Peripheral vascular disease ppt

Question 1

What is PVD?

Answer 1

Circulatory problems in vascular structures that are peripheral to the heart

Question 2

Vascular structures involved in PVD

Answer 2

Arteries

Veins

Lymphatic structures

Question 3

Components of Tunica media

Answer 3

concentric ring of elastic membrane surrounded by smooth muscle

Question 4

arteries: where is there more/less elasticity?

Answer 4

closer to the heart, more elastic (aorta)

farther from the heart, more muscular, less elastic (arterioles)

Question 5

final branching of arteries

Answer 5

capillary beds gas exchange

Question 6

How do veins compare to arteries?

Answer 6

1. walls less distinct
2. walls of veins are thinner
3. less smooth muscle and elastic tissue
4. lower pressure
5. valves

Question 7

capillary beds and lymph

Answer 7

intertwined

Question 8

Why do lymph nodes enlarge when you’re sick?

Answer 8

They’re having to work harder

Question 9

Where do capillaries and peripheral plexuses begin?

Answer 9

blindly in intercellular spaces

Question 10

plexuses

Answer 10

joining of capillaries

Question 11

collecting ducts

Answer 11

follow veins to lymph nodes

multiple layers

thin walls

Question 12

What do lymph nodes do?

Answer 12

filter lymph of unwanted waste products

lymph is returned to the circulatory system through the vena cava

Question 13

What is arteriosclerosis obliterans?

Answer 13

chronic arterial insufficiency associated with atherosclerosis

Question 14

progression of arteriosclerosis obliterans

Answer 14

1. acute occlusion
2. chronic occlusion

Question 15

Series of events that leads to vascular pathology

Answer 15

1. endothelial damage
2. entry of irritants into subendothelium
3. inflammatory response
4. plaque formation

Question 16

What types of irritants make their way into the subendothelium after the endothelium is damaged?

Answer 16

oxidized LDL

monocytes

Question 17

cytokines

Answer 17

chemicals involved in the inflammatory response

Question 18

What is involved in the inflammatory response in the vessel?

Answer 18

cytokines

smooth muscle cells from tunica media

Question 19

What does -oma stand for?

Answer 19

anything with -oma at the end is a tumor could be benign or malignant

Question 20

atheroma formation

Answer 20

macrophage → foam cells → atheroma in the vessel

Question 21

outcomes of endothelial dysfunction

Answer 21

1. stable atherosclerotic narrowing lesions
2. acute plaque rupture

Question 22

Fatty Streaks aka _______

Answer 22

stable atherosclerotic narrowing lesions

Question 23

What are fatty streaks?

Answer 23

chronic condition - inability to vasodilate

~gradual symptoms: angina, decreased activity tolerance

~symptoms untreated: MI

Question 24

acute plaque rupture

Answer 24

1. plaque destabilization
2. acute condition → thrombus formation

Question 25

acute plaque rupture How is the plaque destabilized?

Answer 25

MMPs disrupt fibrous cap

Question 26

acute plaque rupture thrombus formation →

Answer 26

rapid onset of symptoms MI

Question 27

stable vs unstable angina

Answer 27

1. stable: predictable 2. unstable: chest pain that doesn't resolve with rest = medical emergency

Question 28

rupture of fibrous cap

Answer 28

1. embolic fragment into the blood stream 2. coagulation, hemmorhage, and thrombus at lesion site 3. weakening of the vessel resulting in an aneurysm

Question 29

aneurysm

Answer 29

out pouching of the vessel wall

Question 30

acute occlusion S/S

Answer 30

Sudden onset 1. Severe pain, coldness, numbness and pallor 2. Absent pulses distal to obstruction 3. Possible sensory and motor loss (lack of O2 to the neurons long enough)

Question 31

Acute occlusion pain

Answer 31

rarely occurs on both sides at the same time

Question 32

chronic occlusion early asymptomatic stage

Answer 32

1. collateral circulation develops 2. anastamoses

Question 33

anastamoses

Answer 33

adjacent blood vessels share blood supply rather than growing new vasculature around the area

Question 34

chronic occlusion intermittent claudication Where does tissue ischemia occur?

Answer 34

1. Femoro-popliteal junction = calf pain 2. Aorto-iliac block = hip, buttock pain 3. Tibial block = foot pain

Question 35

chronic occlusion in upper extremities

Answer 35

rare except in the case of paraplegics

Question 36

chronic occlusion rest pain (during sleep)

Answer 36

During sleep- vasodilatation systemically however occlusion prevents flow to area Pain wakes patient, dangling foot relieves pain

Question 37

chronic occlusion signs of advancing disease

Answer 37

1. Skin changes-rubor 2. Swelling 3. Decreased nail growth

Question 38

chronic occlusion gangrene: definition and causes

Answer 38

necrobiosis: tissue death and rotting 1. full vessel occlusion 2. infection 3. trauma (burns, frostbite, electrocution) 4. drop in distal arterial pressure

Question 39

chronic occlusion and ABI clinical significance

Answer 39

≥ 1.0 = normal 0.8 – 1.0 = mild PVD, compression therapy with caution 0.5 – 0.8 = PVD, refer to MD, compression therapy contraindicated

Question 40

chronic occlusion and compression

Answer 40

Can wrap wounds with minimal compression. Compromise healing process if you cut off blood supply to the wound.

Question 41

Buerger's disease Who is susceptible?

Answer 41

- heavy smokers - young males 20-40

Question 42

Buerger's disease

Answer 42

- Occlusion of small and medium vessels - Proximal vessels normal distal occlusion - Defined point of occlusion -Both UE’s and LE’s can be affected - Rest pain, distal limbs red, nails deformed, skin is thin, toes may be blue