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Vascular Disorders and Shock, PAD-1-1200x800, peripheral_artery_disease…
Vascular Disorders and Shock
Treatment
Bypass Surgery
Thrombolytic Therapy
Angioplasty
Supervised Excericise Programs
Medication
Medications
Anti-Hypertensive
Cilostazol
Anti-Coagulant
Pentoxifylline
Anti-Platelet
Complications
Restricted Mobility
Severe Pain
Poor Wound Healing
Stroke
Amputation
Education
Healthy Diet Changes
Avoid Cold Medication
Diabetes Management (If applicable)
Careful Foot Care
Excercise
Clinical Manifestations
Decreased Skin Temperature
Weak pulses in legs and feet
Sores on lower extremities that do not heal
Gangrene
Pale or Bluish Skin
Causes
Smoking
Obesity
High Blood Pressure
Physical Inactivity
High Cholestrol Levels
High Saturated Fat Diet
Diagnostic
MRI
Duplex Ultrasound
Angiography
Blood Tests
Doppler Ultrasound
Assessment
CSM
Skin ( Lower Extremities)
Vital Signs
Neurovascular
Types
Periphreal Vascular Disease (PAD)
Thoracic Aortic Aneurysm
Cerebrovascular Disease
Abdominal Aortic Aneurysm (AAA)
CAD ( Coronary Artery Disease)
Carotid Artery Disease (CAD)
Deep Vein Thrombosis (DVT)
Chronic Venous Insufficiency
Varicose Veins
Atherosclerosis
Shock
Morphology
Kidneys: shows "acute tubular necrosis" due to ischemic injury. Oliguria, anuria and electrolyte imbalance occur.
Brain: may develop hypoxic (ischaemic) encephalopathy
Heart: shows sub-endocardial haemorrhages and necrosis of individual myofibres or zonal lesions and scattered contraction bands within myocytes.
Lungs: in hypovolaemic shock lungs are usually not affected. In cardiogenic and septic shock there may be severe pulmonary oedema and shock lung (Acute Respiratory Distress Syndrome ARDS)
Liver: may show fatty changes and central necrosis.
Other organs: like gastrointestinal tract, adrenal and pituitary glands may be affected
Types
Cardiogenic shock
Hypovolaemic shock
Septic Shock
Signs and symptoms
Pale or ashen skin
Bluish tinge to lips or fingernails (or gray in the case of dark complexions)
Cool, clammy skin
Rapid pulse
Rapid breathing
Nausea or vomiting
Enlarged pupils
Weakness or fatigue
Dizziness or fainting
Changes in mental status or behavior, such as anxiousness or agitation
Stages
Non-progressive phase or compensated phase: During this phase of shock, neurohumoral mechanisms help to maintain cardiac output and blood pressure. These include baroreceptor reflexes, release of catecholamines, activation of renin-angiotensinsystem, and antidiuretic hormone secretion. If recovery occurs then it is labelled "reversible shock".
Progressive or de-compensated phase: If compensatory mechanisms fail to prevent circulatory insufficiency then there is a rapid pulse, further lowering of blood pressure, respiratory difficulties, low urine output (oliguric phase) and metabolic acidosis. Hypoperfusion starts to develop leading to circulatory and metabolic imbalances.
Irreversible stage:The patient deteriorates due to failure of the compensatory mechanisms. There is so severe cellular and tissue injury that death occur even if the haemodynamic defects are corrected.
