Peripheral Vascular Diseases
Peripheral Vascular Diseases
Presented by: Dave Jay Manriquez RN.Focus on Disorders of the
Aorta
(Relates to Chapter 38, Nursing Management: Vascular Disorders,
in the textbook)Copyright 2007, 2004, 2000, Mosby, Inc., an
affiliate of Elsevier Inc. All Rights Reserved.Copyright 2007,
2004, 2000, Mosby, Inc., an affiliate of Elsevier Inc. All Rights
Reserved.2Aortic AneurysmsDefinitionOutpouchings or dilations of
the arterial wallCommon problems involving aortaOccur in men more
often than in womenIncidence with age
Copyright 2007, 2004, 2000, Mosby, Inc., an affiliate of
Elsevier Inc. All Rights Reserved.3Aortic AneurysmsEtiology and
PathophysiologyMay involve the aortic arch, thoracic aorta, and/or
abdominal aortaMost are found in abdominal aorta below renal
arteries of aortic aneurysms occur in abdominal aorta found in
thoracicMost common cause is atherosclerosis
Copyright 2007, 2004, 2000, Mosby, Inc., an affiliate of
Elsevier Inc. All Rights Reserved.4Aortic AneurysmsEtiology and
PathophysiologyAtherosclerotic plaques deposit beneath the
intimaPlaque formation is thought to cause degenerative changes in
the mediaLeading to loss of elasticity, weakening, and aortic
dilationMale gender and smoking stronger risk factors than
hypertension and diabetes.inflammation and endotheil injury play
arole.Copyright 2007, 2004, 2000, Mosby, Inc., an affiliate of
Elsevier Inc. All Rights Reserved.5Aortic
AneurysmsClassificationTrue aneurysmtrue aneurysm is one that
involves all three layers of the wall of an arteryFurther
subdividedFusiformCircumferential, relatively uniform in
shapeSaccularPouchlike with narrow neck connecting bulge to one
side of arterial wall
Copyright 2007, 2004, 2000, Mosby, Inc., an affiliate of
Elsevier Inc. All Rights Reserved.6Types of Aneurysms
Fig. 38-3Copyright 2007, 2004, 2000, Mosby, Inc., an affiliate
of Elsevier Inc. All Rights Reserved.7Aortic AneurysmClinical
ManifestationsThoracic aorta aneurysms Often asymptomaticMost
common manifestation Deep diffuse chest pain Pain may extend to the
interscapular area(between the scapul or shoulder blades)
Copyright 2007, 2004, 2000, Mosby, Inc., an affiliate of
Elsevier Inc. All Rights Reserved.8Aortic AneurysmClinical
ManifestationsAscending aorta/aortic archProduce angina
HoarsenessIf presses on superior vena cavaDecreased venous return
can causeDistended neck veinsEdema of head and arms Copyright 2007,
2004, 2000, Mosby, Inc., an affiliate of Elsevier Inc. All Rights
Reserved.9Aortic AneurysmClinical ManifestationsAbdominal aortic
aneurysms (AAA)Often asymptomaticFrequently detectedOn physical
examPulsatile mass in periumbilical areaBruit may be
auscultatedWhen patient examined for unrelated problem (i.e., CT
scan, abdominal x-ray)
Copyright 2007, 2004, 2000, Mosby, Inc., an affiliate of
Elsevier Inc. All Rights Reserved.10Aortic AneurysmClinical
ManifestationsAAA, contMay mimic pain associated with abdominal or
back disordersMay spontaneously embolize plaqueCausing blue toe
syndrome patchy mottling of feet/toes with presence of palpable
pedal pulsesCopyright 2007, 2004, 2000, Mosby, Inc., an affiliate
of Elsevier Inc. All Rights Reserved.11Aortic
AneurysmComplicationsRupture- serious complication related to
untreated aneurysmBleeding may be tamponaded by surrounding
structures, thus preventing exsanguination and deathSevere
painMay/may not have back/flank ecchymosisCopyright 2007, 2004,
2000, Mosby, Inc., an affiliate of Elsevier Inc. All Rights
Reserved.12Aortic AneurysmDiagnostic StudiesX-raysChest -
Demonstrate mediastinal silhouette and any abnormal widening of
thoracic aortaAbdomen -May show calcification within wall of AAAECG
-to rule out MIEchocardiographyUltrasonographyCopyright 2007, 2004,
2000, Mosby, Inc., an affiliate of Elsevier Inc. All Rights
Reserved.13Aortic AneurysmDiagnostic StudiesCT scanMost accurate
test to determine
MRIDiagnose and assess the location and severityCopyright 2007,
2004, 2000, Mosby, Inc., an affiliate of Elsevier Inc. All Rights
Reserved.14Angiography of Aneurysm
Fig. 38-2Copyright 2007, 2004, 2000, Mosby, Inc., an affiliate
of Elsevier Inc. All Rights Reserved.15Aortic AneurysmCollaborative
CareGoal - prevent aneurysm from rupturingEarly detection/treatment
imperativeOnce detectedStudies done to determine size and
location
Copyright 2007, 2004, 2000, Mosby, Inc., an affiliate of
Elsevier Inc. All Rights Reserved.16Aortic AneurysmCollaborative
CareIf carotid and/or coronary artery obstructions presentMay need
to be corrected before repairSmall aneurysm (
