Vascular Flashcards
(26 cards)
What are signs of irreversible leg ischaemia / infarction?
Mottled, tender muscle, motor / sensory signs, major necrosis. Doppler ankle pressure is usually <50mmHg
How is peripheral vascular disease classified?
The Fontaine classification (1 - asymptomatic, 2 - intermittent clarification, 3 - rest pain, 4 - necrosis / gangrene)
What is Leriche’s syndrome?
Triad of reduced femoral pulses, Buttock pain and impotence. Caused by problems at abdo aprta or both of iliac arteries.
What is Buerger’s disease?
Young males who smoke heavily develop inflammation of the vessels, leading to swelling and occlusion with clots.
On this angiogram, what are the labelled vessels?
http://img.medscapestatic.com/pi/meds/ckb/61/23261tn.jpg
A - popliteal artery
B - anterior tibial
D - peritoneal
E - posterior tibial
What are the 4 intervention options for peripheral vascular disease in the legs?
Percutaneous angioplasty +/- stent
Endarterectomy (common femoral)
Bypass graft
Amputation
What are the 6 Ps of acute lung ischaemia?
Pain, paraesthesiae, perishingly cold, pallor, paralysis, pulseless.
Signs of a dead leg?
Mottling and complete neuro defector
Treatment of acute limb ischaemia?
Heparin if recovering, thrombolysis or embolectomy if not.
What is a complication of reperfusing an acutely ischaemic leg?
Sudden release of toxic metabolites, causes oedema which leads to compartment syndrome.
What is an ulcer?
It is a break in an epithelised surface through all the layers.
Risk factors for venous ulcer?
DVT, veinous insufficiency, over-weight, RHF, trauma.
Sloughy ulcer in medial gaiter region?
Venous.
How do you treat venous ulcers?
Swab and clean it. Compression stockings after ABPI confirming no arterial disease
Punched out, painless ulcer which is surrounded by callous?
Neuropathic
Punched out ulcer which is penetrating, painful and ground on pressure founds (between toes, medial aspect of ankle)
Arterial
How do you treat arterial ulcers?
Dress (but not compression bandage), analgesia and manage cardiovascular risk factors.
What vein runs down mid-line of calf and can become varicose?
Small saphenous
What vein runs in the medial aspect of the upper thigh and can become varicose?
Great saphenous vein.
What are varicose veins?
Long, dilated, tortuous veins of the superficial venous system.
How does blood usually flow from
Superficial to deep system?
Perforator veins, sapheno-femoral junction and sapheno-popliteal junctions.
What symptoms can varicose veins have?
Pain, heaviness, tingling, itching. Generally worse at the end of the day.
How are varicose veins classified?
The CEAP classification C0 no signs C1 reticular veins / telangevtasias C2 VV with no complications C3 VV with oedema C4 VV with haemosiderin deposition or lipodetmatosclerosis or eczema C5 healed venous ulcer C6 active ulceration
Treatment for varicose veins?
Conservative - weight loss, avoid prolonged standing
Surgical - radio frequency abalafion, endovascular laser ablation, injection sclerotherapy (liquid sclerosant> foam sclerosant), open surgery.
