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Vascular System Disorders - Coggle Diagram
Vascular System Disorders
Arterial
Anatomy
Aortic Arch
Ascending Aorta
Aortic Arch
Brachiocephalic
R. Common Carotid
R. Subclavin
R. Vertebral Artery
L. Common Carotid
L. Subclavin
L. Vertebral Artery
Disease
Subclavian Steal Syndrome
4 more items...
Descending Aorta (behind esophagus)
Abdominal Aorta (Below Diaphragm) T12
Celiac Trunk (T12)
Superior Mesenteric (L1)
Renal (L1-L2)
Inferior Mesenteric (L3)
1 more item...
Peripheral Artery Disease
:warning:
Peripheral Arterial Disease (PDA
Pathophys
Atherosclerosis leading to decreased Arterial Perfusion
Risk Factor (Smoking)
Presentation
Intermittent Claudication (Calf) (Worsens with Exertion, Improves with Rest
Weakened Pulse (Femoral, Posterior Tibial, Dorsalis Pedis)
Absent Hair Growth due to Cyanosis Distal to Lesion
Improves/Worsens with....
Improves
Increased Arterial Pressure (Lowering the Leg)
Worsens
Worsens with Ambulation (Walking) and Leg Elevation (Elevation Pallor)
Management
Decrease Smoking, Increase Exercise, Cilostazol
Percutaneous Intervention (Balloon Angioplasty/Stenting
Complications
Arterial Ulcers (Lateral Malleolus
Distal Gangrene
Leriche Syndrome
Presentation (Triad)
Bilateral Hip/Thigh Claudication
Erectile Dysfunction
Diminished Femoral Pulse
Arterial Diseases
Arteriosclerosis :warning:
Medium Vessel
Mönckeberg Arteriosclerosis (Media Involved)
Pathophys
Media Involved, Lumen is Unaffected
Dystrophic Calcification within Vessel Walls
Small Vessel
Arteriolosclerosis (Small Vessel)
Pathophys
Caused by High Pressure
Histology
Hyaline (Pink Amorphous Deposits in Arterial Walls)
Hyperplastic (Onion-Skin Appearance)
Large Vessel
Atherosclerosis (Intima)
Risk Factors
Modifiable
Smoking :red_flag:
Diet
Non-Modifiable
DM1
Hypertension
Dyslipidemia (High LDL) :red_flag:
Age :red_flag:
Complications
Vascular Occlusion
Plaque Rupture --> Thrombus --> Vascular Occlusion :red_flag:
Obstructive Plaque --> Vascular Occlusion :red_flag:
Other
Vessel Aneurysm + Rupture (Plaque Formation causes weak vessel walls)
Plaque Stability
Stable Atherosclerotic Plaque
Pahophys
Progressive decrease in Coronary Blood Flow
Increase in Growth Factor Release (VEGF)
Collateral Circulation
Unstable Atherosclerotic Plaque
Chronic Inflammation
--> Macrophage Activation --> MMP ECM Breakdown -->
Thin-Fibrous Cap
-->
Fibroatheromas
(
Statins Inhibit MMP Secretion
)
Increase
Risk of Rupture
-->
Thrombus
Formation (Plaque) -->
Acute Coronary Syndrome
Pathogenesis
Plaque Formation Steps :red_flag:
1st: Endothelial Stress/Dysfunction Leads to
Subendothelium Exposure
2nd:
Platelets
Bind to Subendothelium and release
PDGF + Cytokines
3rd:
Monocyte
Adhesion leading to Activated
Macrophages
in
Vessel Intima
4th: Smooth Muscles + Macrophage
Digest LDL
to form
Foam Cells
which cause
Fatty Streaks
(Foam Cell is the First thing that will form into a Plaque)
5th: Smooth Muscle Proliferation + Deposition of ECM leading to a
Fibrous Cap
6th:
Fibrous Plaque
(Atheroma) leads to Complex Atheroma (
Calcification
)
Location (From Most Common to Least Common)
1st: Abdominal Aorta :red_flag:
2nd: Coronary Artery :red_flag:
3rd: Popliteal Artery
4th: Carotid Artery
5th Circle of Willis
Venous
Anatomy
Vena Cava
Superior Vena Cava
Disease
Superior Vena Cava Syndrome
Etiology
Mass Lesion (malignancy)
Thrombosis (venous Catheter)
Presentation
Edema (Bilateral Face, Upper Extremities)
Jugular Venous Distention
Headache (increase Intracranial Pressure)
R. Brachiocephalic V.
Disease
Brachiocephalic Venous Obstruction
Etiology
Thrombosis (Venous Catheter)
Pancoast Tumor
Presentation
Edema Unilateral Face, Upper extremity
R. Subclavian V.
Disease
Subclavian/Axillary Venous Obstruction
Presentation
1 more item...
Inferior Vena Cava (Transverses Diaphragm at T8)
Disease
Inferior Vena Cava Compression
Supine Hypotensive Syndrome 3rd Trimester
Presentation
Edema (Bilateral Lower Extremities)
Fetal Hypoxia (Improves with Repositioning)
Hepatic V.
Renal V.
Peripheral Venous Disease
:warning:
Superficial
Migratory Superficial Thrombophlebitis (Trousseau Syndrome)
Pathophys
Hypercoagulability leading to Superficial Venous Thrombus
Associated with Malignancy
Reoccurs at multiple Sites
Chronic Venous Insufficiency
Pathophys
Incompetent Venous Valves leading to venous stagnation creating High Hydrostatic Pressure
Presentation
Tortuous Dilated
Superficial Veins
(Varicose Veins) :red_flag:
Lower Extremity Pain
Skin Pigmentation (Medial Malleolus)
Venous Reflux
Improves with...
Raising Leg (Decrease Venous Hydrostatic Pressure) :red_flag:
Ambulation (Walking)
Management
Compression Socks/Leg Elevation
Vein Ablation (remove/destroy vein)
Complications
Venous Ulcer
(Proximal to Ankle) Leading to Possible Infection
:red_flag:
Stasis Dermatitis
due to
Hemosiderin
:red_flag:
Chronic Edema
Deep
Deep Vein Thrombosis
Risk Factors (Virchow's Triad)
Venous Damage (Smoking)
Hypercoagulability (Lack of Movement, Birth Control) :red_flag:
Venous Stasis (causes blood stagnation - clotting) :red_flag:
Presentation
Homan's Sign
Pain on Dorsiflexion
Erythematous Swelling
Calf Tenderness around DVT
D-Dimer
D-Dimer Positive
(Does not confirm DVT, it is just a test that is positive in DVTs) :red_flag:
D-Dimer Negative (Rules out SN-OUT)
Venous Duplex Ultrasound
Incompressible Luminal Mass with decreased blood Flow
Management
Anticoagulation
IVC Filter
Complication
Pulmonary Embolus