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Level 5 Fundamentals > Perioheral Vascular Disease > Flashcards

Perioheral Vascular Disease Flashcards

1
Q

Hyperlipidemia

A

Plaque formation

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2
Q

Hypertension

A

Narrowing of vessels, creates resistance to flow

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3
Q

Diabetes

A

High glucose levels damage blood vessels

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4
Q

Obesity

A

Increased body mass=decreased tissue perfusion

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5
Q

High cholesterol

A

Clogging of vessels

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6
Q

Genetic predisposition

A

Family history

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7
Q

Aging

A

Vessels get weaker and less pliable

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8
Q

Assessment

A
  • pain
  • pallor
  • pulses
  • parenthesias
  • paralysis
  • poikilothermy:coolness to touch
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9
Q

Intermittent claudication

A
  • severe cramping and pain of extremities,happens during activity
  • stage 2 of PVD
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10
Q

Persistent pain at rest

A
  • Sign of stage 3 of PVD

- if pain is prolonged it may feel as if it has gone away due to nerve damage

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11
Q

Homan’s sign

A
  • Calf pain with dorsiflexion of foot
  • suggestive of thrombophlebitis
  • not considered reliable
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12
Q

Changes in skin appearance(pallor) & temperature (poikilothermy)

A
  • may be unilateral or bilateral
  • Adequate blood flow appears rosy in color and feels warm
  • decreased blood flow feels cool and can appear rubor or cyanotic
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13
Q

Rubor

A

Reddish blue color, occurs a few seconds to minutes after that extremity is dependent

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14
Q

Cyanosis

A

Amount of oxygen reduced in the circulation

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15
Q

Other changes in extremities

A
  • loss of hair
  • brittle or thickened nails
  • dry or scaling skin
  • atrophy
  • ulcerations
  • edema
  • gangrene:prolonged severe ischemia that results in necrosis
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16
Q

Pulses

A
  • presence or absence is important
  • quality(+1,+2,+3)
  • changes are important
  • if there is an absent pulse there is probably an obstruction near that site
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17
Q

Paresthesias

A
  • tingling or crawling sensation
  • pins and needles
  • blood is being diverted away from peripheral nerves
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18
Q

Paralysis

A
  • results from severe ischemia

- not often seen

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19
Q

Plaque

A

Accumulation of lipids lining a vessels wall

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20
Q

Thrombus

A

Blood clot

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21
Q

Embolus

A

Mass that is inside of a vessel and can move

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22
Q

Common diagnostic tests done for PVD

A
  • Doppler
  • stress test(treadmill) looking at the body on how they respond to activity
  • MRI and CT
  • veinograms
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23
Q

PAD peripheral arterial disease

A

Arteriosclerosis

Atherosclerosis

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24
Q

Arteriosclerosis

A
  • hardening of the arteries
  • loss of elasticity
  • mostly small arteries& arterioles
  • becomes thicker and less pliable
  • seen most often in carotid arteries, coronary arteries, and renal arteries
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25
Q

Atherosclerosis

A
  • formation of plaque within arterial wall
  • a form of arteriosclerosis
  • mostly in main arteries
  • generalized process in intima of arteries(inner)
  • accumulation of plaque
  • leading factor of cardiovascular disease
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26
Q

Sudden arterial occlusion

A
  • Sudden blockage of blood flow

- leads to profound(often reversible) ischemia and tissue death

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27
Q

Gradual arterial occlusion

A
  • Slow build up of plaque and narrowing of artery

- Leads to development of collateral circulation: new vessels that grow to compensate where blood is not being delivered

28
Q

Common sites of atherosclerotic obstruction in major sites

A
  • renal arteries
  • carotid arteries
  • popliteal
  • coronary arteries
29
Q

Non-surgical management of arterial disease

A
  • exercises
  • positioning: legs to be supported and elevated at or below level of heart
  • promoting vasodilation
  • percutaneous transluminal angioplasty
  • laser assisted angioplasty
  • atherectomy
30
Q

Percutaneous transluminal angioplasty

A

Balloon that will open that vessel

31
Q

Laser assisted angioplasty

A

Laser to open up the vessel

32
Q

Atherectomy

A

Removal of the plaque narrowing the vessel, by use of catheter

33
Q

Smoking

A

Nicotine is a vasoconstrictor

34
Q

Arterial revascularization

A
  • Take a grapht and rerouted around the occluded vessel
35
Q

Inflow

A
  • Inflow: obstruction involving the distal end of the aorta to the iliac arteries
  • bypass ABOVE the superficial femoral arteries
36
Q

