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Part 1

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Cause Thrombus (blood clot) Embolism Trauma Crush injuries

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Most Common location Femoral-Popliteal bifurcation

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Measures Complete bed rest Systemic anti-coagulation therapy, Thromboembolectomy Reconstructive arterial bypass surgery

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Contraindicated Exercise Use of support hose Application of direct heat

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Also called Chronic occlusive arterial disease Peripheral arterial occlusive disease Atherosclerotic occlusive disease

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Accounts for 95% of all the arterial disorders Affecting the lower extremities. Elderly patients men>women

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Risk factors Elevated serum cholesterol ( 200 mg/dL) Smoking High systolic blood pressure Obesity Diabetes

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Atherosclerotic plaque formation.

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Characterized by Chronic, progressive occlusion of the peripheral circulation Most often in the large and medium arteries of the lower extremities. Young male patients who smoke

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An inflammatory reaction of the arteries to nicotine. Small arteries of the feet and hands and progresses proximally. It results in vasoconstriction, decreased arterial circulation to the extremities, ischemia, and eventual ulceration and necrosis of soft tissues.

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The inflammatory reaction and resulting signs and symptoms can be controlled if the patient stops smoking

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Primary Raynauds syndrome Chronic, functional arterial disorder Women>men Caused by an abnormality of the sympathetic nervous system

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Characterized by Digital vasospasm Affecting the small arteries and arterioles of the fingers and sometimes the toes. Exposure to cold, vibration, or stress. Temporary pallor (blanching), then cyanosis and pain, followed by numbness and a cold sensation of the digits.

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Symptoms are relieved slowly by warmth

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Raynauds disease Idiopathic (primary) Raynauds Phenomenon Secondary Scleroderma, systemic lupus erythematosus, systemic sclerosis, or vasculitis

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Diminished or Absent Peripheral Pulses Collateral circulation

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Integumentary Changes Skin discoloration Pallor (elevated), in rest or after exercise Reactive hyperemia (lowered after elevated) Trophic changes (shiny, waxy, dryness, loss of hair Skin temperature ? Ulcerations (weight bearing, bony)

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Sensory Disturbances

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Exercise pain Intermittent claudication Early: feeling of fatigue or weakness Later: cramping or aching in the muscles Does not occur With extended periods of standing (as seen with spinal stenosis) With prolonged sitting (as seen with sciatica) One limb or both??

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Burning, tingling sensation At night?? Heart rate and volume of blood flow to the extremities decreases with rest Relief of pain, if the leg is placed in a dependent

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Weakness Atrophy loss of motor function Pain Weakness

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