Shared Flashcard Set

Details

Clinical Assesment
The peripheral Vascular System Quiz 2
101
Medical
Graduate
11/07/2009

Additional Medical Flashcards

 


 

Cards

Term
Arteries contain 3 concentric layers
Definition
1.intima
2.media
3.adventitia
Term
intima
Definition
-Surrounds the lumen of all blood vessels  a -single continuous lining of endothelial cells with remarkable metabolic properties.Intact endothelium synthesizes regulators of thrombosis like prostacyclin, plasminogen activator, and heparin-like molecules.
It produces prothrombotic molecules such as Von Willebrand factor and plasminogen activator inhibitor. It modulates blood flow and vascular reactivity through synthesis of vasoconstrictors like endothelin and angiotensin-converting enzyme and vasodilators such as nitric oxide and prostacyclin.
-The intimal endothelium also regulates immune and inflammatory reactions through elaboration of interleukins, adhesion molecules, and histocompatibility antigens.
Term
media
Definition
-composed of smooth muscle cells that dilate and constrict to accommodate blood pressure and flow.
-Its inner and outer boundaries are membranes of elastic fibers, or elastin, called internal and external elastic laminae.
-Small arterioles called the vasa vasorum perfuse the media.
Term
adventitia
Definition

-The outer layer of the artery is the adventitia

 -connective tissue containing nerve fibers and the vasa vasorum.

Term
Injury to vascular endothelial cells can provoke
Definition

1-thrombus formation

2-atheromas,

3-vascular lesions of hypertension

Term

An atheroma

1. begins in the 

2. Complex atheromas are 

3.Plaque rupture may precede

Definition

1-intima as lipid-filled foam cells, then fatty streaks.

2-thickened asymmetric plaques that narrow the lumen, reducing blood flow, and weaken the underlying media. They have a soft lipid core and a fibrous cap of smooth muscle cells and a collagen-rich matrix.

3-thrombosis.

Term

Arm Pulse

1- The brachial artery is palpated 

 2-The radial artery "

3-The ulnar artery "
Definition

1-at the bend of the elbow just medial to the biceps tendon

2-on the lateral flexor surface

3-on the medial flexor surface, although overlying tissues may obscure the ulnar artery

Term

Leg Pulse palpation

 

1-The femoral artery

2-The popliteal artery 

3-The dorsalis pedis artery

4-The posterior tibial artery

Definition

1-just below the inguinal ligament, midway between the anterior superior iliac spine and the symphysis pubis

2-an extension of the femoral artery that passes medially behind the femur, palpable just behind the knee

3-on the dorsum of the foot just lateral to the extensor tendon of the big toe

4-posterior to the medial malleolus of the ankle.

Term

Superficial Leg Veins

1-The great saphenous vein

2-The small saphenous vein

3-Anastomotic veins

Definition

1-originates on the dorsum of the foot, passes just anterior to the medial malleolus, continues up the medial aspect of the leg, and joins the femoral vein of the deep venous system below the inguinal ligament

 2-begins at the side of the foot, passes upward along the posterior calf, and joins the deep venous system in the popliteal fossa
3-connect the two saphenous veins that are readily visible when dilated. Bridging or perforating veins connect the superficial system with the deep system.
Term
Deep and Superficial Venous System (Legs).
Definition
-The deep veins of the legs carry approximately 90% of venous return from the lower extremities. They are well supported by surrounding tissues.

-In contrast, the superficial veins are subcutaneous, with relatively poor tissue support
Term
FLUID EXCHANGE AND THE CAPILLARY BED
Definition

-Blood circulates from arteries to veins through the capillary bed

-Blood pressure (hydrostatic pressure) within the capillary bed, especially near the arteriolar end, forces fluid out into the tissue spaces.

-As blood continues through the capillary bed toward the venous end, its hydrostatic pressure falls, and another force gains dominance. This is the colloid oncotic pressure of plasma proteins, which pulls fluid back into the vascular tree.

