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Describe Hypertension
- BP consistenly greater than 140/90
- Insidious onset with mild symptoms
- people don't know they have it until something major happens
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List the Three different types of HTN
- primary (essential)
- Secondary: related to disease (rental)
- Malignant: uncontrollablem, severe, with mnay complications
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What does HTN do to the arteries
damages arterial wall, atheromas form, aneurysms, dilate or tear
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Etiology and S&S of HTN
- risk factors as discuessed for CAD, NA+ intake stress
- S&S: asymptomatic untill well advanced, then fatigue, malaise, AM HA, can cuase complications
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Treatment for HTN
- Lifestyle changes: decrease salt intake, exercise, decrease body weight, decrease stress
- Meds: diuretics, antihypertensive meds
- Implications for functional abilites
- Needs to moitor BP and rest and with exercise
- sideeffects of meds
- Prognosis: more likely to develop CAd stroke and kidney failure
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Define Arteriosclerosis
generalized term used for all types of arterial changes
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Define PVD
any abnormallity in the arteries or veins outside the heart
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Atherosclerosis
gradual formation of fatty plaque
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PVD and Atherosclerosis pathology
- formation of atheroma cuts off blood flow
- Most common sites: abdominal aorta, femoral and iliac
- Partial Occlusion: implaired motor and sensory function in LE's
- Complete occlusion: loss of blood supply to the limb= necrosis, ulcers, gangrene
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S&S of PVD
- fatigues weakness in LE's as blood flow decreases
- INtermittent claudication - pain at rest
- Sensory impairments tingling buring numb decreases peripheral pulses
- Skin is pale when extremity elevated red when dependent
- Skin is dry, hairless, feels COLD
- POOR healing ability
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Diagnosis of PVD
- Doppler studies
- Arteriography
- Plethysmorgaphy
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Treatment for PVD
- Conservative
- Lifestyle modificiations: decrease cholesterol, quit smoking, midify stress, keep LE's in dependent position to increase arterial blood flow, avoid trauma, regular exericse, examine feet
- Medications: anticoagulants, peripheral vasodilators
- Surgiacal
- Bypass grafts, angioplasty, endarterectomy, amputation
- During PT
- care must be taken be avoid any skin trauma
- regular examination of the feet especially if sensory loss
- special fitted shoes
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Buergers disease
- inflamm of medium and small vessels in legs and arms from nicotine
- inflammation thrombus occlusion similar to atheromas
- severe pain eeven at reast can lead to ulcers and gangrene
- smoking has a role in the inflammaotry process may also be related to an immune system defect
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Raynauds Syndrome
Vasospasm with exposure to cold stress or smoking
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Patho and Etiology of Aneurysms
- Patho: Localized dilitation of arterial wall can rupture causing massive hemorrhage
- Etiology: atherosclerosis, trauma congenital defects in arterial wall
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S&S of Aneurysms
- Asymptomatic until very large
- can cause sym related to compression of nearby structures
- if it ruptures severe pain, shock - loss of pulses - death
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Diagnosis and Treatment of Aneurysms
- Diagnosis: x-ray, us CT scan
- Treatment: if detected before rupture maintain normal blood pressure, prepare for surgery to resect graft clip.
- Implication for functional activity: may see pt for PT post surgery. Monitor BP ICP
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Varicose Veins Patho and Etiology
- Patho: irregular, dilated tortuous areas of superficial/ deep veins (legs, esophagus, ructum) defect in valves or weakness of vein walls. Can increase incidence of thrombus
- Etiology: familial tendency, trauma, IV fluids, long term standing crossing legs, tight clothing. pregnancy
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Varicose Veins S&S and Treatment
- S&Sbluish purple bulging circles
- edema in feet
- fatigues and achiness
- Treatment
- Elevate legs, use of support stockings
- Eliminate precipitating factors
- Use muscle contraction
- Surgical Stripping
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Thrombophlebitis or Phlebothrombosis patho and factors
- Pathology: inflammtion, thrombis formation in a vein
- Factors: stasis or sluggish blood flow (immobility)
- Endothelial injury (trauma, chemial injury)
- Increased coagulabilty (cancer, dehydration)
- RISK OF PULMONARY EMBOLISM
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Thrombophlebitis or Phlebothrombosis S&S and Treatment
- Superficial: aching tender, warm, red
- Deep (DVT): pain, tenderness, edema, positvie homans sings (doris flex increase pain
- Treatment: preventions
- Exercise, Elevate Legs, Elastic stocking and or sequential compression device
- Anticoaguland Meds
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Types of Shock
- Hypovolemic: loss of blood volume
- Cardiogenic: inability of heart to pump blood through circulation
- Neurogenic: Pooling of blood in periphery (pain, fear, drugs, SCI-loss of SNS input)
- Anaphylactic:
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