Transcript of Part 1. Cause Thrombus (blood clot) Embolism Trauma Crush injuries.
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- Part 1
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- Cause Thrombus (blood clot) Embolism Trauma Crush injuries
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- Most Common location Femoral-Popliteal bifurcation
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- Measures Complete bed rest Systemic anti-coagulation therapy,
Thromboembolectomy Reconstructive arterial bypass surgery
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- Contraindicated Exercise Use of support hose Application of
direct heat
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- Also called Chronic occlusive arterial disease Peripheral
arterial occlusive disease Atherosclerotic occlusive disease
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- Accounts for 95% of all the arterial disorders Affecting the
lower extremities. Elderly patients men>women
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- Risk factors Elevated serum cholesterol ( 200 mg/dL) Smoking
High systolic blood pressure Obesity Diabetes
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- Atherosclerotic plaque formation.
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- Characterized by Chronic, progressive occlusion of the
peripheral circulation Most often in the large and medium arteries
of the lower extremities. Young male patients who smoke
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- An inflammatory reaction of the arteries to nicotine. Small
arteries of the feet and hands and progresses proximally. It
results in vasoconstriction, decreased arterial circulation to the
extremities, ischemia, and eventual ulceration and necrosis of soft
tissues.
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- The inflammatory reaction and resulting signs and symptoms can
be controlled if the patient stops smoking
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- Primary Raynauds syndrome Chronic, functional arterial disorder
Women>men Caused by an abnormality of the sympathetic nervous
system
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- Characterized by Digital vasospasm Affecting the small arteries
and arterioles of the fingers and sometimes the toes. Exposure to
cold, vibration, or stress. Temporary pallor (blanching), then
cyanosis and pain, followed by numbness and a cold sensation of the
digits.
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- Symptoms are relieved slowly by warmth
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- Raynauds disease Idiopathic (primary) Raynauds Phenomenon
Secondary Scleroderma, systemic lupus erythematosus, systemic
sclerosis, or vasculitis
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- Diminished or Absent Peripheral Pulses Collateral
circulation
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- Integumentary Changes Skin discoloration Pallor (elevated), in
rest or after exercise Reactive hyperemia (lowered after elevated)
Trophic changes (shiny, waxy, dryness, loss of hair Skin
temperature ? Ulcerations (weight bearing, bony)
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- Sensory Disturbances
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- Exercise pain Intermittent claudication Early: feeling of
fatigue or weakness Later: cramping or aching in the muscles Does
not occur With extended periods of standing (as seen with spinal
stenosis) With prolonged sitting (as seen with sciatica) One limb
or both??
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- Burning, tingling sensation At night?? Heart rate and volume of
blood flow to the extremities decreases with rest Relief of pain,
if the leg is placed in a dependent
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- Weakness Atrophy loss of motor function Pain Weakness
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