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23 Cards in this Set
- Front
- Back
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origin of the subclavian artery (right before the vertebral) has a stenotic plaque |
everythings ok until the arm gets exercised, then the arm sucks blood away from the brain by reversing the flow in the vertebral artery |
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clinical sx of subclavian steal syndrome |
claudication of the arm (cold, tingly, pain) and posterior neuo signs (vision, blance) when the arm is exercised |
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vascular AND neurologic sx when exercising the arm |
subclavian steal |
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ONLY vascular sx with arm exercise |
thoracic outlet syndrome |
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dx of subclavian steal |
duplex scan shows reversal of flow, treat with bypass surgery |
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if you find a pulsatle abd mass, what do you do next |
confrim with U/S or CT |
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when do repair AAA |
5cm or more, or growing over 1cm per year |
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how to repair AAA |
stent |
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TENDER pulsatile abd mass |
will rupture in a couple days! repair immediately! |
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excruciating back paci + pulsatile abd mass |
AAA is already leaking: retroperitoneal hematoma is already forming. emergency repair!! |
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first clinical manifestation of arteriosclerotic occlusive dz of LE |
pain with walking, relieved with rest |
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unless claudication interferes with patient's lifestly, no workup is necessary. |
just STOP SMOKING and start exercising and use Cilostazol |
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workup for DISABLING intermittent claudication |
1. dopple for pressure gradient: if there is no prssure gradient, then dz is in the small vessels and surgery is not possible 2. CT angio or MRI angio to find specific areas of stenosis and find the good distal vessels |
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bad sign of PVDz |
rest pain....eventually leads to ulceration and gangrene |
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pt with claudictation presents: |
can't sleep at night (leg pain), if dangles leg it feels beter but after he does this his leg gets deep purple. atrophic skin without hair and no periphearl pulses on PEx |
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early tx of DVT |
doppler to find it, then treat early incomplete occlusion with clot busters |
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DVT: complete obstruction |
embolecty with Fogarty catheter |
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DVT complete obstruction and several hours have passsed before revascularization |
tx: fasciotomy |
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risk for dissecting aortic aneurysm |
poorly controlled HTN |
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patient presentation of disssecting aortic aneurysm |
like "MI" -tearing chest/back pain unequal pulses in upper extremities wide mediastinum on cxr EKG & cardiac enzymes rule out MI |
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best way to confirm dissecting aortic aneurysm |
spiral CT |
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ascending aorta dissectionst |
tx: surgically |
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descending aorta dissections; |
manage medically with HTN control in the ICU |
