Question | Answer |
anastomosis | junction of two vessels |
aneurysm | localized sac or dilation of an artery formed at a weak point in the vessel wall |
Ankle Brachial Index (ABI)
Ankle Arm Index (AAI) | ratio of the ankle systolic pressure to the arm systolic pressure; an objective measurement of arterial disease /provide degree of stenosis info |
arteriosclerosis | diffuse process - muscle fibers and endothelial lining of small arteries and arterioles THICKEN |
ATHEROSCLEROSIS | imflammatory process involving the accumulation of lipids, calcium, blood components, carbs, and fibrous tissue on the intimal layer of a lg-med artery |
bruit | sound of turbulent blood flow thru an irregular, tortuous, stenotic, or dilated vessel |
dissection | separation of the weakened elastic and fibromuscular elements in the medial layer of an artery |
ischemia | deficient blood supply |
rubor | reddish blue discoloraton of the extremities; indicative of severe peripheral arterial damage; vessels remain dilated, unable to constrict |
stenosis | narrowing or constriction of a vessel |
arterioles are also referred to as.. | 'resistance vessels'
bcuz they alter their diameter and offer resistance to blood flow |
veins distend more than arteries.
large volumes of blood can remain.
veins are also called... | capacitance vessels |
@ what % of total blood volume is contained in the veins | @ 75%
total blood volume
is contained in the veins |
the __ nervous system __ veins, thereby __ the blood volume in circulation. | the SYMPATHETIC nervous system
CONSTRICTS veins,
thereby INCREASEING
blood volume in circulation. |
when metabolic needs increase,
blood vessels... | dilate to increase the flow of oxygen and nutrients to the tissues. |
when metabolic needs decrease,
blood vessels... | constrict and blood flow to the tissues decreases. |
reasons metabolic needs increase: | -physical activity
-local heat application
-fever
-infection |
reasons metabolic needs decrease: | -rest / inactivity
-local cold applicatoin
-cooling of the body |
systemic
arteriovenous
oxygen
difference | blood in the Vena Cava contains @25% less oxygen than aortic blood..
~ > diff when less O2 delivered than tissues require~ |
location of arterial ulcers: | -tip of toes
-toe webs
-heels or pressure areas if confined to bed |
location of venous ulcers: | -medial malleolus
(rarely: lat malleolus / ant tibial) |
pain characteristic of arterial ulcers: | VERY PAINFUL |
pain characteristic of venous ulcers: | -minimal pain if superficial
(possibly very painful depending..) |
shape of arterial ulcers: | usually circular |
shape of venous ulcers : | irregular borders |
arterial ulcer base characteristics | pale to black and dry gangrene |
venous ulcer base characteristics | granulation tissue
beefy red to yellow fibrinous (long term ulcer) |
leg edema in arterial ulcers | minimal unless extremity kept in dependent position constantly to relieve pain |
leg edema in venous ulcers | moderate to severe |
arterial ulcer pain characteristics | intermittent claudication to sharp, unrelenting, constant |
venous ulcer pain characteristics | aching, cramping |
arterial insufficiency skin characteristics | -dependent rubor
-elevation foot pallor
-dry, shiny, skin
-cool - cold
-loss of hair
-nails-thickened and ridged |
venous insufficiency skin characteristics | -pigmentation in gaiter area
(medial and lateral malleolus)
-skin thickened and tough
-may be reddish/blue
-frequently assoc. w. dermatitis |
all blood vessels are innervated by the __ nervous system | all blood vessels are innervated by the SYMPATHETIC nervous system |
SYMPATHETIC nervous system stimulation causes vaso___? | SYMPATHETIC nervous system stimulation causes vasoCONSTRICTION |
WHAT CHARACTERIZES ALL PERIPHERAL VASCULAR DISEASES? | REDUCED BLOOD FLOW THROUGH PERIPHERAL BLOOD VESSELS |
LEFT sided heart failure causes: | -accumulation of blood in the lungs
-reduction in cardiac output
-inadequate blood flow to tissues |
RIGHT sided heart failure causes: | -systemic venous congestion
-reduction in cardiac output |
arteries can become damaged or obstructed as result of: | -atherosclerotic plaque
-thromboemboli
-chemical/mechanical traums
-infection / inflammation
- congenital or vasospastic disorder |
venous blood flow can be reduced by: | -thromboembolus
-incompetent venous valves
-ineffective pumping of muscles |
decreased venous blood flow results in: | -subsequent EDEMA |
MOST PVD's result in .. | -pain
-skin changes
-diminished pulse
-possible edema |
aging considerations in peripheral vascular fxn: | -stiffened vessels
-increased peripheral resistance
-impaired blood flow
-increased left ventricular workload |
REST PAIN: persistent pain in the forefoot when resting indicates... | severe degree of arterial insufficiency and critical state of ischemia. usually worse at night. |
diagnosis of arterial disorders requires thorough assessment of... | -skin color / temp / character
-peripheral pulses |
in inactive elderly people __ may be the first sign of PVD | in inactive elderly people GANGRENE may be the first sign of PVD |
arterial insufficiency effects on ADLs.. | -reduced mobility / activity
-reduced or loss of independence
-higher rates of hospitalization
-poorer quality of life |
What is the most common disease of the arteries? | ARTERIOSCLEROSIS |
The most common direct results of atherosclerosis in arteries include: | -stenosis of the lumen
-obstruction by thrombosis
-aneurysm -ulceration - rupture |
what is ischemic necrosis? | death of cells due to deficient blood flow |
gradual narrowing of the lumen stimulates the development of... | collateral circulation |
RISK FACTORS FOR ATHEROSCLEROSIS & PAD | -TABACO/NICOTINE US
-diet - hyperlipidemia
-hypertension - obesity -stress
-diabetes - age -gender |
prevention of atherosclerosis includes: | -reduce fat consumption -lowering cholesterol -use saturated fats -lower BP -QUIT SMOKING -GET EXERCISE |
PTA = | percutaneous transluminal angioplasty |
nurses can help pts improve peripheral arterial circulation by.. | -assisting w/ ambulation
or
-isometric exercises
STOP IF PAIN |
peripherl vascular conditions that worsen with exercise: | -ulcers
-cellulitis
-gangrene
-acute thrombotic occlusions |
RN interventions to promote vasodilation/prevent vascular compression: | -warm applications
-better applied to abdomen than extremities
USE W. CAUTION &
NOT > THAN BODY TEMP
-teach avoid cold
-ENCOURAGE STOP SMOKING
-AVOID STRESS (vasoconstrictor) |
RN DX with PVD = | -ineffect. periph. tissue perfusion
-chronic pain
-risk for impaired skin integrity
-deficient knowledge r/t self care |
peripheral arterial occlusive disease / arterial insufficiency of the extremities.. most often occurs in .. | -men
-diabetes
-elderly |
hallmark symptom of peripher arterial occlusive disease / PAD.. | INTERMITTENT CLAUDICATION: pain w. activity, relieved with rest. severe if rest pain. elevation = pain. dependent position = less pain |
Rx for PAD | -Trental / Pletal
-antiplatelet agents (Plavix)
-Statin therapy |