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What does ASO stand for?
What is ASO?
The term that is used to describe atherosclerosis, which is the most common cause of chronic occlusion in the Western World.
What are the 6 P's of acute arterial disease?
- 1.) pain
- 2.) pulselessness
- 3.) Pallor-whitish color
- 4.) Polar or Poikilothermia
- 5.) Parathesia- loss of feeling or tingling
- 6.) Paresis- loss of motor ability
What are the 7 trophic changes that occur with chronic arterial disease?
- 1.) loss of hair on feet
- 2.) thickening of toe nails
- 3.) shining tone to skin
- 4.) Polar-Poikilothermia
- 5.) NO palpable pulse
- 6.) Dry, flaking skin and nails
- 7.) Dependent Rubor
What is Atherosclerosis?
fatty deposits in vessel- plaque
Intimal cells are damaged.
Most common form of chronic occlusion disease
What is Arteriosclerosis?
hardening of the arteries which cause loss of compliance.
Multiple disease processes.
Define rest pain. (3)
Pain that usually occurs at night and is often severe.
Usually involves the distal foot and toes.
Define Intermittent claudication. (3)
Pain with exercise, relieved with rest. Pain within a muscle group.
Usually single level disease.
Define instep claudication. (3)
Pain located in the foot.
More severe than intermittent claudication.
Define pseudoclaudiation. (4)
Symptoms are similar to true claudiation but vascular blood flow is okay.
Not constant or reproductive
Can be caused by osteoarthritis, neuropathy, nerves.
What makes Claudication true?
it is constant and reproducable
Meaning the walk-pain-rest cycle does not vary day to day.
Ulcers or death of tissue due to absence of blood supply.
What is the most common site of peripheral arterial disease?
Distal superficial femoral (SFA), Hunter's canal and extends into proximal popliteal artery
What is the 2nd most common site for the non-diabetic?
aortoiliac segments- Inflow disease
What is the 2nd most common site for the diabetic?
Calf vessels- Runoff Disease (everything below popliteal artery
What does TAO stand for?
What is TAO?
Thromboangiitis obliterans or Buerger's Disease
Chronic vascular disease found in young, male smokers that involves medium to small sized arteries. Inflammation in the artery that sets off a thrombus formation obstruction.
Where is the most common place in the upper extremity for atherosclerotic occlusive disease to occur?
Subclavian A. proximal to vertebral A.
Left side more prone than right.
What are the symptoms of Subclavian STeal?
Asymptomatic but if symptomatic- posterior circulation symptoms
What are the health history questions for lower arterial segmental testing? (14)
1.) What brings you in today?
- 2.) Are you experiencing any pain in your legs?
- 3.) Hx of TIA/CVA
- 4.) Hypertension and meds
- 5.) Hyperlipidemia and meds
- 6.) Diabetes and meds
- 7.) Tobacco use
- 8.) Any surgeries? Stents or grafts?
- 9.) Obesity
- 10.) Blood thinners?
- 11.) Hx of CAD
- 12.) Hx of PVD
- 13.) Any heart disease? Heart attack?
- 14.) Look for: color changes, ulcers, gangrene
What is the difference between TIA and CVA?
TIA lasts less than 24 hours
CVA last greater than 24 hours
What vessels are involved with anterior circulation?
Anterior communicating A.
Anterior cerebral A.
Middle cerebral A.
What vessels are involved with posterior circulation?
Posterior communication A.
Posterior Cerebral A.
What are the 6 signs and symptoms of anterior circulation?
- 1.) Monocular visual disturbances- loss of vision in one eye.
- 2.) Amaurosis Fugax- shade being pulled over eye.
- 3.) Aphasia- without speech or unable to communicate
- 4.) Mono or hemiparesthesia- 1 sided numbness
- 5.) Mono or hemiparesis- 1 sided paralysis
- 6.) Homonymous hemianopia/hemianopsia- partial loss of visual field in both eyes.
What are the 9 signs and symptoms of posterior circulation?
- 1.) Homonymous hemianopia/hemianopsia- partial loss of visual field in both eyes.
- 2.) Paraesthesias of any or all extremities- numbness, tingling sensation in both arms or both legs.
- 3.) Paresis of any or all extremities- paralysis
- 4.) Ataxia- gait disturbance
- 5.) Drop attacks- sudden musculature weakness, do not lose consciousness
- 6.) Diplopia- Double vision- bilateral visual blurring
- 7.) Dysphagia- difficultly in swallowing
- 8.) Dysarthria- difficultly with speech due to problem with tongue and muscles we use for speech.
- 9.) Vertigo- spinning sensation
If a patient is experiencing monocular visual disturbance where should you look first?
ICA and Ophthalmic A.
What are the characteristics of arterial ulcers?
Color of leg:
- Location: toes, heel, foot
- Pain: Severe
- Pulse: NO palpable pulse
- Color of leg: Blue/Black
- Ulcer bed: Dry edges are irregular
- Temperature: Cool, cold
- Associated findings: Trophic changes