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Y3 surg > vascular > Flashcards

vascular Flashcards

1
Q

What is chronic arterial insufficiency

A
  • Any condition that slows or stops the flow of blood through vessels
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2
Q

what is formed in angiogenesis / neoangiogenesis

A

collateral vessels

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3
Q
  • Peripheral arterial disease more common in
A

men in elderly

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4
Q

order of blood flow

A
  • Artery arteriole capillaries venule vein
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5
Q

layers of arteries

A
  • Intima -> media -> adventitia (innermost to outermost layer of arteries)
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6
Q

anatomy of leg arteries

A

L4 = aorta goes into r and l external iliac arteries
femoral and then popliteal artery
splits into anterior and posterior tibial, peroneal, dorsal pedal and plantar arch

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7
Q

Define Arteriosclerosis, arteriolosclerosis, and atherosclerosis

A
  • Arteriosclerosis- hardening of the arteries due to thickening of blood vessel wall (usually medium and large size arteries)
  • Arteriolosclerosis - small arteries (hyaline/hyperplastic) (caused by thinks like DM and HTN)
  • Atherosclerosis - hardening of arteries specifically due to build up of cholesterol and plauque in tunica intima
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8
Q

what process occurs alongside atherosclerosis

A

remodelling

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8
Q

Hypercalcaemia can cause what

A

monckeberg medial calcific sclerosis (tunica media)

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9
Q

Modifiable risk factors for arterial disease

A

high bp, smoking, DM, physical inactivity, obesity, high blood cholesterol

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10
Q

N-m risk factor for artery disease

A

race gender age

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11
Q

Fontane classification of PAD

A

I Asymptomatic
IIa Mild claudication
IIb Moderate-severe claudication
III Ischaemic rest pain
IV ulceration or gangrene

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12
Q

Main symptom of arterial disease

A

Intermittent claudication- cramp like pain. Arises after walking a set distance, relieved by standing still (unlike neuropathy), not present on first step (unlike OA)

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13
Q

IC common cause

A

Superficial femoral artery 70% of time

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14
Q

symptom location IC

A

generally have symptoms from joint above/below artery

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15
Q

Boyd’s classification

A
16
Q

3 main symptoms of CAI

A

Intermittent claudication, rest pain, Ulceration and gangrene (tissue loss)

17
Q

Describe rest pain

A

Occurs with limb at rest, felt in foot, worse when lying down and at night, improves with hanging foot out of bed, involvement of Vasa Nervosum, pressure of environment on foot makes it worse

18
Q

what is vasa nervosum

A

nerve endings in tunica adventitia- ischaemia causes severe pain

19
Q

What is critical stenosis

A

more than 70% occlusion

20
Q

which bacteria causes gas gangrene

A

clostridium perfringens

21
Q

3 types of gangrene

A

dry wet gas

22
Q

when do you get wet gangrene

A

superadded infection

23
Q

DATES meaning with regards to conservative management of lowering cholesterol

A

diet alcohol tobacco exercise and stress (avoid recreational drug use)

24
Q

strongest risk factors

A

non modifiable - age
modifiable - smoking

25
Q

Best medical therapy for PAD

A

Antiplatelets (clopidogrel), statins, PPI

26
Q

Platelet activation and clopidogrel

A

Clopidogrel inhibits ADP receptors in platelet activation

  • platelet adhesion to vascular injury
  • activation of platelets ADP increases expression of GPIIb/IIa receptors
  • Cross linking by fibrinogen
27
Q

Aspirin MOA

A

inhibits AA -> TXA2

28
Q

statin MOA

A

HMG-CoA reductase inhibition - decreased liver cholesterol, increased LDL receptor expression, decreased plasma LDL, decreased VLDL synthesis

29
Q

2 main long term conditions affecting PAD

A

DM and HTN

30
Q

Why are TEDS contraindicated in someone with chronic CAI

A

will compress the blood vessels further which may result in further ischaemia or occlusion

Get enoxaparin after vte risk assessment instead

31
Q

acute limb ischaemia important point for clinical examination

A

6 Ps

pallor, pain, paresthesia, paralysis, pulselessness, and poikilothermia

32
Q

2 surgical options for CAD

A

Bypass (create a graft to form a collateral channel) or angioplasty (balloon and stent)

33
Q

least likely to be involved in PAD

A

brachial artery

34
Q

only 2 parts of body not involved in peripheral artery disease

A

heart and aorta

35
Q

common or internal iliac PAD can cause

A

decreased blood supply to external genitalia = impotence

36
Q

Are anticoagulants part of BMT for PAD

A

no

37
Q
A

Y3 surg (14 decks)

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