Vascular Disorders

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Vascular Disorders
2011-03-05 22:55:36
Patho Test Two

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  1. Describe Hypertension
    • BP consistenly greater than 140/90
    • Insidious onset with mild symptoms
    • people don't know they have it until something major happens
  2. List the Three different types of HTN
    • primary (essential)
    • Secondary: related to disease (rental)
    • Malignant: uncontrollablem, severe, with mnay complications
  3. What does HTN do to the arteries
    damages arterial wall, atheromas form, aneurysms, dilate or tear
  4. Etiology and S&S of HTN
    • risk factors as discuessed for CAD, NA+ intake stress
    • S&S: asymptomatic untill well advanced, then fatigue, malaise, AM HA, can cuase complications
  5. Treatment for HTN
    • Lifestyle changes: decrease salt intake, exercise, decrease body weight, decrease stress
    • Meds: diuretics, antihypertensive meds
    • Implications for functional abilites
    • Needs to moitor BP and rest and with exercise
    • sideeffects of meds
    • Prognosis: more likely to develop CAd stroke and kidney failure
  6. Define Arteriosclerosis
    generalized term used for all types of arterial changes
  7. Define PVD
    any abnormallity in the arteries or veins outside the heart
  8. Atherosclerosis
    gradual formation of fatty plaque
  9. PVD and Atherosclerosis pathology
    • formation of atheroma cuts off blood flow
    • Most common sites: abdominal aorta, femoral and iliac
    • Partial Occlusion: implaired motor and sensory function in LE's
    • Complete occlusion: loss of blood supply to the limb= necrosis, ulcers, gangrene
  10. S&S of PVD
    • fatigues weakness in LE's as blood flow decreases
    • INtermittent claudication - pain at rest
    • Sensory impairments tingling buring numb decreases peripheral pulses
    • Skin is pale when extremity elevated red when dependent
    • Skin is dry, hairless, feels COLD
    • POOR healing ability
  11. Diagnosis of PVD
    • Doppler studies
    • Arteriography
    • Plethysmorgaphy
  12. Treatment for PVD
    • Conservative
    • Lifestyle modificiations: decrease cholesterol, quit smoking, midify stress, keep LE's in dependent position to increase arterial blood flow, avoid trauma, regular exericse, examine feet
    • Medications: anticoagulants, peripheral vasodilators
    • Surgiacal
    • Bypass grafts, angioplasty, endarterectomy, amputation
    • During PT
    • care must be taken be avoid any skin trauma
    • regular examination of the feet especially if sensory loss
    • special fitted shoes
  13. Buergers disease
    • inflamm of medium and small vessels in legs and arms from nicotine
    • inflammation thrombus occlusion similar to atheromas
    • severe pain eeven at reast can lead to ulcers and gangrene
    • smoking has a role in the inflammaotry process may also be related to an immune system defect
  14. Raynauds Syndrome
    Vasospasm with exposure to cold stress or smoking
  15. Patho and Etiology of Aneurysms
    • Patho: Localized dilitation of arterial wall can rupture causing massive hemorrhage
    • Etiology: atherosclerosis, trauma congenital defects in arterial wall
  16. S&S of Aneurysms
    • Asymptomatic until very large
    • can cause sym related to compression of nearby structures
    • if it ruptures severe pain, shock - loss of pulses - death
  17. Diagnosis and Treatment of Aneurysms
    • Diagnosis: x-ray, us CT scan
    • Treatment: if detected before rupture maintain normal blood pressure, prepare for surgery to resect graft clip.
    • Implication for functional activity: may see pt for PT post surgery. Monitor BP ICP
  18. Varicose Veins Patho and Etiology
    • Patho: irregular, dilated tortuous areas of superficial/ deep veins (legs, esophagus, ructum) defect in valves or weakness of vein walls. Can increase incidence of thrombus
    • Etiology: familial tendency, trauma, IV fluids, long term standing crossing legs, tight clothing. pregnancy
  19. Varicose Veins S&S and Treatment
    • S&S
    • bluish purple bulging circles
    • edema in feet
    • fatigues and achiness
    • Treatment
    • Elevate legs, use of support stockings
    • Eliminate precipitating factors
    • Use muscle contraction
    • Surgical Stripping
  20. Thrombophlebitis or Phlebothrombosis patho and factors
    • Pathology: inflammtion, thrombis formation in a vein
    • Factors: stasis or sluggish blood flow (immobility)
    • Endothelial injury (trauma, chemial injury)
    • Increased coagulabilty (cancer, dehydration)
  21. Thrombophlebitis or Phlebothrombosis S&S and Treatment
    • Superficial: aching tender, warm, red
    • Deep (DVT): pain, tenderness, edema, positvie homans sings (doris flex increase pain
    • Treatment: preventions
    • Exercise, Elevate Legs, Elastic stocking and or sequential compression device
    • Anticoaguland Meds
  22. Types of Shock
    • Hypovolemic: loss of blood volume
    • Cardiogenic: inability of heart to pump blood through circulation
    • Neurogenic: Pooling of blood in periphery (pain, fear, drugs, SCI-loss of SNS input)
    • Anaphylactic: