Unit 3 Peripheral Arterial Evaluation part 1

PAD -

Peripheral Arterial Disease

PAD is characterized by a -

blockage

primary disease that leads to PAD -

atherosclerosis (plaque buildup)

treatment types for PAD -

• medical management

• endovascular procedures

• surgical intervention

risk factors of peripheral arterial disease -

• HYPERTENSION

• diabetes

• high cholesterol

• poor diet

• tobacco smoking

• increased age

• documented/family history atherosclerosis

• gender

most common symptom of peripheral arterial disease is -

Claudication

Claudication is -

walking-induced muscular discomfort of calf, thigh, hip, buttock due to ischemia

claudication is described as -

cramping or aching in muscles of legs as they walk or exercise

claudication can be relieved by -

resting for 2-5 minutes

Claudication is also called -

intermittent claudication

intermittent claudication is happening in -

large muscle groups caused by activity

pain caused by intermittent claudication may be described as -

• fatigue

• cramping

• aching

• tiredness

Site of symptoms in claudication occur -

distal to the site of disease

Inflow -

• Aortoiliac disease

• Claudication progresses from calf-thigh-hip-buttock

Outflow -

• Fem-Pop disease

• Claudication progresses from calf-thigh

Runoff -

• Tibial vessel disease

• Claudication calf

Stenosis at 1 level can typically walk -

>4 blocks before having symptoms

Stenosis at 2 levels patient can typically walk -

2-4 blocks before having symptoms

stenosis > 2 level patient can typically walk -

< 2 blocks

total occlusion patient can typically walk -

< 2 blocks

Pseudoclaudication -

disease that may mimic claudication

diseases that may mimic claudication include -

• spinal stenosis

• herniated disk

• osteoarthritis

True claudication symptoms will start with -

exercise

True claudication symptoms will end when patient -

rests

Ischemic rest pain implies -

critical ischemia of distal limb when patient at rest

Ischemic rest pain causes patient to complain of -

pain in toes when lying down, pain often awakens patient

Physical signs are also called -

Trophic signs

Trophic (physical signs) -

• elevation of limb pallor (white) and dependent rubor (red)

• ischemic ulcers

• gangrene

• bruits

• decreased peripheral pulses

• dry flakey skin

• cool temperature

• thickened toenails & hair loss on toes

pulses usually compared from side to side and graded on a -

scale from 0 to 3+

Pulse scale includes -

• = no pulse

• 1+ = questionable pulse

• 2+ = weak pulse

• 3+ = normal pulse