Blood VesselsBlood Vessels

Blood VesselsBlood Vessels

There are 100,000 miles of blood vessels.There are 100,000 miles of blood vessels.With the exception of hyaline cartilage With the exception of hyaline cartilage (which is avascular), no cell is more than a (which is avascular), no cell is more than a few cell diameters away from a blood few cell diameters away from a blood vessel, so they can get oxygen, nutrients, vessel, so they can get oxygen, nutrients, remove waste.remove waste.

Blood VesselsBlood VesselsArteries get smaller and thinner and are then Arteries get smaller and thinner and are then called arterioles.called arterioles.Arterioles get smaller and thinner until their Arterioles get smaller and thinner until their lumen is just one red blood cell in diameter. At lumen is just one red blood cell in diameter. At this point, they are called capillaries, and this is this point, they are called capillaries, and this is where the oxygen exchange takes place. where the oxygen exchange takes place. Capillaries then get larger as they take waste Capillaries then get larger as they take waste products away from the cells in the capillary bed products away from the cells in the capillary bed and head back to the heart; now they are called and head back to the heart; now they are called venules. venules. As venules get bigger, they are called veins until As venules get bigger, they are called veins until they return to the heart. they return to the heart.

Blood VesselsBlood VesselsFrom the heart the blood is pumped to the lungs From the heart the blood is pumped to the lungs to get more oxygen. to get more oxygen. During this trip, they get smaller again until they During this trip, they get smaller again until they are capillaries, then they get the oxygen from are capillaries, then they get the oxygen from the lungs and drop off the waste products the lungs and drop off the waste products (carbon dioxide). (carbon dioxide). Then the blood returns to the heart to get Then the blood returns to the heart to get pumped out to the body again. pumped out to the body again. All blood vessels (except the smallest) look All blood vessels (except the smallest) look similar.similar.

Tunica intima Endothelium SubendotheliumTunica media Smooth muscles Elastic fibersTunica adventitia

Vasa vasorum

Structure of Blood VesselsStructure of Blood Vessels

Composed of three layers (tunics)Composed of three layers (tunics)– Tunica intimaTunica intima

ENDOTHELIUMENDOTHELIUM: simple squamous epithelium. : simple squamous epithelium. Allows for smooth flow of blood. Similar to Allows for smooth flow of blood. Similar to endocardium.endocardium.SUBENDOTHELIUMSUBENDOTHELIUM: loose connective tissue.: loose connective tissue.

Structure of Blood VesselsStructure of Blood Vessels

Composed of three layers (tunics)Composed of three layers (tunics)– Tunica mediaTunica media

SMOOTH MUSCLE: SMOOTH MUSCLE: allows vasoconstriction. allows vasoconstriction. Allows blood to be directed to parts of body.Allows blood to be directed to parts of body.ELASTIC FIBERSELASTIC FIBERS: within smooth muscles. : within smooth muscles. Allows for forced vasodilation during heart Allows for forced vasodilation during heart contraction.contraction.

Structure of Blood VesselsStructure of Blood Vessels

Composed of three layers (tunics)Composed of three layers (tunics)– TUNICA ADVENTITIA (TUNICA EXTERNA)TUNICA ADVENTITIA (TUNICA EXTERNA): :

dense fibrous connective tissue which thins out dense fibrous connective tissue which thins out to loose connective tissue.to loose connective tissue.

Protects the blood vessel (strong)Protects the blood vessel (strong)Gives vessel strength for shapeGives vessel strength for shapeAnchors vessel to surrounding tissue; loosens with Anchors vessel to surrounding tissue; loosens with age.age.

Lumen – central blood-filled space of a Lumen – central blood-filled space of a vesselvessel

These layers are thick, These layers are thick, so they need their own so they need their own vascular supply: vascular supply: VASA VASA VASORUM VASORUM (blood (blood vessel for a blood vessel for a blood vessel) to supply the vessel) to supply the oxygen. oxygen. The endothelium layer The endothelium layer does not need this does not need this because it’s in direct because it’s in direct contact with the blood, contact with the blood, but the subendothelium but the subendothelium needs it.needs it.