-Lymphatic capillaries, which also play an important role in this equilibrium, remove excessive fluid, including protein, from the interstitial space.

-Lymphatic dysfunction or disturbances in hydrostatic or osmotic forces can all disrupt this equilibrium. The most common clinical result is the increased interstitial fluid known as edema 

Term

superficial lymph nodes, accessible to physical examination.

3

 

Definition

 

 1-cervical nodes

 2-axillary nodes

3-nodes in the arms and legs.

 

Term
Cervical Nodes
Definition

Pre auricular

post auricular

occipital

tonsilar

submandibular

submental

posterior cervical

superficial cervical

deep cervical

supraclavicular

Term
Axillary nodes
Definition

Central

lateral

apical

subscapular

pectoral

Term
nodes of the arm
Definition

epitrochlear nodes- These are located on the medial surface of the arm approximately 3 cm above the elbow and they drain the distal portion of the arm.

 

(-most of the arm(proximal portion) is drained by the axillary nodes)

Term

Nodes of the Leg

(superficial, palpable system)

Definition

 horizontal group-  chain high in the anterior thigh below the inguinal ligament. It drains the superficial portions of the lower abdomen and buttock, the external genitalia (but not the testes), the anal canal and perianal area, and the lower vagina.

 

 vertical group- clusters near the upper part of the saphenous vein and drains a corresponding region of the leg. 

Term
Capillary Bed
Definition
-blood circulates from the arteries to veins through the capillary bed
Term
Peripheral Arterial Disease (PAD)
Definition
stenotic, occlusive, and aneurysmal disease of the aorta, its visceral arterial branches, and the arteries of the lower extremities, exclusive of the coronary arteries
Term
intermittent claudication.
Definition
pain or cramping in the legs during exertion that is relieved by rest within 10 minutes
Term

 -symptomatic limb ischemia with exertion, relieved by rest, suggests 

 

-distinguish this from spinal stenosis, which produces leg pain with exertion that may be reduced by leaning forward (stretching the spinal cord in the narrowed vertebral canal) and less readily relieved by rest.

Definition
Atherosclerosis 
Term

-coldness, numbness, or pallor in the legs or feet or loss of hair over the anterior tibial surfaces suggests

-“Dry” or brown-black ulcers from gangrene may ensue.

Definition
decreased arterial perfusion
Term

1-risk facors of PAD

6

 

2-whats warrented if symtoms  and/or risk factors are present

Definition

1-older than 50

2-smoking

3-diabetes

4-HTN

5-elevated cholesterol

6-CAD

7-Any first-degree relatives with an abdominal aortic aneurysm

 

2-examination of ankle-brachial index

 

 

 

Term

Symptoms of aching, numbness, pain in a location suggests the site of arterial ischemia 

1- buttock, hip: 
2- erectile dysfunction: 
3- thigh:
4- upper calf:
5- lower calf:
6- foot:

Definition

1-buttock, hip: aortoiliac
2-erectile dysfunction: iliacpudendal
3-thigh: common femoral or aortoiliac
4-upper calf: superficial femoral
5-lower calf: popliteal
6-foot: tibial or peroneal

Term
PAD Symptoms
Definition

1-Fatigue, aching, numbness, or pain that limits walking or exertion in the legs

2-Any poorly healing or nonhealing wounds of the legs or feet
3- Any pain at rest in the lower leg or foot and changes when standing or supine
4- Abdominal pain after meals and associated “food fear” and weight loss

Term

Abdominal pain after meals and associated “food fear” and weight loss suggests

Definition
intestinal ischemia of the celiac or superior or inferior mesenteric arteries.
Term

Screening for renal artery disease

when should we screen

Definition

1-HTN

2-unexplained small kidney

3-sudden unexplained pulmonary edema

4-renal function worsening after use of an antiotensin-coverting enzyme or an angiotensin-receptor blocking agent

