Atherosclerosis and Other Arterial Diseases

Which is the most common location for peripheral artery disease? femoral artery aorta femoral vein carotid artery

Femoral artery

A patient has Raynaud's phenomenon. What area of the body does the clinician expect to be affected?

Hands

Which of the following cell types form foam cells? Erythrocytes Platelets T cells Macrophages

Macrophages

Atherosclerosis

-Basic physiological change that results in cardiovascular disease -Foam cell formation -Hyperlipidemia -C-reactive protein and homocysteine levels are used for assessment -Atherosclerosis, a common disease, is form of arteriosclerosis in which the lumen of arterial wall becomes occluded with plaques. -The plaques are formed from cholesterol and white blood cells forming foam cells. -Although white blood cells are involved, formation of the plaques is not caused by an autoimmune response. -Elevated C-reactive protein (an inflammation marker), homocysteine levels, and hyperlipemia are associated with atherosclerosis

Aortic Dissection

-Blood pressure differential between R and L arm -Sudden onset of symptoms including chest pain and tearing sound -Surgical repair required -33% of patients die within first 24 hours -Aortic dissection is a life-threatening condition in which a tear in the inner layer of the aortic wall appears. -Blood pours into the tear, separating (dissecting) the inner layer from the middle layer. - If the tear ruptures, death may result. Almost one-third of patients with aortic dissection die within the first 24 hours. -Surgical repair of the tear is needed. -Signs and symptoms include a sudden onset of severe chest pain. -Depending on the location of the dissection, blood flow to either arm may be compromised, resulting in a difference in pressure between the arms.

Vasculitis

-Immune complexes deposited in arterial walls -takayasu arteritis is an example -Associated with autoimmune process -Classified based on vessel size affected -Vasculitis is inflammation of the vessels and is classified according to the size of the vessels affected. -The disease may be systemic or affect one area or tissue of the body. -Several forms of vasculitis exist, and an autoimmune component, with immune complexes deposited in the arterial walls, has been found to play a role. -Signs and symptoms of vasculitis vary, depending on the tissues involved. -Takayasu arteritis is one example of vasculitis; it affects the aorta and pulmonary arteries.

Peripheral Arterial Disease (PAD)

-Intermitted claudication -Decreased peripheral pulses -Ankle-brachial index used for assessment -Peripheral artery disease results in decreased blood flow to the extremities. -Most commonly, the arteries of the legs are affected. -Depending on the extent of the blockage, peripheral pulses may be diminished in one limb compared with the other. -The ankle-brachial index (ABI) compares the blood pressure in the ankles with the blood pressure in the arms and may be reduced with peripheral arterial disease in the lower extremities. -When blood flow through the narrowed arteries cannot match the metabolic demands of the tissues, intermittent claudication results.

Abdominal Aortic aneurysm

-May be detected as a bulge in the abdominal aorta -May rupture, leading to internal bleeding -Most common type of aneurysm -Abdominal aortic aneurysms are the most common type of aneurysm and may present as a bulge along the abdominal aorta. -On detection, monitoring over time for changes is the most common course of action. -If an abdominal aortic aneurysm were to rupture, internal bleeding will result. -A "berry aneurysm" refers to a cerebral aneurysm.

Which of the following statements about atherosclerosis are true?

-Risk factors for atherosclerosis include obesity, tobacco use, and family history -Diagnostic tests for atherosclerosis include those for hyperlipidemia -Diabetes mellitus accelerates the development of atherosclerosis

Aneurysm

-Weak arterial wall resulting in bulging of the artery -Abdominal aorta most commonly affected -Fusiform and saccular shapes -An aneurysm is a bulge in an arterial wall. -The most common location for an aneurysm is the abdominal aorta. -An aneurysm may present in different forms including fusiform and saccular. -Surgical repair is not always necessary with an aneurysm, and death does not occur at a high rate within the first 24 hours of development. -Takayasu arteritis is a form of vasculitis and is not a type of aneurysm.

Which of the following statements about aortic dissection are true?

-When left untreated, 33% of patients die within 24 hours. -In aortic dissection, layers of the aortic wall split and allow blood to flow between them. -Aortic dissection requires surgical repair.

Raynaud's phenomenon

-commonly associated with autoimmune diseases -Exagerrated sympathetic response causes vessel constriction -Calcium channel blockers may be effective treatment -Raynaud's phenomenon occurs with an exaggerated sympathetic response causing vasoconstriction resulting in numbness, coolness, and tingling of the extremities. -Raynaud's phenomenon is associated with certain autoimmune conditions, such as lupus. -Calcium channel blockers can be an effective treatment. -Kawasaki's disease, not Raynaud's phenomenon, is a disease that affects the coronary arteries of children.

Intermittent claudication _______________

-occurs most frequently in the legs -Is pain that is alleviated by rest

Which of the following conditions refers to a weakened, bulging arterial wall?

Aneurysm

Which of the following is an immediate, life-threatening condition?

Aortic Dissection

What basic physiological change underlies most cardiovascular diseases?

Atherosclerosis

An outpatient in the clinic complains of leg pain while walking. However, the patient adds that the pain ceases when he is at rest. Which condition would the nurse suspect?

Peripheral Arterial disease