Tunica intima Endothelium SubendotheliumTunica media Smooth muscles Elastic fibersTunica adventitia

Vaso vasorum

Structure of Arteries, Veins, and CapillariesStructure of Arteries, Veins, and Capillaries

Figure 19.1a

Types of Blood VesselsTypes of Blood Vessels

Arteries – carry blood away from the heartArteries – carry blood away from the heart– It does not matter if it is oxygenated or deoxy It does not matter if it is oxygenated or deoxy

blood. If it is leaving the heart, it is an artery.blood. If it is leaving the heart, it is an artery.

Capillaries – smallest blood vesselsCapillaries – smallest blood vessels– The site of exchange of molecules between The site of exchange of molecules between

blood and tissue fluidblood and tissue fluid

Veins – carry blood toward the heartVeins – carry blood toward the heartIt does not matter if it is oxygenated or deoxy blood. If It does not matter if it is oxygenated or deoxy blood. If it is entering the heart, it is a vein.it is entering the heart, it is a vein.

ArteriesArteriesARTERIES ARTERIES carry carry blood away from the blood away from the heart.heart. Arteries have a Arteries have a smaller lumen than smaller lumen than veins of similar size. veins of similar size. Arterial walls are Arterial walls are thicker than venous thicker than venous walls.walls.Arteries have more Arteries have more elastin than veins.elastin than veins.Arteries have no Arteries have no valves because the valves because the blood pressure in blood pressure in arteries is high enough arteries is high enough that there is no that there is no backflow of blood.backflow of blood.

ArteriesArteries

Two types of large arteries:

Elastic

Muscular

Types of ArteriesTypes of Arteries

Elastic arteries – Elastic arteries – the largest arteries the largest arteries – Diameters range Diameters range

from 1 - 2.5 cm from 1 - 2.5 cm – Includes the aorta Includes the aorta

and its major and its major branchesbranches

– High elastin High elastin content dampens content dampens surge of blood surge of blood pressurepressure

Figure 19.2a

ELASTIC ARTERIESELASTIC ARTERIESa.a. Largest, closest to heart. Largest, closest to heart. b.b. Has to take the full force of the systolic Has to take the full force of the systolic

contraction; compensates by expanding a contraction; compensates by expanding a lot. lot.

c.c. There of lots of elastic fibers in the tunica There of lots of elastic fibers in the tunica intima as well. intima as well.

d.d. Does blood flow during diastole? Yes; Does blood flow during diastole? Yes; elastic arteries return to original size, pumps elastic arteries return to original size, pumps blood. blood.

e.e. This is another pump besides the heart.This is another pump besides the heart.

Muscular ArteriesMuscular ArteriesMuscular Muscular (distributing) (distributing) arteriesarteries– Distal to elastic Distal to elastic

arteriesarteries– From 0.3 mm- 1 From 0.3 mm- 1

cm cm – Includes most of Includes most of

the named arteriesthe named arteries– Tunica media is Tunica media is

thickthick

Figure 19.2b

MUSCULAR ARTERIESMUSCULAR ARTERIESa.a. Function is to distribute blood, and help Function is to distribute blood, and help

control which regions of the body get blood. control which regions of the body get blood. b.b. When you are exercising, you want the When you are exercising, you want the

blood from the GI system to go to muscles.blood from the GI system to go to muscles.c.c. When your hands are cold, your body is When your hands are cold, your body is

using its blood for something more using its blood for something more important. Therefore, the vessels will important. Therefore, the vessels will constrict in the hands. constrict in the hands.

d.d. Dilation is just lack of constriction.Dilation is just lack of constriction.

