Bates Chapter 12

Front 1

intermittant claudication

Back 1

Episodic muscular ischemia induced by exercise d/t atherosclerosis of arteries.

Pain or cramping in legs during exertion that is relieved by rest within 10 minutes.

Front 2

PAD Risk Factors

Back 2

Over age 50, smoking, diabetes, CAD, African-American, HTN.

Front 3

PAD warning signs

Back 3

Fatigue, aching, numbness, or pain that limits walking.

Poor healing or non-healing wound

Any pain present when at rest in the lower leg or foot and changes when standing or supine.

Abdominal pain after meals.

Any 1st degree relatives with an AAA.

Front 4

PAD buttock hips

Back 4

aortoiliac artery

Front 5

PAD erectile dysfunction

Back 5

iliac-pudendal

Front 6

thigh

Back 6

common femoral or aortiliac

Front 7

upper calf

Back 7

superfical femoral

Front 8

lower calf

Back 8

popliteal

Front 9

foot

Back 9

tibial or peroneal

Front 10

ABI

Back 10

Assesses the circulation or PAD of the legs.

measures SBP in the arms and in the pedal pulses using doppler ultrasound.

Front 11

Interventions to reduce onset and progression of PAD

Back 11

tobacco cessation, tx of hyperlipidemia, DM control, HTN control, use of antiplatlets, meticulous foot care and well fitting shoes.

Front 12

Conditions suspicious for renal artery diease

Back 12

HTN if less than or equal to 30 years

Severe HTN if less than or equal to 55 years

Accelerated, resistant or malignant HTN

New or worsening renal fxn

Worsening renal fxn after use of angiotensin

inhibitor.

Sudden unexplained pulmonary edema.

Front 13

Raynaud's diease

Back 13

wrist pulses are typically normal but spasm of more distal arteries cause severe pallor of fingers followed by cyanosis and then redness. Cold aggravates/warmth helps.

(reynaud's phemomen-secondary to other conditions such as collagen vascular disease, arterial occlusion, trauma, drugs-usually not painful but numbness/tingling.)

Front 14

Pitting edema

Back 14

Edema is soft, bilateral with pitting after 1-2 seconds of thumb pressure.

Causes: prolonged standing, heart failure, nephrotic syndrome, cirrhosis, malnutrition (low albumin/protein), medications.

Front 15

chronic venous insufficiency

Back 15

Edema is soft, with pitting pressure. Thickened skin. Common to have ulceration and brownish pigmentation. Arises from chronic obstruction and incompetent valves in the venous system. Often painful, normal pulses. Normal skin temp. Gangrene does not develop.

Front 16

lymphedema

Back 16

Edema is soft in early states and then becomes hard, indurated, and non-pitting. Skin is thick, ulceration rare. Lymphedema develops shen lymph channels are obstructed by tumor, fibrosis, or inflammation.

Front 17

Acute arterial Occlusion

Back 17

Embolism or thrombosis or arteriosclerosis.

Distal leg pain, usually involving the foot and leg.

Front 18

superficial thrombosis

Back 18

clot formation and acute inflammation in a superficial vein. Pain located in vein. Local redness, swelling and possibly fever.

Front 19

DVT

Back 19

Clot in a deep vein, tight, may be painful. Swelling of foot, leg.

Front 20

Chronic venous insufficiency

Back 20

Chronic venous engorgement secondary to venous occlusion or incompetency of venous valves. Diffuse aching of the legs. Will have chronic edema, pigmentation, possibly ulceration.

Front 21

Thromboangiitis Obliterans (buerger's diease)

Back 21

inflammation and thrombotic occlusions of small arteries and also of veins occurring in smokers.

Intermittent claudicaiton. Rest pain in the fingers or toes.

Front 22

Compartment syndrome

Back 22

Pressure builds from trauma or bleeding. Each compartment is enclosed in fascia and cannot expand. tight bursting pain. Needs surgical incision to relieve pressure. Paralysis if unrelieved.

Front 23

acute lymphangitis

Back 23

Acute bacterial infection (usually strep)spreading up the lymphatic channels from a portal of entry such as an injured area or ulcer in the arm or legs. S/S-red streaks on the skin, tenderness, enlarged and tender lymph nodes, and fever.

Front 24

acute cellulitis

Back 24

acute bacterial skin infection and SQ tissue. A local area of redness, tenderness, with enlarged tender lymph nodes, fever.

Front 25

erythema nodosum

Back 25

raised tender bilateral SQ lesion seen in systemic conditions such as pregnancy, sarcoidosis, TB, strep, inflammatory bowel dz.

s/s-local area of swelling, redness, tender lymph nodes and fever. Lesions recur in crops: often malaise, joint pain and fever.

Front 26

Chronic arterial insufficiency

Back 26

Intermittent claudication, progressing to pain at rest. Tissue ischemia. Pulses are decreased or absent. Pale or dusky red on dependency. Cool temp. Absent or mild edema. thin, shiny skin, loss of hair over foot/toes, nails thickened and ridged. Ulceration usually occur on toes/feet. Gangrene may develop.

Front 27

lymphadenopathy

Back 27

enlargement of lymph nodes .

Front 28

Diminished/absent pulses

Back 28

partial or complete occlusion 10's more likely.

Front 29

femoral aneurysm/popliteal aneurysm

Back 29

pathologic dilation of the artery. widened femoral/popliteal pulse. Usually called by atherosclerosis and usually in men over 50.

Front 30

Atherosclerosis

Back 30

Most commonly obstructs arterial circulation in the thigh. The femoral pulse is normal and the popliteal pulse is absent or decreased.

Front 31

Thickened brawny skin

Back 31

Suggests lymphedema and advance venous insufficiency.