 

Term

abdominal aortic aneurysm (AAA)

1-when is it present

2-risk factors 6

Definition

-aaa is present when the infrarenal aortic diameter exceeds 3.0 cm (mortality rates increase over 5.5 cm)

-2-smokers

-CAD

-PAD

-Fam History

-HTN

-elevated cholesteol

Term

Important Areas of Examination
THE ARMS
(vascular)

Definition

  • Size, symmetry, skin color
  • Radial pulse, brachial pulse
  • Epitrochlear lymph nodes

Term

Important Areas of Examination
THE LEGS
(vascular)

Definition

  • Size, symmetry, skin color
  • Femoral pulse and inguinal lymph nodes
  • Popliteal, dorsalis pedis, and posterior tibial pulses
  • Peripheral edema

Term
Asymmetric blood pressures seen in 
Definition

-coarctation of the aorta  

-dissecting aortic aneurysm

Term
Lymphedema of the arm and hand may follow
Definition
axillary node dissection and radiation therapy
Term
Prominent veins in an edematous arm suggest 
Definition
venous obstruction.
Term
wrist pulses are typically normal, but spasm of more distal arteries causes episodes of sharply demarcated pallor of the fingers seen in
Definition
In Raynaud's disease, 
Term
if an artery is widely dilated it is
Definition
 it is aneurysmal.
Term
Grading of Pulses
Definition

3+

Bounding

2+

Brisk, expected (normal)

1+

Diminished, weaker than expected

0

Absent, unable to palpate

Term
Bounding carotid, radial, and femoral pulses in  
Definition
aortic insufficiency
Term
asymmetric diminished pulses in 
Definition
arterial occlusion from atherosclerosis or embolism
Term
If you suspect arterial insufficiency, feel for the 
Definition
brachial pulse. Flex the patient's elbow slightly, and palpate the artery just medial to the biceps tendon at the antecubital crease. The brachial artery can also be felt higher in the arm in the groove between the biceps and triceps muscles.
Term

Epitrochlear nodes are difficult or impossible to identify in most normal people.

Definition
local or distal infection or may be associated with generalized lymphadenopathy.
Term

1. Lymphadenopathy refers to  

2. Try to distinguish between local and generalized lymphadenopathy, respectively, by finding either 

Definition

1. enlargement of the nodes, with or without tenderness.

 

2)- (1) a causative lesion in the drainage area or (2) enlarged nodes in at least two other noncontiguous lymph node regions.

Term

1- A diminished or absent pulse indicates  

2- Chronic arterial occlusion, usually from atherosclerosis, causes 3

Definition

1-partial or complete occlusion proximally; for example, at the aortic or iliac level, all pulses distal to the occlusion are typically affected.

 

2-intermittent claudication , postural color changes , and trophic changes in the skin .

Term
An exaggerated, widened femoral pulse suggests a
Definition
 femoral aneurysm, a pathologic dilatation of the artery.
Term
An exaggerated, widened popliteal pulse suggests 
Definition
an aneurysm of the popliteal artery. Popliteal and femoral aneurysms are not common. They are usually caused by atherosclerosis and occur primarily in men older than 50 years.
Term
Atherosclerosis (arteriosclerosis obliterans) most commonly obstructs 
Definition
arterial circulation in the thigh. The femoral pulse is then normal, the popliteal decreased or absent.
Term
The dorsalis pedis artery may be congenitally absent or may 
Definition
branch higher in the ankle. Search for a pulse more laterally.
Term
Decreased or absent pedal pulses (assuming a warm environment) with normal femoral and popliteal pulses suggest 
Definition
occlusive disease in the lower popliteal artery or its branches—often seen in diabetes mellitus.
Term

1-Sudden arterial occlusion from embolism or thrombosis causes

 2-The limb distal to the occlusion becomes

3- If collateral circulation is good, only 

Definition

1-pain and numbness or tingling.

