010 Arteries - Introduction to Clinical Surgery Lectures

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Information about 010 Arteries - Introduction to Clinical Surgery Lectures

Published on July 1, 2008

Author: memorablemedicine

Source: slideshare.net

Description

Lecture on arteries from a series of lectures on an introduction to clinical surgery. It has been devised with medical students in mind.

The Arteries Nick Harvey

Limb Ischaemia: Definitions Acute Sudden interruption if blood supply Caused by emboli, trauma No collaterals Chronic Gradual obstruction of blood supply Caused by atherosclerosis Collaterals often well developed Acute on Chronic Acute thrombosis

Acute

Sudden interruption if blood supply

Caused by emboli, trauma

No collaterals

Chronic

Gradual obstruction of blood supply

Caused by atherosclerosis

Collaterals often well developed

Acute on Chronic

Acute thrombosis

Limb Ischaemia: Symptoms of Chronic Ischaemia Claudication Rest Pain Impotence Commonly associated with: CVS – hypertension, angina, MI Cerebrovascular – strokes, TIAs Risk factors: smoking, hyperlipidaemia, DM, sedentary life

Claudication

Rest Pain

Impotence

Commonly associated with:

CVS – hypertension, angina, MI

Cerebrovascular – strokes, TIAs

Risk factors:

smoking, hyperlipidaemia, DM, sedentary life

Limb Ischaemia: Presentation of Acute Ischaemia Pain Pallor Perishingly cold Pulseless Paresthesia Paralysis

Pain

Pallor

Perishingly cold

Pulseless

Paresthesia

Paralysis

Limb Ischaemia: History Claudication Pain Cramping muscle pain that is caused by exercise and relieved by rest Due to muscle ischaemia Claudication distance: increasing, decreasing or static? Does it affect patient’s lifestyle?

Claudication Pain

Cramping muscle pain that is caused by exercise and relieved by rest

Due to muscle ischaemia

Claudication distance: increasing, decreasing or static?

Does it affect patient’s lifestyle?

Limb Ischaemia: History Rest Pain Continuous pain present at rest Toes or forefoot Increased by exercise and warmth Relieved by hanging legs over the side of the bed Rest pain is due to nerve ischaemia Diabetic neuropathy sufferers?

Rest Pain

Continuous pain present at rest

Toes or forefoot

Increased by exercise and warmth

Relieved by hanging legs over the side of the bed

Rest pain is due to nerve ischaemia

Diabetic neuropathy sufferers?

Limb Ischaemia: Aorto-iliac Occlusive Disease Bilateral Claudication Impotence Bilateral decreased or absent pulsations

Bilateral Claudication

Impotence

Bilateral decreased or absent pulsations

Limb Ischaemia: Femoro-popliteal Occlusive Disease Unilateral Calf Claudication Absent Pulses Below Femoral Artery

Unilateral Calf Claudication

Absent Pulses Below Femoral Artery

Limb Ischaemia: Tibio-peroneal Occlusive Disease Unilateral Foot Claudication Absent Pulses Below Popliteal Rest pain, ulcers or gangrene

Unilateral Foot Claudication

Absent Pulses Below Popliteal

Rest pain, ulcers or gangrene

Limb Ischaemia: General Examination Pulse, BP both arms Pallor Heart Scars of previous arterial surgery

Pulse, BP both arms

Pallor

Heart

Scars of previous arterial surgery

Limb Ischaemia: Local Examination Inspection Skin Nails Trophic changes Hair loss, thin skin, muscle wasting Ulcers check pressure areas including between digits Gangrene

Skin

Nails

Trophic changes

Hair loss, thin skin, muscle wasting

Ulcers

check pressure areas including between digits

Gangrene

Limb Ischaemia: Local Examination Inspection Colour Horizontal Elevated determine vascular (Buerger’s) angle Depended

Colour

Horizontal

Elevated

determine vascular (Buerger’s) angle

Depended

Limb Ischaemia: Local Examination Palpation & Auscultation Palpate Skin temperature CRT Pulses DP, PT, popliteal, femoral, aorta, carotids, brachial, radial Auscultation All major arteries

Palpate

Skin temperature

CRT

Pulses

DP, PT, popliteal, femoral, aorta, carotids, brachial, radial

Auscultation

All major arteries

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