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135 Cards in this Set
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any disease or condition caused by a disturbance or dysfunction on the peripheral vasculature |
Peripheral vascular diseases |
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Layers of blood vessels |
Tunica intima Tunica media/intermidia Tunica Adventitia/Externa |
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innermost layer of blood vessels and most exposed to the blood |
Tunica intima |
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other name for tunica intima |
Tunica interna/endothelium |
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This blood vessel layer is very well developed in the arteries |
Tunica media/intermidia |
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this blood vessel layer is very well developed in the veins |
Tunica adventita/externa |
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peripheral vasculatures |
Veins Arteries Capillaries |
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This peripheral vasculature has valves which is then used for properlling blood towards the heart since it has lower pressure, it also prevents backflow |
Veins (Blue) |
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this peripheral vasculature carries dexoygenated blood towards the heart, to then be oxygenated by the heart |
Veins (Blue) |
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Backflow of veins and can be removed via anti-coagulant injections |
Varicose veins |
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peripheral vasculature that carries oxygenated blood away from the heart and needs to deliver oxygen toward the organs |
Arteries (Red) |
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peripheral vasculature that is the site of gas exchange |
Capillaries |
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Vascular/Circulatory system is divided into |
Vascular Lympathic |
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the function of this system is to delivr blood to the organs of the body and has arteries and veins |
Vascular system |
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This system participates in the immune function of the body by protecting one's self from foreign bodies |
Lymphatic system |
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the lymphatic system has a drainage of foreign bodies called |
Lymph nodes |
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Kulani or swollen lymph nodes are from? |
Lymph nodes |
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Beke can be a viral infection or a CN 9 affectation, which affects what gland? |
Parotid gland |
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Functions of the circulatory/vascular system |
Drains excess fluid from the interstitial space removing excess fluid, bood waste, and protein molecules |
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when we do therapeutic massages, we must do it from |
distal to proximal d/t drainages |
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Lympatic ducts |
Thoracic duct Right lymphatic duct |
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This lympathic duct is larger and serves the LE and abdomen; left side of arm, neck, and thoracic region |
Thoracic duct |
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this lymphatic duct is smaller and serve the right side of arm, neck, and thoracic region |
Right lymphatic duct |
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Disorders of the circulatory system |
Occlusion Inflmmation Vasomotor dysfunction Neoplasm OVIN |
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this disorder is d/t lack of adequate blood flow to a region of the body |
Arterial disorders |
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Manifestations of Arterial disorders (6PUT) |
Pain Pulselessness Paresthesia Paralysis Pallor Polar Ulcerations Tropical skin changes |
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Pain of the arterial disorder is usually described as? |
Cramping pain |
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Kinds of pain |
Resting - 90% is blockage Intermittent - Blockage of at most 70% |
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Worst case scenario for arterial disorder manifestations |
ulcerations |
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in this disorder, there is decreased blood supply to the working/exercising muscles |
Intermittent claudication |
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T/F therapy for intermittent claudication can be continued but only to the point of pain |
T |
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Goal of treating intermittent claudication |
Inc. collateral circulation of working muscles |
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artery that is not included in circle of willis |
MCA |
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Manifestation of Intermittent claudication (4PUT) |
Paresthesia Paralysis Pallor Polar Ulcerations Trophic skin changes |
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Severe consequence of circulatory disorders |
Ulcerations |
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Dry, scaly skin, and hair loss in distal body parts |
Trophic skin changes |
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Arterial disorders |
Lack of adequate blood flow to a region of the body Arteriosclerosis obliterans Thromboangitis obliterans Raynaud's disease |
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this arterial disorder usually affects the large and medium arteries or LE, and the usual risk factor is smoking. it is occlusion through the abogating fatty streaks. Build up of fatty substances leading to narrowed and decreased blood flow |
Arteriosclerosis Obliterans (ASO) |
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if ASO affects the heart, what can happen? |
Myocardial infarction |
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MOI of ASO |
Plaques, platelet aggregation or accumulation - inc. blood pressure |
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T/F ASO can damage the endothelium and tunica intima d/t increased pressure |
T |
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How many percentage before ASO can be contraindicated |
90% |
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this arterial disorder is affects medium and small arteries of the LE, and is the 2nd most common arterial disorder |
Thromboangitis Obliterans (TAO) |
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Main cause of TAO |
Smoking |
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EVALI stands for? |