2-cold, pale, and pulseless. 

3-numbness and coolness may result.

Term

Note the temperature of the feet and legs with the backs of your fingers. Compare one side with the other. Bilateral coldness is most often caused by 

Definition
a cold environment or anxiety.
Term
Coldness, especially when unilateral or associated with other signs, suggests 
Definition
arterial insufficiency from inadequate arterial circulation.
Term
Edema causes swelling that may obscure the 
Definition
veins, tendons, and bony prominences.
Term
If you suspect edema, measure the legs to identify the edema. Compare one side with the other. A difference of more than ___________________ suggests edema.
Definition
 1 cm just above the ankle or 2 cm at the calf is unusual in normal people and
Term
Conditions such as muscular atrophy can also cause 
Definition
different circumferences in the legs.
Term

If edema is present, look for possible causes in the peripheral vascular system. 

3

Definition
These include (1) recent deep venous thrombosis, (2) chronic venous insufficiency from previous deep venous thrombosis or incompetence of the venous valves, and (3) lymphedema. Note the extent of the swelling. How far up the leg does it go
Term

1-In deep venous thrombosis, the extent of edema suggests 

2- when the lower leg or the ankle is swollen the location of the thrombosis is in the 

3-when the entire leg is swollen "

Definition

1-the location of the occlusion

2-the popliteal vein

3-the iliofemoral veins 

Term
Venous distention suggests and edema, whats the cause of edema?
Definition
a venous cause of edema
Term
A painful, pale swollen leg, together with tenderness in the groin over the femoral vein, suggests 
Definition

deep iliofemoral thrombosis. 

 

Only half of patients with deep venous thrombosis in the calf have tenderness and cords deep in the calf. Calf tenderness is nonspecific and may be present without thrombosis.

Term
Local swelling, redness, warmth, and a subcutaneous cord suggest 
Definition
superficial thrombophlebitis.
Term
Brownish discoloration or ulcers just above the malleolus suggest 
Definition
chronic venous insufficiency.
Term
Thickened brawny skin suggests 
Definition
lymphedema and advanced venous insufficiency.
Term

1-Varicose veins appear  

2-Their walls may feel  

 

 

Many varicose veins can be seen in the leg

Definition

1-dilated and tortuous.

2-somewhat thickened.

Term
The Allen test 
Definition

-The patient should rest with hands in lap, palms up.

-Ask the patient to make a tight fist with one hand; then compress both radial and ulnar arteries firmly between your thumbs and fingers.

-Next, ask the patient to open the hand into a relaxed, slightly flexed position. The palm is pale (Extending the hand fully may cause pallor and a falsely positive test)

-Release your pressure over the ulnar artery. If the ulnar artery is patent, the palm flushes within about 3 to 5 seconds.(Persisting pallor indicates occlusion of the ulnar artery or its distal branches)

-Patency of the radial artery may be tested by releasing the radial artery while still compressing the ulnar artery.

Term

Arterial occlusive disease is much less common in the arms than in the legs. Absent or diminished pulses at the wrist are found in 

3

Definition

1-acute embolic occlusion

2-Buerger's disease

3- thromboangiitis obliterans.

Term

If pain or diminished pulses suggest arterial insufficiency, look for postural color changes by 

(supine exam)

Definition

Raise both legs to about 60° until maximal pallor of the feet develops— slight pallor is normal.

-Marked pallor on elevation suggests arterial insufficiency



Term

If pain or diminished pulses suggest arterial insufficiency, look for postural color changes by 

(sitting exam)

Definition

-ask the patient to sit up with legs dangling down. Compare both feet, noting the time required for:
• Return of pinkness to the skin, normally about 10 seconds or less
• Filling of the veins of the feet and ankles, normally about 15 seconds
(any longer, abnormal)

Term
Persisting rubor on the dependent foot suggests 
Definition
arterial insufficiency
Term

 When veins are incompetent, (what tests are not reliable)


Definition
dependent rubor and the timing of color return and venous filling are not reliable tests of arterial insufficiency.
Term
Mapping Varicose Veins.
Definition

-You can map out the course and connections of varicose veins

-With the patient standing, place your palpating fingers gently on a vein and, with your other hand below it, compress the vein sharply.

