SEMIO CH19 TRIGGER

2 MAIN TYPES OF PERIPHERAL VASCULAR DISEASE ?

P° ARTERIAL DISEASE

P° VENOUS DISEASE

P° ARTERIAL DISEASE ASSOCIATED W/ ?

ATHEROSCLEROSIS

P° ARTERIAL DISEASE BECOMES SYMPTOMATIC WHEN ?

ARTERIAL STENOSIS >70%

2 MAIN MANIFESTATIONS OF P° A° D° ?

ACUTE AND CHRONIC LOWER LIMB ISCHEMIA

ACUTE LOWER LIMB ISCHEMIA = SUDDEN OBSTRUCTION OF ?

ILIAC , FEMORAL OR POPLITEAL ARTERY

TRIGGER → 4 SYMPTOMS OF LOWER LIMB ISCHEMIA

COLD + PALLOR + NO PULSE + PAIN

WHAT CAUSES “NO PULSE” ?

THE ARTERIAL OBSTRUCTION → NO BLOOD PASSES

IF NO VASCULARIZATION DURING 12 HOURS →

GANGRENE

CHRONIC ISCHEMIA STAGE I

STENOSIS = <70%

→ ASYMPTOMATIC

CHRONIC ISCHEMIA STAGE II

STENOSIS 70-95%

→ INTERMITTENT CLAUDICATION

CHRONIC ISCHEMIA STAGE III

~99%

→ ISCHEMIC REST PAIN

CHRONIC ISCHEMIA STAGE IV

100%

→ GANGRENE / ULCERS

TRIGGER → LEG PAIN ONLY DURING EXERCISE

INTERMITTENT CLAUDICATION → STENOSIS 70-95%

TRIGGER → ISCHEMIC REST PAIN

STENOSIS 99% → VERY SEVERE ARTERIAL STENOSIS → STAGE III

ARTERIAL vs VENOUS → BIG DIFFERENCE IN SYMPTOMS

ARTERIAL → BLOOD CANNOT ARRIVE SO → PALLOR / COLD / ISCHEMIC PAIN / GANGRENE

VENOUS → BLOOD CANNOT RETURN PROPERLY SO → CONGESTION / EDEMA / TRHOMBOSIS

TRIGGER → THE 2 VENOUS SYSTEMS OF LEGS ? % ?

SUPERFICIAL → 10%

DEEP → 90%

TRIGGER VARICOSE VEINS →

DILATED + DISTENDED + TORTUOUS SUPERFICIAL VEIN

TRIGGER : REDDISH / BROWN SKIN AROUND ANKLE + VENOUS ULCERS ?

CHRONIC VENOUS INSUFFICIENCY

2 KEYS MECHANISMS OF DEEP VEIN THROMBOSIS →

BLOOD STAGNASIS + HYPERCOAGULABILITY

3 MAJORS SIGNS OF DEEP VEIN THROMBOSIS →

SWELLING OF CALF + HEAT + ERYTHEMA

TRIGGER ++ → IF COLD LEG ? HOT LEG ?

COLD → ARTERIAL PROBLEM

HOT → VENOUS PROBLEM

3 POSSIBLE EVOLUTIONS OF DEEP VENOUS THROMBOSIS ?

COMPLETE LYSIS

PARTIAL LYSIS

PULMONARY THROMBOEMBOLISM

COMPLETE LYSIS =

DISSOLUTION COMPLETE DU CAILLOT

PARTIAL LYSIS →

DISSOLUTION PARTIELLE DU CAILLOT POUVANT MENER À CHRONIC VENOUS INSUFFICIENCY

PULMONARY THROMBOEMBOLISM →

DETACHEMENT DU CAILLOT → CAILLOT BLOQUE L’ARTERE PULMONAIRE → EMBOLIE PULMONAIRE

THROMBUS vs EMBOLUS ?

THROMBUS = CAILLOT RESTE DANS SA ZONE D’ORIGINE

EMBOLUS = CAILLOT PASSE DANS CIRCULATION SANGUINE

ANEURYSM =

ABNORMAL WIDENING OF AN ARTERY

ARTERIO VENOUS FISTULA →

COMMUNICATION BETWEEN AN ARTERY AND A VEIN

LYMPHEDEMA →

EDEMA DUE TO LYMPHATIC SYSTEM DISORDER