Diseases of Arteries & Veins Part 2
Inflammatory Disease --> Chronic Venous Insufficiency
What is Vasculitis?
Inflammation of blood vessels
What are the characteristics of Polyarteritis Nodosa?
Numerous inflammatory nodules form in small & medium size vessels.
What vessels would you expect to see polyarteritis nodosa in?
Small & Medium size
What vasculitis disease is typically found in small and medium size vessels?
What vasculitis disease is characterized by numerous inflammatory nodules?
What population is typically associated with polyarteritis nodosa?
I.V. drug abusers
What are the symptoms of polyarteritis nodosa?
Anorexia, weight loss, NVD, organ effects due to ischemia, and increased risk of thromus, stroke and aneurysm.
Why does polyarteritis nodosa increase risk of thrombus, stroke & aneurysm?
Inflammation damages the BV walls activating the clotting cascades.
How do we treat polyarteritis nodosa?
High-dose corticosteroids & immunosuppression
What is the most common vasculitis?
Giant Cell Arteritis
What group of people is most effected by Giant Cell Arteritis?
What vasculitis disease is typically found in large size vessels?
Giant Cell Arteritis
What vasculitis is identified by branching off the larger arteries?
Giant Cell Arteritis
What large arteries are typically effected by Giant Cell Arteritis?
Opthalmic, Temporal, Vertebral
What are the characteristics of giant cell arteritis?
Inflammation develops raidly and eventually involves the entire vessel wall.
What type of cells would you expect to see with giant cell arteritis?
What are some common manifestations of giant cell arteritis?
Headache, blurred vision, blindness, aortic aneurysm (10% of patients) and 50% have polymalgia.
How do we treat giant cell arteritis?
What is Buerger disease?
Inflammation of the peripheral arteries
What is another name for Buerger Disease?
What population would you typically see buerger disease in?
Young men who are heavy cigarette smokers
What is the main cause of buerger disease?
What are the characteristics of buerger disease?
Vasospasm, thrombus formation, destroys function of small & medium arteries in extremities.
What vasculitis disease destroys function in small & medium arteries in the extremities?
What are the manifestations of Buerger Disease?
Pain, tenderness, sluggish blood flow, ischemia, hypoxia, skin & nails "thin", and gangrene if severe.
How do we treat Buerger Disease?
Stop smoking and vasodilators
What is Raynaud Phenomenon & Disease?
Uncontrolled vasospasm of small arteries in the fingers and toes.
What vasculitis disease effects primarily small arteries in the fingers and toes?
Raynaud Phenomenon & Disease
Name the vasculitis disease(s) that are caused by inflammatory response:
1. Polyarteritis Nodosa
2. Giant Cell Arteritis
3. Buerger Disease
What are some examples of causes of Raynaud Phenomenon?
Frostbite, butchers, jackhammers
What group does Raynaud Disease primarily affect?
Healthy young women exposed to stress and cold.
What are the possible causes of Raynaud Disease?
What are some manifestations of Raynaud Disease?
Numbness, Tingling, Ischemia, cyanosis, Rubor after vasospasm, brittle skin and nails, gangrene and ulceration if severe.
How do we treat Raynaud Disease?
Avoidance, vasodilators, sympathetic denervation if intractable.
Name the vasculitis disease(s) that are caused by trama:
1. Raynaud Disease
2. Raynaud Phenomenon
What do we call a blood clot that can occur in arteries or veins?
What are the causes of a thrombus?
Injury, stasis of blood, surgery, immobility, hypercoaguability, post-partum, and atherosclerosis.
What is a thrombus?
What do we call an obstruction of a blood vessel by something that lodges there?
What is an Embolism?
Obstruction of a blood vessel by something that lodges there.
What is the most common cause of embolism?
What can cause a embolism?
Thrombus, bacteria, fat...broken long bone, lymphatic blockage, air, and cancer cells.
Why is deep vein thrombus more common than arterial thrombus?
Stagnant blood at a lower pressure
Where would one expect to see deep vein thrombus?
What are the symptoms of DVT?
Often asymptomatic, swelling, edema, pain with compression
What is the bancroft sign?
Pain with compression typically in the legs.
How would we treat DVT?
Thrombolytics and anti-coagulants
How does TPA work?
Breaks up clot
How do anti-coagulants work?
Prevents formation of clots
What are some common agent that can be used to prevent the formation of a DVT?
Warfarin, and Aspirin
What disease is characterized by distended vein in which blood has pooled?
What are varicose veins?
Distended vein in which blood has pooled.
What veins are typically effected by varicose veins?
Large veins of the leg
What are the causes of varicose veins?
Prolonged standing, pregnancy, and obesity.
What are the manifestations of varicose veins?
Painful, unsightly, swelling, edema.
It is important to know that varicose veins are rarely serious but may lead to _______ _______ ________ which is dangerous.
Chronic venous insufficiency
What is Chronic Venous Insufficiency characterized by?
Failure of venous valves to close
What are some causes of chronic venous insufficiency?
Chronic distention of veins
Trauma to valves
What are the manifestations of CVI?
Pathological changes to tissues due to ischemia, accumulation of wastes, hypoxia.
Stasis dermatitis, stasis ulcer
Marked edema of feet & ankles
What is a common inflammatory skin disease that occurs on the lower extremities in patients with chronic venous insufficiency with venous hypertension?
What are wounds that are thought to occur due chronic venous insufficiency, usually of the legs. They are the major cause of chronic wounds, occurring in 70% to 90% of chronic wound cases.
How do we treat chronic venous insufficiency?
Elastic stockings, avoid standing, elevate feet, and surgery