-Feel for a pressure wave transmitted to the fingers of your upper hand. A palpable pressure wave indicates that the two parts of the vein are connected.

Term

the retrograde filling (Trendelenburg) test,

what ar we testing for

Definition
 the valvular competency in both the communicating veins and the saphenous system
Term

he retrograde filling (Trendelenburg) test,

steps

Definition

-Start with the patient supine. Elevate one leg to about 90° to empty it of venous blood.
-Next, occlude the great saphenous vein in the upper thigh
 -Ask the patient to stand. While you keep the vein occluded, watch for venous filling in the leg. Normally the saphenous vein fills from below, taking about 35 seconds 
-After the patient stands for 20 seconds, release the compression and look for sudden additional venous filling. Normally there is none; competent valves in the saphenous vein block retrograde flow. Slow venous filling continues.

Term

1-When both steps of this test are normal, the response is termed 

 

2-When both steps are abnormal, 

Definition

1-negative-negative.


*Negative-positive and positive-negative responses may also occur.

 

2-the test is positive-positive.

Term
Sudden additional filling of superficial veins after release of compression indicates 
Definition
incompetent valves in the saphenous vein.
Term

“Extremities are warm and without edema. No varicosities or stasis changes. Calves are supple and nontender. No femoral or abdominal bruits. Brachial, radial, femoral, popliteal, dorsalis pedis (DP), and posterior tibial (PT) pulses are 2+ and symmetric.”
OR
“Extremities are pale below the midcalf, with notable hair loss. Rubor noted when legs dependent but no edema or ulceration. Bilateral femoral bruits; no abdominal bruits heard. Brachial and radial pulses 2+; femoral, popliteal, DP and PT pulses 1+.” (Alternatively, pulses can be recorded as below.)

Definition
Suggests atherosclerotic peripheral arterial disease
Term

 


Arterial Disorders
3

 

Definition

1-Atherosclerosis (arteriosclerosis obliterans)

-Intermittent claudication

-Rest pain

 

2-Acute Arterial Occlusion

 

3-Raynaud's Disease and Phenomenon

Term


Atherosclerosis (arteriosclerosis obliterans)

Intermittent claudication

Definition

-Episodic muscular ischemia induced by exercise,

-Usually calf muscles, but also may be in the buttock, hip, thigh, or foot, depending on the level of obstruction

-Rest usually stops the pain in 1-3 min.

-Local fatigue, numbness, diminished pulses, often signs of arterial insufficiency 

Term

Atherosclerosis (arteriosclerosis obliterans)

Rest pain

Definition

-Ischemia even at rest

-Distal pain, in the toes or forefoot (often worse at night with elevation of the feet)

-Sitting with legs dependent, relieves the pain

-Numbness, tingling, trophic signs and color changes of arterial insufficiency 

Term

Acute Arterial Occlusion

Definition

-Embolism or thrombosis, 

-Sudden onset of distal pain, usually involving the foot and leg

-Coldness, numbness, weakness, absent distal pulses

Term
Raynaud's Disease and Phenomenon
Definition

-Raynaud's disease:Episodic spasm of the small arteries and arterioles; no vascular occlusion

-Raynaud's phenomenon:Syndrome secondary to other conditions such as collagen vascular disease, arterial occlusion, trauma, drugs

-Distal portions of one or more fingers. Pain is usually not prominent unless fingertip ulcers develop. Numbness and tingling are common.