ARTERIOLESARTERIOLES

These are microscopic; they are the These are microscopic; they are the smallest type of artery. smallest type of artery. Large ones look like muscular arteries.Large ones look like muscular arteries.Small ones only have two layers: Small ones only have two layers: endothelium and tunica media. endothelium and tunica media. One of the characteristics of an arteriole is One of the characteristics of an arteriole is that when it contracts, the lumen closes that when it contracts, the lumen closes completely.completely.

Types of ArteriesTypes of Arteries

ArteriolesArterioles– Smallest Smallest

arteriesarteries– Diameters Diameters

range from 10 range from 10 µm to 0.3 mm µm to 0.3 mm

Figure 19.2c

AneurysmAneurysmA sac-like outpouching of an A sac-like outpouching of an arteryartery– Can rupture at any time; Can rupture at any time;

in aorta or brain can in aorta or brain can cause death within a few cause death within a few seconds. seconds.

– Symptoms: Swelling or Symptoms: Swelling or throbbing (asymptomatic throbbing (asymptomatic in brain)in brain)

Some common locations for Some common locations for aneurysms include:aneurysms include:– AortaAorta– Brain Brain – Leg Leg – Intestine (mesenteric Intestine (mesenteric

artery aneurysm) artery aneurysm) – Splenic artery Splenic artery

aneurysm (can form aneurysm (can form during pregnancy) during pregnancy)

AneurysmAneurysm

Causes of an aneurysm:Causes of an aneurysm:– Defect in part of the artery wallDefect in part of the artery wall– High blood pressure (abdominal aortic High blood pressure (abdominal aortic

aneurysms)aneurysms)– Congenital (present at birth)Congenital (present at birth)

Usually not detected except by an Usually not detected except by an angiogram or ultrasound.angiogram or ultrasound.Treatment: surgical repairTreatment: surgical repair

AneurysmAneurysm

StrokeStroke

The Ovation Abdominal Stent Graft System

Aneurysms can be repaired through open surgery or less invasively with endograft repair using a stent graft otherwise known as an endograft. Endografts feature a tube typically made of plastic material that is supported by a metal frame or stent. They are compressed into a delivery catheter, inserted into the femoral artery of the leg and then threaded into position in the weakened portion of the artery where they are released. Once released, the endograft expands against the wall of the aorta to redirect blood flow away from the aneurysm.

How to Recognize a Stroke How to Recognize a Stroke (“STROKE”)(“STROKE”)

S * Ask the individual to SMILE. S * Ask the individual to SMILE. T * Ask the person to TALK and SPEAK A SIMPLE T * Ask the person to TALK and SPEAK A SIMPLE SENTENCE (Coherently; i.e. It is sunny out today)SENTENCE (Coherently; i.e. It is sunny out today) R * Ask him or her to RAISE BOTH ARMS.R * Ask him or her to RAISE BOTH ARMS.O * Open the mouth and stick out the tongueO * Open the mouth and stick out the tongueK * Keep them comfortable and stillK * Keep them comfortable and stillE * Get EMERGENCY help (911)E * Get EMERGENCY help (911)

If one side of the body responds differently than the If one side of the body responds differently than the other side, or if they have trouble with the task, call other side, or if they have trouble with the task, call 911.911.

Important:Important:You don’t have enough blood to go around; you You don’t have enough blood to go around; you only have 5 liters for 100,000 miles of blood only have 5 liters for 100,000 miles of blood vessels. vessels. At any given time, most blood vessels will be At any given time, most blood vessels will be closed (except at lungs). closed (except at lungs). Are you using your legs now? When your legs Are you using your legs now? When your legs run low on oxygen, the vessels there will open run low on oxygen, the vessels there will open up again. up again. Are you using your brain now? I hope so! The Are you using your brain now? I hope so! The vessels there will be open. vessels there will be open. When your leg falls asleep, there is pressure on When your leg falls asleep, there is pressure on an artery which stops the blood flow. When the an artery which stops the blood flow. When the nerves are deprived of oxygen, they tingle.nerves are deprived of oxygen, they tingle.

