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Pathology > Vascular Disease > Flashcards

Vascular Disease Flashcards

1
Q

what is the key difference in arteriole structure, venule structure and capillaries

A
  • arteriole have 3 tunica
  • venules only feature a tunica intima
  • capillaries consist of single epithelium
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2
Q

where does dorsalis pedis pass deep into the foot, and what does it join

A

between the first and second metatarsals, to join the lateral plantar artery (plantar arch)

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3
Q

what does dorsalis pedis branch into

A
  • lateral tarsal arterty
  • arcuate artery
  • 1st dorsal metatarsal artery
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4
Q

where does the dorsal venous arch drain

A

the great saphenous vein (medially) and
the small saphenous vein (laterally)

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5
Q

what are typical venous pressures

A
  • ankle, suppine 10-25 mmHg
  • ankle, standing 90 mmHg
  • ambulatory pressure - 250 mmHg
  • sustained exercise - 25-39 mmHg
  • 40 secs to return to normal after exercise
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6
Q

what diseases are included in periferal vascular disease

A
  • periferal arterial disease
  • atherosclerosis
  • Buerger’s disease
  • Raunaud’s disease
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7
Q

what is atherosclerosis

A

the build up of fatty plaques in vessels

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8
Q

what is Virchow’s triad

A
  1. stasis of blood flow
  2. endothelial injury
  3. hypercoagulability
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9
Q

what factors contribute to atherosclerosis

A
  • smoking
  • hypertension
  • DM
  • obesity
  • sedentary lifestyle
  • high cholesterol
  • stress
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10
Q

where is the most common site for an annurism in the lower limb

A

popliteal area

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11
Q

key points of Buerger’s disease

A
  1. males 25-40
  2. commonly lower limb
  3. greater prevalence in HLA A9 and B5
  4. sometimes anti-collagen antibodies
  5. affects small - med arteries and veins
  6. strong association with heavy tobacco use
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12
Q

what causes varicose veins

A
  • valve weakness
  • pelvic tumours (pregnancy)
  • obesity
  • standing jobs
  • trauma
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13
Q

what are the objective symptoms of varicose veins

A
  • aching
  • pain and oedema, alleviated by elevation
  • apparent on standing
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14
Q

what are the subjective symptoms of varicose veins

A
  • fatigue, leg heaviness
  • nocturnal cramps
  • claudication
  • pain from stasis dermatitis
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15
Q

observations of varicose veins

A
  • teliangectasia (spider veins)
  • oedema
  • family history
  • leg ulcers
  • history of PE
  • pigmentation
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16
Q

key points of venous ulcers

A
  • 85% of all leg ulcers
  • more common in women
  • gaiter area
  • inverted champagne bottle
17
Q

appearance of venous ulcers

A
  • swollen, diffuse, shallow
  • irregular border
  • necrosis
  • painful if infected
  • indolent
  • malignant changes
18
Q

trendellenberg test

A
  • soft rubber cuff applied below the knee when patient is supine
  • when patient stands - immediate filling means perforators are incompetant
  • filling from top down means superficial veins are incompetant
19
Q

perthe’s test

A
  • standing patient, cuff below knee
  • plantarflex foot repeatedly
  • periferal veins should be empty
  • (if not, indicate incompetant perforators)
20
Q

PHLEBOTHROMBOSIS

A

simple clotting in the blood vessel

21
Q

problems with thrombosis

A
  • PE
  • common in lower limb
  • circulatory stasis
  • injury to vessel wall
  • increased coaguability
22
Q

DVT

A
  • usually in soleal arcade
  • may resolve
  • can lead to obstruction
  • can lead to phlebitic limb
23
Q

clinical features of thrombsis

A
  • painful, swelling
  • may be silent in younger patients
  • discomfort in calf on walking
24
Q

clinical features of post phlevitic syndrome

A
  • nocturnal leg cramps
  • necrosis
  • claudication
  • swelling
  • varicosities
  • pigmentation
  • chronic indurated cellulitis
  • stasisdermatitis
  • venous stasis ulceration
25
Q

management of venous disorders

A
  • support hoisery
  • weight reduction
  • emollients
  • rest with feet up
  • protect prominent veins
26
Q

surgical interventions for venous disorders

A
  • injection sclerotherapy
  • ligation (tying) and stripping
27
Q

management of patients with venous disorders

A
  1. analgesics
  2. antibiotics
  3. anti-inflammatory drugs
  4. anticoagulents
28
Q

management of patients with DVT

A
  • refer ASAP, 999, avoid walking
  • hospitalisation, bed rest
  • drug therapy
29
Q

signs and symptom vascular

A
  • temperature
  • colour
  • skin appendages
  • skin texture
  • visual angina etc
  • claudication distance
  • rest pain
30
Q

vascular tests

A
  • pulses
  • reperfusion time
  • doppler sounds
  • ABPI
  • pole test
  • toe pressures
  • plethsmography
  • angiograms
31
Q

vascular tests

A
  • pulses
  • reperfusion time
  • doppler sounds
  • ABPI
  • pole test
  • toe pressures
  • plethsmography
  • angiograms
32
Q

what are the 6P’s of ischemia/PVD

A
  1. pallor
  2. pain
  3. parasthesia
  4. perishing cold
  5. pulselessness
  6. paralysis
33
Q

what other signs of PVD

A
  • arterial/ischemic ulcers - dry punched out
  • swelling
  • claudication of larger muscles
  • night pain
  • rest pain
  • shiny skins
  • lack of hair
  • atrophic skin
  • distance claudication
34
Q

how to assess PVD

A
  • visual assessment
  • doppler
  • capillary refil test
  • ABPI (0.9-1.2)
  • medical history
  • lifestyle
  • angiogram
  • toe pressures
  • poles test
  • beurgers elevation test - 30°
35
Q

how does venous disease present

A
  • varicose veins - painful, heavy
  • pitting oedema
  • anhidrotic and puritis
  • leg fatigue
  • reduced mobility
  • wet, moth-eaten ulcers
  • venous eczema
  • telangiectasia (spider veins)
  • fibrosis of skin
  • lipodermtosclerosis
  • heamosiderosis
  • indolent
  • reduced skin integrity
36
Q

venous assessment

A
  1. dopler venous flow
  2. venogram - imaging
  3. ultrasound
  4. pitting oedema

Pathology (10 decks)

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