-pain gets worse w/ Exposure to cold, emotional upset and better w/ Warm environment

-Color changes in the distal fingers: severe pallor (essential for the diagnosis) followed by cyanosis and then redness

Term
Venous Disorders
Definition

Superficial Thrombophlebitis

 

Deep Venous Thrombosis (DVT)

 

Chronic Venous Insufficiency (deep)

Term
Superficial Thrombophlebitis
Definition

-Clot formation and acute inflammation in a superficial vein

-Pain in a local area along the course of a superficial vein, most often in the saphenous system

-pain is An acute episode lasting days or longer

-Local redness, swelling, tenderness, a palpable cord, possibly fever

Term

Definition

Term
Deep Venous Thrombosis (DVT)
Definition

Clot formation in a deep vein

 

Possible swelling of the foot and calf, local calf tenderness

 

wlakin makes it worse elevation of feet makes it better

Term
Chronic Venous Insufficiency (deep)
Definition

-Chronic venous engorgement secondary to venous occlusion or incompetency of venous valves

-Diffuse chronic aching of the leg(s), that worsens as the day goes on, worse with prolonged standing and better with elevation of legs

-Chronic edema, pigmentation, possibly ulceration

Term
Thromboangiitis Obliterans (Buerger's disease)
Definition

-Inflammatory and thrombotic occlusions of small arteries and also of veins, occurring in smokers

-Intermittent claudication, particularly in the arch of the foot, worse with excercise and better w/ rest

-Rest pain in the fingers or toes, chronic, may get worse at night

-both pains get better with cessation of smoking

 

-Distal coldness, sweating, numbness, and cyanosis; ulceration and gangrene at the tips of fingers or toes; migratory thrombophlebitis

Term
Compartment Syndrome
Definition

-Pressure builds from trauma or bleeding into one of the four major muscle compartments between the knee and ankle (Each compartment is enclosed by fascia and thus cannot expand)

-Tight, bursting pain in calf muscles, usually in the anterior tibial compartment, sometimes with overlying dusky red skin.

-Pain lasts Several hours if acute (pressure must be relieved to overt necrosis). During exercise if chronic.

-Aggravates pain-Acute:anabolic steroids; surgical complication; crush injury.Chronic:occurs with exercise

-Relives pain-Acute: surgical incision to relieve pressure

Chronic:avoiding exercise; ice elevation

 

-Tingling, burning sensations in calf; muscles may feel tight, full, numbness, paralysis if unrelieved

Term
Acute Lymphangitis
Definition

-Acute bacterial infection (usually streptococcal) spreading up the lymphatic channels from a portal of entry such as an injured area or an ulcer

-Pain in An arm or a leg, An acute episode lasting days or longer

 

-Red streak(s) on the skin, with tenderness, enlarged, tender lymph nodes, and fever

Term

Mimics of Peripheral Vascular disorder

Mistaken primarily for acute superficial thrombophlebitis.

2

Definition

Acute Cellulitis

 

Erythema Nodosum

Term

 

Acute Cellulitis


 

Definition

-Acute bacterial infection of the skin and subcutaneous tissues

-Pain in Arms, legs, or elsewhere with an An acute episode lasting days or longer

 

-A local area of diffuse swelling, redness, and tenderness with enlarged, tender lymph nodes and fever; no palpable cord

Term
Erythema Nodosum
Definition

-Raised tender bilateral subcutaneous lesions seen in systemic conditions such as pregnancy, sarcoidosis, tuberculosis, streptococcal infections, inflammatory bowel disease

 

-pain in Anterior surfaces of both lower legs, associated with a series of lesions over several weeks

 

-Lesions recur in crops; often malaise, joint pains, and fever

Term
 Measuring the Ankle-Brachial Index (ABI)
Definition
Term
Definition
[image]
Term

Chronic Arterial Insufficiency (Advanced)