Some clinically significant arteries Femoral artery: easy to find pulse,

but susceptible to injury. Circle of Willis: loop of arteries

around pituitary and optic chiasma. Common area for stroke to cause blindness.

Circle of Circle of WillisWillis

CapillariesCapillaries

Smallest blood vessels; they are found Smallest blood vessels; they are found everywhereeverywhereThese are the only sites of nutrient, gas These are the only sites of nutrient, gas exchange, and waste exchange in the exchange, and waste exchange in the cardiovascular system. cardiovascular system. – Diameter from 8–10 µmDiameter from 8–10 µm

Diameter is similar to an erythrocyteDiameter is similar to an erythrocyteRed blood cells pass through single fileRed blood cells pass through single fileThey only have an endothelium. They only have an endothelium.

CapillariesCapillaries

Site-specific functions of capillariesSite-specific functions of capillariesIn the lungs – oxygen enters blood, carbon dioxide In the lungs – oxygen enters blood, carbon dioxide leavesleavesIn the small intestines – receive digested nutrientsIn the small intestines – receive digested nutrientsIn endocrine glands – pick up hormonesIn endocrine glands – pick up hormonesIn the kidneys – removal of nitrogenous wastesIn the kidneys – removal of nitrogenous wastes

Capillary PermeabilityCapillary Permeability

Intercellular clefts – gaps of unjoined Intercellular clefts – gaps of unjoined membrane membrane – Small molecules can enter and exit Small molecules can enter and exit

Three types of capillariesThree types of capillaries– Continuous – most commonContinuous – most common– Fenestrated (“window”) – have poresFenestrated (“window”) – have pores– Discontinuous (Sinusoids) – have very large Discontinuous (Sinusoids) – have very large

gapsgaps

Types of CapillariesTypes of Capillaries

CONTINUOUS CAPILLARIESCONTINUOUS CAPILLARIES FENESTRATED CAPILLARIESFENESTRATED CAPILLARIES DISCONTINUOUS CAPILLARIESDISCONTINUOUS CAPILLARIES

CONTINUOUS CAPILLARIESCONTINUOUS CAPILLARIESAll capillaries are made of simple squamous All capillaries are made of simple squamous epithelium. epithelium. Continuous capillaries are most common, found in Continuous capillaries are most common, found in all organs of body. all organs of body. They have intracellular clefts, the function of which They have intracellular clefts, the function of which is essential for plasma to leak out and bathe each is essential for plasma to leak out and bathe each cell with extracellular fluid, which is rich in oxygen cell with extracellular fluid, which is rich in oxygen and nutrients. and nutrients. Erythrocytes and platelets don’t fit through, but Erythrocytes and platelets don’t fit through, but leukocytes can squeeze through so they can enter leukocytes can squeeze through so they can enter and leave the blood vessels as needed. and leave the blood vessels as needed.

Continuous CapillaryContinuous Capillary

Figure 19.4a

FENESTRATED CAPILLARIESFENESTRATED CAPILLARIES

These have a lot more leakage because These have a lot more leakage because there are more pores (holes). there are more pores (holes). Found in areas where lots of fluids need to Found in areas where lots of fluids need to be moved back and forth (synovial be moved back and forth (synovial membrane, small intestine). membrane, small intestine).

Fenestrated CapillaryFenestrated Capillary

Figure 19.4b

DISCONTINUOUS CAPILLARIES DISCONTINUOUS CAPILLARIES (sinusoidal capillaries) (sinusoidal capillaries)

These have very large gaps in the capillary. These have very large gaps in the capillary. Anything can go in and out here, including Anything can go in and out here, including erythrocytes. erythrocytes. These are found in red bone marrow, where These are found in red bone marrow, where RBCs are made, and they need to enter the RBCs are made, and they need to enter the circulation by way of the sinusoidal capillaries. circulation by way of the sinusoidal capillaries. These capillaries are also in the liver and These capillaries are also in the liver and spleen, where red blood cells are destroyed. spleen, where red blood cells are destroyed.

