Term
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Definition
- ratio of the anke systolic pressure to the brachial systolic pressur
- measures arterial disease that provides quantification of degree of stenosis
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Term
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Definition
- proces whereby the muscle fibers and endothelial lining of small arteries and arterioles thicken
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Term
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Definition
- inflammatory process involving accumulation of lipids, calcium, blood componenets and carbs on the intima layer of the large artery
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Term
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Definition
- an invasive procedure that uses a balloon-tipped catheter to dilate a stenotic area of a blood vessel
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Term
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Definition
- combines B-mode grayscale imaging of tissue organs and vessels with capabilities of estimating velocity changes by the use of the pulsed Doppler
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Term
| Characteristics of Arterial Insufficiency |
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Definition
- sharp, unrelenting constant pain
- dependant rubor, loss of hair over feet, nails thicken
- diminished or absent pulses
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Term
| Characteristics of Venous Insufficiency |
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Definition
- aching, cramping pain
- pulses are present, but can be hard to palpate
- skin is thick and tough, may be reddish blue
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Term
| Intermittent Claudication |
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Definition
- pain, discomfort or fatigue caused by the inability of the arteries to support adequate blood flow to the tissues
- pain is majoritively felt upon movement or physical activity
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Term
| Rubor may be observed w/in _____ to _____ after the extremity is placed in a dependent position. |
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Definition
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Term
| If a pulse cannot be palpated, always palpate the pulse _____ to the site. |
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Definition
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Term
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Definition
- Normal ABI - 1.0
- Claudicated ABI - 0.90 - 0.50
- Ischemic ABI - less than 0.50
- Severe Ischemic and tissue loss ABI - 0.40 or less
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Term
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Definition
- used to diagnose: occlusive arterial disease r/t surgery, aneurysm
- inject radiopaque contrast agent to visualize the vessels
- the patient may experience a warm sensation, irritation from the needle
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Term
| Magnetic Resonance Angiography |
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Definition
- MRI programmed to isolate blood vessels
- contraindicated in metal implants, tattoos
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Term
| Contrast Phlebography (Venography) |
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Definition
- injection of radiopaque isotope to diagnosis if thrombus is present
- if present, segment of vein will show up unfilled
- injection may cause inflammation and be briefly painful
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Term
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Definition
- injection of radioactive colloid SC into second interdigital space
- exercise the limb to facilitate the colloid by the lymphatic system and images are obtained
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Term
| If there a lymphatic leak r/t lymphoscintigraphy, what color is the drainage? |
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Definition
- blue from the incision; clearing the system takes days
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Term
| What is the most common disease of the arteries? |
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Definition
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Term
| Pathophysiology of Atherosclerosis |
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Definition
- caused by malnutrition and fibrosis of organs w/o sufficient blood
- tissue cells needs sufficient nutrients, w/ reduction --> fibrous ---> impairs blood flow
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Term
| Where does atherosclerosis commonly develop? |
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Definition
- where arteries branch into smaller vessels
- males have more below the knee, women above the knee
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Term
| Atherosclerosis: Fatty Streaks |
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Definition
- yellow and smooth, protrude slightly from the artery and composed of lipids
- can be found in all age groups
- do not usually cause clinical symptoms
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Term
| Atherosclerosis: Fibrous plaques |
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Definition
- composed of smooth muscle, collagen, plasma and lipids
- white and yellow and protrude into various degrees of the artery; can completely obstruct
- mostly in abdominal, popliteal, coronary and internal coratid arteries
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Term
| Modifiable Risks of Atherosclerosis and PAD |
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Definition
- nicotine use
- diet
- HTN
- Diabetes
- stress, sedentary lifestyle
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Term
| Nonmodifiable risks of Atherosclerosis and PAD |
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Definition
- increasing age
- female gender
- familial predisposition/genetics
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Term
| Inflow procedure vs. Outflow procedure |
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Definition
- Inflow - improve blood supply from the aorta into the femoral artery; diseases of the aorta
- Outflow - provide blood supply to vessels below the femoral artery; diseases of the peripheral arterial occlusive
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Term
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Definition
- keep lower extremities in neutral, dependent position
- elevate the extremities elevated if venous insufficiency
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Term
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Definition
- situation in which blood pressure is very elevated but there is no evidence of impending or progressive organ damage
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Term
| What medications are recommended for the treatment of hypertensive urgencies? |
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Definition
- beta-adrenergic blockers (ie. labetalol)
- ACE inhibitors (ie. captopril)
- alpha2-agonists (ie. clonidine)
