Can lead to aortic aneurysm or atrial fibrillation
6 P’s of leg ischaemia?
Pain Pallor Paralysis Pulseless Perishing with cold Paraesthesia
What is ischaemia of a limb so dangerous and may require amputation?
Dead cells can leak potassium resulting in myocardial infarction
Chronic peripheral arterial disease?
Has similarities to coronary heart disease
Intermittent claudication is pain on exertion and relieved by rest similar to stable angina and is caused by atherosclerosis
Critical ischaemia comes with rest pain. May relieve by dangling leg from bed for gravity and heat relief. Untreated leads to ulceration, gangrene
Where can the lower limbs be palpated?
Femoral pulse
Popliteal pulse
Posterior tibial pulse behind medial malleolus
Dorsal pedis pulse
Doppler ultrasonography?
Echoes used to look at blood flow through veins and arteries and find potential occlusions