Outflow

A

Obstructions involving the femoral, popliteal, and tibial arteries

  • bypass is BELOW the superficial femoral arteries
37
Q

Thrombectomy

A

Invasive removal of a clot

38
Q

Important assessment data after any vascular surgery

A
  • check incision site for bleeding
  • color
  • distal pulses: pulses below surgical site
  • edema
  • mobility
  • sensation
  • temperature
39
Q

Aneurysms

A
  • Weakness or herniated area of vessel wall

- at risk for a rupture of vessel

40
Q

Peripheral venous disease

A

Venous alterations caused by:

  • obstruction of vein by thrombus
  • incompetent venous valves
  • reduction in effectiveness of pumping actions of surrounding muscles
41
Q

Edematous tissue

A

Decrease in veinous flow leads to edema

Edematous tissue cannot receive adequate nutrition, it can lead to infection in the extremities

42
Q

High risk for thrombophlebitis

A

Bed rest, MI, CHF, SEPSIS, Traction, general surgery in patients over 40

43
Q

Treatment for thrombophlebitis

A
  • bed rest: prevent movement of clot is broken apart, it could move breakage to more severe area
  • elevate extremities
  • inferior vena cava filtration
  • thrombectomy
44
Q

Varicose veins

A

Distended protruding veins, can be superficial or deep inside of the tissue (deep are usually more painful)

45
Q

Invasive treatment of varicose veins

A
  • vein ligation and stripping
  • sclerotherapy: injecting an irritating chemical into that vein causing it to occlude
  • endovenous ablation laser treatment or radio frequency
46
Q

Arterial ischemic ulcer

A
  • Caused by chronic occlusion of small arterioles and the arteries
  • results in skin breakdown and ulceration
47
Q

Venous stasis ulcer

A
  • caused by venous blood pooling in tissues of extremities

- pooling provides medium for bacterial growth, causing skin lesions and infections

48
Q

Unfractionated heparin therapy

A
  • often given subcut or IV
  • has a shorter half life
  • faster absorption rate
49
Q

Low molecular weight heparin

A
  • ex: lovenox
  • preferred for prevention of DVT
  • typically 1 mg per 1kg body weight
  • longer half life
50
Q

PTT

A

Partial thromboplastin time

-checking clotting cascades

51
Q

APTT

A

Activated Partial Thromboplastin Time

52
Q

Anti-factor Xa test

A
  • looking at factor X in the blood
  • therapeutic range is 0.1-1 if on heparin

-on low molecular weight heparin 0.3-0.7

53
Q

Important when giving heparin

A
  • watch for signs of bleeding

- be aware of any other medications patient may be recieving with anti-coagulant effects

54
Q

Antidote for heparin

A

Protamine Sulfate

55
Q

PT

A

-prothrombin time
-normal value: 11-16 seconds
-

56
Q

Antidote for Coumadin

A

Vitamin K

57
Q

Decrease in venous congestion

A
  • elevate Lower extremities
  • discourage smoking
  • avoid emotional stress
  • avoid constrictive clothing
  • avoid leg crossing
  • patient should test bath water and and avoid heating pads
58
Q

INR

A

1.5-2.0

Contact practitioner if 4.0 or higher

59
Q

Prothrombin time

A

Normal value 11-16 seconds

Desired value is 1 1/2 times control value

60
Q

Virchows triad

A

-factors that cause clots to develop

  • stasis of blood
  • injury to vessel wall
  • altered blood coagulation
61
Q

Lymphatic system

A
  • consists of a set of vessels that spread throughout most of the body
  • not from heart but back toward heart
62
Q

Lymph nodes

A

Act as filters keeping matter, especially bacteria, from gaining entrance to blood stream

63
Q

Lymphangitis

A

Acute inflammation of the lymphatic channels

64
Q

Lymphadenitis

A

Enlarged inflamed lymph nodes

65
Q

Lymphedema

A

-an abnormal collection of excessive tissue proteins, edema, chronic inflammation, and fibrosis

66
Q

Primary Lymphedema

A

Abnormality in the lymph system

67
Q

Secondary Lymphedema

A

Due to an injury or surgical reasoning

Level 5 Fundamentals (8 decks)

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