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Term
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Definition
- blood pressures are extremely elevated and must be lowered immediately to prevent damage to the organs
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Term
| Therapuetic goals of hypertensive emergencies |
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Definition
- lower mean blood pressure by 20-25% w/in first hour
- reduce BP with 160/100 mm Hg w/in six hours
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Term
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Definition
- treatment with a single agent
- helps simplify regimen and lessen costs
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Term
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Definition
- occurs suddenly if antihypertensive medications are suddenly stopped
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Term
| Glomular Filtration Rate (GFR) |
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Definition
- flow rate filtered fluid through the kidney, an indicator of renal function
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Term
| Isolated systolic hypertension |
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Definition
- a condition most commonly see in the older adult which the systolic pressure is greater than 140 and diastolic is within normal limits
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Term
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Definition
- denotes high blood pressure from an unidentified cause
- also called essential hypertension
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Term
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Definition
- high blood pressure from an identified cause such as renal disease
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Term
| Classification of Blood Pressures |
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Definition
- Normal: <120/<80
- Prehypertension: 120-139/80-89
- Stage 1: 140-159/90-99
- Stage 2: >160/>100
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Term
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Definition
- increased sympathetic nervous system activity
- increased renal reabsorption of sodium, chloride and water
- decreased vasodilation of the arterioles
- resistance to insulin action
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Term
| For patients with uncomplicated hypertension, what are the initial medications? |
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Definition
- diuretics
- betablockers
- OR BOTH
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Term
| Lifestyle modifications to prevent and manage hypertension |
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Definition
- weight reduction and daily exercise
- DASH diet (fruit, veggies, low-fat dairy, low salt - no more than 2 grams of sodium a day)
- moderation of alcohol consumption
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Term
| Foods appropriate for the DASH diet |
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Definition
- grain products - 7/8 servings
- fruits and vegetables - 4/5 servings
- low-fat/fat-free dairy - 2/3 servings
- meat, fish - >2 servings
- nuts, seeds - 4/5 servings weekly
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Term
| Promoting Vasodilation and prevent vascular compression |
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Definition
- applying warm applications, such as heating pads or hot water bottles, blankets or hot baths
- avoid tight clothing
- minimize emotional stress
- avoid nicotine and tobacco products, avoid alcohol intake
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Term
| Hallmark symptom of PAD is _____? |
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Definition
- intermittent claudication
- aching, cramping or induced fatigue/weakness that occurs with some degree of exercise and relieved with rest
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Term
| Maintaining Tissue Integrity |
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Definition
- well-fitting, sturdy shoes and slippers; do not go barefoot
- neutral soaps and body lotions; do not apply lotion between the toes
- do not scratch or rub the skin, pat wet skin dry, trim finger/toe nails
- good nutrition
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Term
| Peripheral Arterial Occlusive Disease |
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Definition
- occurs most often in the legs
- tends to extend from the aorta to below the renal arteries to the popliteal artery
- frequently seen in diabetes and older patients
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Term
| Assessment of Diagnostic Findings of PAD |
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Definition
- cool, pale extremities when elevated or cyanotic, ruddy extremities when dependent
- ulcers, gangrene or muscle atrophy may occur
- peripheral pulses may be diminished or absent
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Term
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Definition
- treatment of symptomatic claudication
- increases increased erythrocyte flexibility, lowers fibrin and inhibits neutrophil adhesion/activation
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Term
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Definition
- vasodilator
- inhibits platelet aggregation
- contraindicated in patients with a history of CHF or ejection fraction <40%
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Term
| ____ improve endothelial fxn in patients with PAD. |
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Definition
- statins; not enough evidence to support whether or not symptoms of claudication are decreased
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Term
| The distal outflow must be at least ____% patent for the graft to remain patent. |
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Definition
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Term
| Left sided heart failure causes? |
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Definition
- accumulation of blood in the lungs and reduction in foward flow
- results in inadequate arterial flow to the tissues
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Term
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Definition
- localized sac formed at a weak point at the wall within an artery; sacular or fusiform
- most common cause is atherosclerotic changes in the aorta
- if ruptures, can lead to hemorrhage and death
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Term
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Definition
- when collateral circulation develops, pts with stenosis or occlusion of aortoiliac segment can be symptomatic
- may complain of buttock or lower back pain and have decreased/absent femoral pulses
- men can experience impotence
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Term
| Upper Extremity Arterial Oclusive Disease |
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Definition
- arterial occlusions of the upper extremities
- cause less severe symptoms because of collateral circulation is better in the arms
- rare
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