SinusoidsSinusoids

Figure 19.4c

Capillary BedsCapillary Beds

Figure 19.3a

PRE-CAPILLARY SPHINCTERPRE-CAPILLARY SPHINCTERA small muscle in front of each capillary, controls A small muscle in front of each capillary, controls the flow of blood to individual capillaries.the flow of blood to individual capillaries.ARTERIOLESARTERIOLES direct the blood flow to the direct the blood flow to the specific specific tissuetissue. PRE-CAPILLARY . PRE-CAPILLARY SPHINCTERS direct the blood flow to specific SPHINCTERS direct the blood flow to specific cellscells. . If one cell is starving, the capillary next to it will If one cell is starving, the capillary next to it will open. The sphincter opens and closes open. The sphincter opens and closes depending on the needs of individual cells.depending on the needs of individual cells.

Capillary BedsCapillary Beds

Figure 19.3b

PRE-CAPILLARY SPHINCTERPRE-CAPILLARY SPHINCTERThere is not enough blood to go around, There is not enough blood to go around, so blood always flows only to those cells so blood always flows only to those cells and tissues that need it. and tissues that need it. They drop off nutrients, pick up CO2 They drop off nutrients, pick up CO2 waste, etc. waste, etc.

VeinsVeins

Veins take blood TO the heart. Two types:Veins take blood TO the heart. Two types:– Venuole: from the capillary to the veinVenuole: from the capillary to the vein– Vein: takes blood to the heart.Vein: takes blood to the heart.

Thinner walls (less pressure here)Thinner walls (less pressure here)Larger lumen (blood moves more slowly)Larger lumen (blood moves more slowly)Skeletal muscle pushes on the vein to move the Skeletal muscle pushes on the vein to move the blood uphill. blood uphill. Need valves in veins Need valves in veins

Valves in VeinsValves in Veins

How does blood get uphill back to the heart? How does blood get uphill back to the heart? Veins need valves. Veins need valves. Veins are the only BLOOD vessels that have Veins are the only BLOOD vessels that have valves (although LYMPH vessels also have valves (although LYMPH vessels also have valves). valves). Valves in veins allow blood to move in only one Valves in veins allow blood to move in only one direction. What pushes the blood? The muscles direction. What pushes the blood? The muscles of the body constrict, squeezing the vessels. of the body constrict, squeezing the vessels. This is a type of blood pump.This is a type of blood pump.

VeinsVeins

BLOOD PUMPS

The heart Elastic arteries Muscles constricting the veins

Clinically Significant Veins Greater Saphenous vein: used for

coronary bypass; most likely becomes varicose.

Facial vein: “Danger triangle” infection spreads to meninges in brain.

Renal vein: oxygen poor, and contains the lowest concentration of nitrogen waste.

Veins that are rich in oxygen and nutrients

Umbilical vein Hepatic Portal vein Pulmonary vein

Fun Fact Shivering increases your body heat

by 18 fold. Moderate walking only increases it

by 3 fold.

Varicose VeinsVaricose Veins

The valves become incompetent:The valves become incompetent:They can’t close all the way because too They can’t close all the way because too much fluid has built up in them and the much fluid has built up in them and the lumen has stretched too wide. lumen has stretched too wide. They might be asymptomatic or they may They might be asymptomatic or they may be painful (phlebitis).be painful (phlebitis).

