Peripheral Vascular Disease Overview

A comprehensive set of flashcards covering key concepts regarding Peripheral Vascular Disease, including its types, symptoms, risk factors, diagnostics, and management.

What are the two main vascular systems assessed?

Arterial and Venous systems.

What are the two main types of vascular disorders?

Arterial disorders: atherosclerosis, aneurysms, emboli, vasculitis; Venous disorders: thrombosis, venous insufficiency, varicosities.

What are key symptoms suggesting peripheral vascular disease (PVD)?

Pain in extremities, claudication, color or temperature changes, edema or ulcerations, numbness, tingling, or rest pain.

What is essential to assess in peripheral vascular disease?

Always assess bilaterally — asymmetry is often the earliest clue to pathology.

What is PAD?

Atherosclerotic narrowing of peripheral arteries causing ischemia to limbs and tissues.

What are major risk factors for PAD?

Non-modifiable: Age > 50, male sex, family history; Modifiable: Smoking, diabetes, HTN, hyperlipidemia, obesity, sedentary lifestyle.

What are the hallmark symptoms of PAD?

Intermittent claudication, rest pain, cool/pale/hairless skin, weak or absent pulses.

What symptom helps gauge severity and progression of PAD?

Claudication distance (how far they can walk before pain starts).

What physical exam findings suggest PAD?

Pale on elevation, rubor when dependent, hair loss, thin shiny skin, thick nails, cool temperature, delayed capillary refill, ulcers on toes and heels.

What is Buerger’s test?

Elevate leg → it becomes pale; lower leg → it turns red (dependent rubor) — indicates arterial insufficiency.

What are the main types of venous disorders?

1. Superficial thrombophlebitis 2. Deep vein thrombosis (DVT) 3. Chronic venous insufficiency (CVI).

What are typical symptoms of venous disease?

Aching, heaviness or fatigue in legs, worse with standing, edema, skin changes, ulcerations near medial malleolus.

What are key risk factors for venous disease?

Prolonged standing, pregnancy, obesity, sedentary lifestyle, trauma, prior DVT.

What findings suggest venous insufficiency?

Edema, brownish hyperpigmentation, thick tough skin, varicosities, ulcers on medial malleolus.

How do venous and arterial ulcers differ?

Venous ulcers are painful, shallow, and have irregular borders, while arterial ulcers are pale, punched-out, usually over toes or pressure points.

What are the five Ps of acute arterial occlusion?

Pain, Pallor, Pulselessness, Paresthesia, Paralysis.

How do you assess for arterial perfusion?

Palpate pulses, compare sides, use Doppler if non-palpable, assess capillary refill and skin temperature.

How do you test for venous competency?

Trendelenburg test and tap test over varicosity.

What are the components of a full peripheral vascular exam?

Inspection, Palpation, Auscultation, Special tests.

What is the Ankle-Brachial Index (ABI)?

Ratio of ankle systolic BP / brachial systolic BP with values indicating severity of PAD.

What imaging studies are used for vascular assessment?

Doppler ultrasound, CT angiography/MR angiography, Venography (gold standard for DVT).

What lab work may assist in diagnosing vascular diseases?

Lipid profile, fasting glucose, coagulation studies, inflammatory markers.

What are the management goals for PAD?

Smoking cessation, exercise therapy, antiplatelet therapy, control of BP, glucose, lipids, revascularization if severe.

How is chronic venous insufficiency managed?

Compression stockings, leg elevation, avoid prolonged standing, skin care, treat ulcers or infection.

How is DVT treated?

Anticoagulation therapy, early ambulation, compression therapy, evaluate for underlying hypercoagulable states.

What should never be done in cases of suspected DVT?

Never massage a swollen calf.

What are complications of arterial disease?

Critical limb ischemia, gangrene, limb loss.

What are complications of venous disease?

Recurrent ulcers, pulmonary embolism (from DVT).

What is important in the comparison of arterial vs. venous disease for pain?

Arterial pain is intermittent claudication/rest pain; venous pain is aching, heavy, worse with standing.

What is the color difference in arterial and venous diseases?

Arterial: Pale or dependent rubor; Venous: Brown or cyanotic.

What is the temperature difference between arterial and venous disease?

Arterial: Cool; Venous: Warm.

How do the pulses differ in arterial and venous disease?

Arterial: Decreased or absent; Venous: Normal.

What are the edema characteristics in arterial vs venous disease?

Arterial: Minimal; Venous: Marked.

Where do arterial ulcers typically occur?

On toes or pressure points.

Where do venous ulcers typically occur?

Near medial malleolus.

What does the Trendelenburg test assess?

Venous competency.

Why is the Ankle-Brachial Index (ABI) important?

It helps in the diagnosis and assessment of PAD severity.

What does delayed capillary refill mean?

It indicates ischemia.

What are the significance of varicosities in the venous system?

They indicate valve incompetence.

What does claudication refer to?

Cramping pain in calf/thigh with exertion, relieved by rest.

What is the first-line study for assessing DVT?

Doppler ultrasound.

What type of skin changes are seen in venous disease?

Hyperpigmentation and thickening.

What is the role of exercise therapy in managing PAD?

It helps improve walking distance and reduces symptoms.

What are the recommended treatments for managing varicosities?

Compression therapies and possibly surgical interventions.

What symptom of advanced PAD may occur at night?

Rest pain.

What is a common vascular complication after surgery?

Deep vein thrombosis (DVT).

What lifestyle modification is crucial for preventing PAD progression?

Smoking cessation.

How does chronic venous insufficiency develop?

From prolonged venous hypertension leading to structural changes in veins.

Which demographic is at a higher risk for PAD?

Individuals over 50 years old.

What vascular condition do obesity and lack of exercise contribute to?

Peripheral Arterial Disease (PAD).

What is a concerning clinical finding when evaluating for PAD?

Weak or absent pulses.

What does color change from pale to red indicate in Buerger’s test?

Arterial insufficiency.

What skin condition may indicate chronic venous insufficiency?

Lipodermatosclerosis.

What is a defining feature of arterial ulcers?

They have a pale appearance and are usually punched-out.

What is the significance of checking capillary refill in a vascular exam?

It helps assess peripheral perfusion.

What is the primary purpose of using anticoagulation in DVT?

To prevent thrombus growth and embolization.

What does a Doppler ultrasound allow clinicians to do?

Assess blood flow and detect obstructions.