E-vape Associated Lung Injury |
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MOI of TAO |
Smoking; mainly nicotine |
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causes inflammation and vasoconstriction of blood vessels which leads to dec. arterial circulation and ischemia |
Nicotine |
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Sequelae/End game for TAO |
Ulceration and Necrosis |
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This arterial disease is because of sympathetic nervous system abnormality, has vasospasm of digital arteries and vasospasm secondary to triggering factors |
Raynaud's Disease |
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Triggering factors of Raynaud's Vasospasm |
Cold Emotional distress |
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this sign of Raynaud's disease mimics the color of the flag of france (white, blue, and red) |
French Flag sign |
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Vasospasm of digital arteries usually associated with arthritic conditions |
Raynaud's phenomenon |
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Arthritic conditions under Raynaud's Phenomenon includes? |
Systemic Lupus Erythematosus (SLE) Scleroderma Polymyositis Dermatomyositis |
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thickening of skin, blood vessel, muscles, and internal organs |
Scleroderma |
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Inflammation of the muscles |
Polymyositis |
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Infalammation of the muscles and integumentary system |
Dermatomyositis |
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Cause of raynaud's phenomenon |
Idiopathic |
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Contraindication for Raynaud's Phenomenon |
Cryotherapy |
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It is an inadequate drainage of venous blood from a body part usually associated with valvular or muscular defect or dysfunction |
Venois disorders |
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this venous disorder has (+) valvular and muscular dysfunction and is the most common PVD and venous disorder. It is usually unilateral and affects LE |
chronic venous insufficiency (CVI) |
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MOI of CVD |
Venous pooling -> Inc. blood volume in affected extremity -> Inc. pressure -> Venous HTN -> Lysis of RBC (+ hemosiderin) -> Brownish discoloration -> Stasis pigmentation |
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Type of CVI that has edema + pigmentation |
Type I |
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Type of CVI that has edema + pigmentation + dermatitis + varicosities |
Type II |
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Type of CVI that has edema + pigmentation + dermatitis + varicosities + ulcerations and is the most severe between the CVI types |
Type III |
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This venous disorder is associated with musuclar defect/dysfunction and is usually secondary to immobilization |
Deep Vein Thrombosis |
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DVT affects which first? |
(L) LE > (R) LE |
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What medications should we note of before treating patients admitted to wards if we want to check if they have DVT |
Heparin Warfarin |
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If the thrombus occludes on the heart, it may lead to? |
Myocardial infarction |
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if the thrombus occludes the lungs, what is it called? |
Pulmonary embolism |
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if the thrombus occludes the brain, what is it called? |
thrombotic stroke |
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Triad for DVT is called? |
Virchow's Triad |
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Manifestation of DVT |
Hypercoagulability Intimal wall damage Venous stasis |
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Special test for DVT where there is forced ankle DF and squeeze calf muscle that (+) pain or discomfort at the back of the knee |
Homan's Sign |
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T/F Homan's sign can be used to confirm DVT |
F - it has low reliability |
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management for DVT |
Warfarin and Heparin Antiplatelet therapy |
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This venous disorder is usually associated with valvular dysfunction and is described as spiderweb-like |
Varicose veins |
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MOI of varicose vens |
Valve dysfunction -> backflow of venous blood -> inc. blood volume -> inc. pressure -> inc. venous distenibility or venous collapse |
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Predisposing factors of varicose veins |
Prolonged standing Obesity Pregnancy Family hx |
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Lymphatic disorders are usually accompanied by |
Edema |
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lymphatic disorder that is the accumulation of fluids in interstitial spaces |
Edema |
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in lymphatic disorders, there are cardinal signs of inflammation |
Rubor (Redness) Calor (Warmth) Tumor (Swelling) Dolor (Pain) Functio Laesa (loss of function) |
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Lymphatic disorder that is the accumulation of fluid in an anatomic space |
Effusion |
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Effusion cannot be usually seen, what do we need to do to see it |
Ancillary procedures |
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Accumulation of fluid in linings of lungs |
Pleural effusion |
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Types of lymphatic disoders |
Milroy's disease primary lymphedema secondary lymphedema non pitting edema pitting edema brawny edema |
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this lymphatic disorder is congenital lymphedema and is autosomal dominant |
Milroy's Disease |
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This lymphatic lymphedema happens without cause and has 2 types |
Primary lymphedema |
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primary lymphedema type that is 1st degree lymphedema before 35 y/o |
Praecox |
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primary lymphedema type that is 1st degree lymphedema after 35 y/o |
Tarda |
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This lymphedema is when edema is usually due to an underlying pathology |
