Week 9: Peripheral HA

This set covers anatomical branches of the abdominal aorta, lower extremity vascular pathologies, clinical assessment techniques for pulses and edema, and screening guidelines for vascular diseases.

Celiac artery

An artery supplying blood to the distal esophagus, stomach, proximal duodenum, liver, spleen, and pancreas.

Superior mesenteric artery

An artery supplying blood to the distal duodenum, jejunum, ileum, and the ascending and transverse colon.

Inferior mesenteric artery

An artery providing blood supply to the ascending colon and cecum.

Intermittent claudication

A symptom of peripheral artery disease characterized by leg pain triggered by walking and relieved by rest.

Peripheral Arterial Disease (PAD)

A condition caused by tissue ischemia resulting in decreased or absent pulses, pale skin on elevation, dusky red skin on dependency, and thin, shiny atrophic skin with loss of hair.

Pitting Edema

Swelling caused by increased fluid and salt retention, often associated with heart failure, nephrotic syndrome, cirrhosis, malnutrition, or medications like gabapentin.

Chronic Venous Insufficiency

A condition resulting from deep venous system obstruction and incompetent valves, characterized by soft bilateral pitting edema, brownish pigmentation, and skin thickening near the ankle.

Lymphedema

Nonpitting, indurated edema arising from protein-rich fluid accumulation due to lymphatic obstruction, fibrosis, or axillary node dissection.

Varicose Veins

Dilated and tortuous veins that appear when extremities are dependent, often causing aching, heavy, or tired legs.

Virchow triad

The three factors contributing to Deep Vein Thrombophlebitis: venous stasis, vessel wall injury, and coagulation abnormalities.

Deep Vein Thrombophlebitis (DVT)

A condition often characterized by unilateral edema, tugging pain, and a positive Homan’s sign.

Superficial Venous Thrombophlebitis

Inflammation and clotting in a superficial vein, presenting with a visible dilated vessel, pain, erythema, and warmth.

Pulse Grade $3+$

Bounding.

Pulse Grade $2+$

Brisk, expected (normal).

Pulse Grade $1+$

Diminished, weaker than expected.

Pulse Grade $0$

Absent, unable to palpate.

Epitrochlear Nodes

Lymph nodes located in the groove between the biceps and triceps muscles, approximately $3\,cm$ above the medial epicondyle.

Poikilothermia

Asymmetric coolness of the skin that suggests Peripheral Arterial Disease (PAD) or other vascular conditions.

Edema Grade $1+$

Barely detectable impression when a finger is pressed into the skin.

Edema Grade $2+$

Moderate pitting where the indentation subsides rapidly.

Edema Grade $3+$

Deep pitting where the indentation remains for a short time.

Edema Grade $4+$

Very deep pitting where the indentation lasts a long time.

Ankle-Brachial Index (ABI)

A test for Peripheral Artery Disease calculated by the formula: $\frac{\text{higher ankle pressure}}{\text{higher brachial pressure}}$.

Allen Test

An evaluation of arterial perfusion of the hand involving the compression and release of the radial and ulnar arteries to ensure patency.

Raynaud Disease

Condition featuring episodes of intermittent, bilateral symmetrical pallor, cyanosis, and rubor, nearly always involving the hands and often triggered by cold.

Abdominal Aortic Aneurysm (AAA) Screening

A one-time screening recommended for men aged $65-75$ years who have smoked more than $100$ cigarettes in their lifetime. Selectively offer screening to men aged 75 years who have never smoked.