Varicose VeinsVaricose Veins

Varicose Vein TreatmentVaricose Vein Treatment

Laser can be used to seal off the distal Laser can be used to seal off the distal end of the vein. It will close off.end of the vein. It will close off.Sclerosing agents (alcohol or saline) Sclerosing agents (alcohol or saline) injected around the vein can be used to do injected around the vein can be used to do the same thing.the same thing.Large painful veins can be surgically Large painful veins can be surgically removed (vein stripping)removed (vein stripping)

EdemaEdemaIf the veins are varicose for a long time, If the veins are varicose for a long time, plasma may leak out into the tissues, plasma may leak out into the tissues, causing edema. causing edema. Edema means swelling anywhere in the Edema means swelling anywhere in the body (including from an injury or from body (including from an injury or from hanging your legs down too long like when hanging your legs down too long like when on an airplane), but it frequently occurs on an airplane), but it frequently occurs from incompetent veins in the legs.from incompetent veins in the legs.

EdemaEdemaThere are two types of edema:There are two types of edema:– PittingPitting– Non-pittingNon-pitting

Pitting EdemaPitting Edema

Pitting edema is when you can push your finger Pitting edema is when you can push your finger into the skin and it leaves behind your print into the skin and it leaves behind your print when you remove it.when you remove it.This type is less serious; it tends to be better in This type is less serious; it tends to be better in the morning since the legs have been horizontal the morning since the legs have been horizontal all night.all night.It will improve if a pressure bandage is applied.It will improve if a pressure bandage is applied.

Pitting Edema Pitting Edema in the Footin the Foot

Treatment for Pitting EdemaTreatment for Pitting EdemaAce wrapAce wrap– In the foot or leg always wrap from base of toes all the way In the foot or leg always wrap from base of toes all the way

to below the knee. Don’t leave a hole at the heel!to below the knee. Don’t leave a hole at the heel!– In the hand, always wrap from the base of the fingers to In the hand, always wrap from the base of the fingers to

right before the bend of the elbowright before the bend of the elbow

Support hose (don’t use the kind with the open heel; Support hose (don’t use the kind with the open heel; edema will push out of that area)edema will push out of that area)Jobst Intermittent Compression Jobst Intermittent Compression – A machine is used to inflate air in a bag around the A machine is used to inflate air in a bag around the

leg. The air pressure is increased and decreased leg. The air pressure is increased and decreased every few minutes to milk the edema out. Patient every few minutes to milk the edema out. Patient goes in for therapy several times a week.goes in for therapy several times a week.

Jobst Intermittent CompressionJobst Intermittent Compression

Non-Pitting EdemaNon-Pitting Edema

Non-pitting edema is hardened tissue that Non-pitting edema is hardened tissue that does not leave your fingerprint.does not leave your fingerprint.It is just as bad in the morning as it is at It is just as bad in the morning as it is at the end of the day.the end of the day.This is more severe because it does not This is more severe because it does not go away easily.go away easily.

Tip For Everyone!Tip For Everyone!

Buy your shoes at the end of the day when Buy your shoes at the end of the day when your feet are the most swollen.your feet are the most swollen.Wear new shoes around the house for two Wear new shoes around the house for two hours to make sure they don’t hurt.hours to make sure they don’t hurt.Diabetic people need to have someone else Diabetic people need to have someone else examine their feet after wearing a new pair examine their feet after wearing a new pair of shoes for two hours. Check for redness of shoes for two hours. Check for redness and blisters that they might not see or feel.and blisters that they might not see or feel.

Venous Stasis UlcersVenous Stasis Ulcers

Might occur after the formation of varicose Might occur after the formation of varicose veins, when plasma has leaked out into the veins, when plasma has leaked out into the tissues, causing edema.tissues, causing edema.Acid products from the blood plasma (carbon Acid products from the blood plasma (carbon dioxide, etc) can eventually erode all the way dioxide, etc) can eventually erode all the way to the skin.to the skin.Common in diabetics.Common in diabetics.Treatment must address sugar levels, vein Treatment must address sugar levels, vein problem, and the open wound.problem, and the open wound.