Secondary lymphedema |
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underlying pathologies that can cause secondary lymphedema |
Infection Malignancy |
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di lulubog or mabilis and pagbalik ng lubog |
Non-pitting edema |
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This lymphatic disorder has wood like texture due to being fibrotic |
Brawny edema |
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Assessment procedures |
temperature girth measurement pulse auscultation |
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This assessment procedure is done through palpation |
Temperature |
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if the skin is cold in palpation, what disorder does it signify |
Arterial disorders |
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girth measurement is usually done for what disorders |
Venous and lymphatic disorders |
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In this assessment procedure, weak pulse usually pertains to what disorder |
Arterial disorder - Venous has normal pulse |
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in assessment procedures, auscultation is done to confirm what? |
Bruit/turbulent blood flow |
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ABI stands for? |
Ankle Brachial index (ABI) |
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This range in ABI is (N); probable venous disorder and should proceed to compressive therapy |
1.19 - 0.95 |
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This range in ABI is probable mild arterial disorder; (+) intermittent claudication |
0.94 - 0.75 |
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this range in ABI has probable moderate arterial disorder; (+) resting pain, so it is best to defer therapy |
0.74 - 0.50 |
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In this ABI, there is severe arterial problem and usually needs amputation |
<0.50 |
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In this ABI range, PT should not apply compression as it may further impede circulation |
<0.80 |
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Normal time for venous filling time |
15 - 20 s (N) |
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In rubor of dependency test, the normal time or seconds are |
20 - 30 s (N) |
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In interpreting rubor of dependency test if <15 or <20 sec, what circulatory disorder does that usually mean |
Venous Disorder |
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In interpreting rubor of dependency test if >20 or >30 sec, what circulatory disorder does that usually mean |
Arterial disorder |
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this indicates chronic lympedema, which usually leads to fibrosis |
Stemmer's sign |
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You use which fingers to pinch in doing stemmer's sign |
Thumb and index |
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if there is pain upon elevation of limb, there is (Arterial, Venous) problem |
Arterial |
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If there is pain upon dangling, there is (Arterial, Venous) problem |
Venous |
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If there is relief upon elevation, there is (Venous, Arterial) problem |
Venous |
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If there is relief upon dangling, there is (Arterial,Venous) problem |
Arterial |
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Management guidelines for arterial disorders |
graded exercises Lifestyle modification especially smoking |
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According to a systematic review of Brandsma et. al, this program will significantly improve walking distance of pt with intermittent claudication |
Walking program |
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In exercise guidelines, how many minutes should the warm up period should be |
10 mins |
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When we exercise, we should do it within pt's tolerance, above tolerance level, but not elciting symptoms for how many minutes? |
20 - 60 mins - 3-5 days per week |
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Cool down period in exercise guidelines is how many minutes? |
5 - 10 minutes |
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Precautions for Chronic Arterial Insufficiency |
Avoid exercising outside during cold weather Wear well-fitting shoes Check feet for skin irritation after exercise If leg pain increases after the program, discontinue |
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Contraindication for Chronic Arterial Insufficiency |
(+) skin irritation of wounds leg pain at rest |
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Factors affecting prognosis |
Comorbidities Presence of leg pain at rest Presence of wounds and ulcerations Lifestyle of the pt |
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Conditions associated wirh arterial insufficiency |
Comorbidities |
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Denotes severe arterial disease |
Presence of leg pain at rest |
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may lead to necrosis and amputation if not managed effectively; exercise programs are not advisable |
Presence of wounds and ulcerations |
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Management of venosu or lymphatic disorders |
Compression Leg elevation and ankle pumps Manual lymphatic drainage AROME Low intensity resistance exercises Ambulation Proper skin care |
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Compression presure for venous/lymphatic disorders |
30 - 80 mmHG |
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What massage is needed for manual lymphatic draingae |
Petrissage and kneading |
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In dressing non infected wounds, what should be used? |
NSS gauze (Normal saline solutions) |
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In dressing dry wounds (arterial disoder), what should be used? |
Hydrogel |
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In dressing minimal exudation, what should be used? |
Hydrocolloid |
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In dressing moderate exudation (venous), what should be used? |
Semipermeable foam |
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In dressing severe exudation (venous), what should be used? |
Calcium Alginate |
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In dressing moderate to severe exudation and (+) infection, what should be used? |
Collagenase |