Pain

Mechanism

Pulses

Color

Temperature

Edema

Skin Changes

Ulceration

Gangrene

Definition

Pain-Intermittent claudication, progressing to pain at rest

Mechanism- Tissue ischemia

Pulses- Decreased or absent

Color- Pale, especially on elevation; dusky red on dependency

Temperature- Cool

Edema-Absent or mild; may develop as the patient tries to relieve rest pain by lowering the leg

Skin Changes-Trophic changes: thin, shiny, atrophic skin; loss of hair over the foot and toes; nails thickened and ridged

Ulceration-If present, involves toes or points of trauma on feet

Gangrene- May develop

Term

Chronic Venous Insufficiency (Advanced)

Pain

Mechanism

Pulses

Color

Temperature

Edema

Skin Changes

Ulceration

Gangrene

Definition

Pain-Often painfulMechanism- Venous hypertension

Pulses- Normal, though may be difficult to feel through edema

Color- Normal, or cyanotic on dependency
Petechiae and then brown pigmentation appear with chronicity.
Temperature- Cool

 

Edema-Absent or mild; may develop as the patient tries to relieve rest pain by lowering the leg

Skin Changes-Trophic changes: thin, shiny, atrophic skin; loss of hair over the foot and toes; nails thickened and ridged

Ulceration-If present, involves toes or points of trauma on feet

Gangrene- May develop

 

 

 

 

 

 

 

 

Term

Ulcers of the Ankles and Feet

in Chronic Venous Insufficiency

 

 

Definition

-This condition usually appears over the medial and sometimes the lateral malleolus. 

-Borders are irregular, flat, or slightly steep. 

-Painful granulations

 

-Associated findings include edema, reddish pigmentation and purpura, venous varicosities, the eczematous changes of stasis dermatitis (redness, scaling, and pruritus), and at times cyanosis of the foot when dependent. Gangrene is rare.

Term
Ulcers of the Ankles and Feet in Arterial Insufficiency
Definition

-This condition occurs in the toes, feet, or possibly areas of trauma (e.g., the shins).

 -Surrounding skin shows no callus or excess pigment, although it may be atrophic.

-Pain often is severe unless neuropathy masks it. -Gangrene may be associated, along with decreased pulses, trophic changes, foot pallor on elevation, and dusky rubor on dependency.

Term
Neuropathic Ulcer
Definition

-This condition develops in pressure points of areas with diminished sensation;

-seen in diabetic neuropathy, neurologic disorders, and Hansen disease.

-Surrounding skin is calloused. There is no pain, so the ulcer may go unnoticed. In uncomplicated cases, there is no gangrene. Associated signs include decreased sensation and absent ankle jerks

Term
capillary leak syndrome
Definition
in which protein leaks into the interstitial space, seen in burns, angioedema, snake bites, and allergic reactions
Term
Pitting Edema
Definition

-Edema is soft, bilateral, with pitting on pressure, on the anterior tibiae and feet.

-There is no skin thickening, ulceration, or pigmentation.

Term
Pitting edema results from several conditions:
Definition

-when legs are dependent from prolonged standing or sitting, which leads to increased hydrostatic pressure in the veins and capillaries; -congestive heart failure leading to decreased cardiac output;

-nephrotic syndrome,

-cirrhosis, or malnutrition leading to low albumin and decreased intravascular colloid oncotic pressure; 

 -drug use.

Term
Chronic Venous Insufficiency
Definition

Edema is soft, with pitting on pressure, and occasionally bilateral.

-Look for brawny changes and skin thickening, especially near the ankle.

-Ulceration, brownish pigmentation, and edema in the feet are common. Arises from chronic obstruction and from incompetent valves in the deep venous system.

Term
Lymphedema
Definition
Edema is soft in the early stages, then becomes indurated, hard, and nonpitting. Skin is markedly thickened; ulceration is rare. There is no pigmentation. Edema is found in the feet and toes, often bilaterally. Lymphedema develops when lymph channels are obstructed by tumor, fibrosis, or inflammation, and in cases of axillary node dissection and radiation.
Supporting users have an ad free experience!