Venous Venous Stasis Stasis UlcersUlcers

PHLEBITISPHLEBITIS

Inflammation of a veinInflammation of a veinUsually in the legs.Usually in the legs.When phlebitis is associated with the When phlebitis is associated with the formation of blood clots (thrombosis), formation of blood clots (thrombosis), usually in the deep veins of the legs, the usually in the deep veins of the legs, the condition is called Deep Vein condition is called Deep Vein TThrombophlebitis (DVT)hrombophlebitis (DVT)..

DEEP VEIN DEEP VEIN THROMBOPHLEBITISTHROMBOPHLEBITIS

Signs and SymptomsSigns and SymptomsRedness (erythema) and warmth with a Redness (erythema) and warmth with a temperature elevation of a degree or more temperature elevation of a degree or more above the baseline above the baseline Pain or burning along the length of the Pain or burning along the length of the vein vein Swelling (edema) Swelling (edema) Vein being hard, and cordlike Vein being hard, and cordlike Need ER if all symptoms are presentNeed ER if all symptoms are present

DVTDVT

Severe DVTSevere DVT

Spider VeinsSpider VeinsSmall superficial veins become varicose and Small superficial veins become varicose and do not function properly.do not function properly.Cause an unsightly appearance but are not Cause an unsightly appearance but are not dangerous.dangerous.Injections of alcohol or saline into the vein Injections of alcohol or saline into the vein will sclerose them (scar them shut).will sclerose them (scar them shut).A laser can also be used to do the same.A laser can also be used to do the same.After treatment, macrophages will eventually After treatment, macrophages will eventually phagocytize them and they will disappear.phagocytize them and they will disappear.

Spider VeinsSpider Veins

Tissue NecrosisTissue Necrosis

Necrosis = deadNecrosis = deadCaused by infection, toxins, or traumaCaused by infection, toxins, or traumaAlmost always detrimental and can be Almost always detrimental and can be fatalfatal

Peripheral Vascular Disease Peripheral Vascular Disease (PVD)(PVD)

Refers to the obstruction of large arteries, frequently in the Refers to the obstruction of large arteries, frequently in the lower extremity. Usually caused from atherosclerosis (fatty lower extremity. Usually caused from atherosclerosis (fatty plaques).plaques).SymptomsSymptoms– Claudication: pain, weakness, numbness, or cramping Claudication: pain, weakness, numbness, or cramping

in muscles due to decreased blood flowin muscles due to decreased blood flow– Sores, wounds, or ulcers that heal slowly or not at allSores, wounds, or ulcers that heal slowly or not at all– Change in color (blueness or paleness) or temperature Change in color (blueness or paleness) or temperature

(coolness) when compared to the other limb(coolness) when compared to the other limb– Diminished hair and nail growth on affected limb and Diminished hair and nail growth on affected limb and

digits (shiny, hairless skin)digits (shiny, hairless skin)

MigrainesMigrainesMigraines are severe headaches that cause Migraines are severe headaches that cause vomiting and photosensitivity (the person vomiting and photosensitivity (the person cannot tolerate any light).cannot tolerate any light).They can be caused by several things, They can be caused by several things, including muscle spasms in the blood vessels.including muscle spasms in the blood vessels.Caffeine can cause them, and so can caffeine Caffeine can cause them, and so can caffeine withdrawal.withdrawal.Treatments may include medicines, botox Treatments may include medicines, botox injections, and magnesium infusions. injections, and magnesium infusions.

Restless Leg Syndrome (RLS)Restless Leg Syndrome (RLS)

This is NOT a blood vessel disease. It is a This is NOT a blood vessel disease. It is a neurological condition that is characterized by neurological condition that is characterized by the irresistible urge to move the legs. the irresistible urge to move the legs. The need to move is often accompanied by The need to move is often accompanied by uncomfortable sensations. uncomfortable sensations. RLS symptoms start or become worse when RLS symptoms start or become worse when resting. resting. RLS symptoms are relieved soon after starting RLS symptoms are relieved soon after starting an activity. an activity.