NURS 287 Lecture Notes - Lecture 4: Intermittent Claudication, Critical Limb Ischemia, Claudication
28 Apr 2013
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Lecture 4: peripheral arterial disease of the lower extremities. Pad of the lower extremities affects the aortoiliac, femoral, popliteal, tibial, or peroneal arteries. Paresthesia, manifested as numbness or tingling in the toes or feet, may result from nerve tissue ischemia. Gradually diminishing perfusion to neurons produces loss of both pressure and deep pain sensations. Rest pain most often occurs in the forefoot or toes, is aggravated by limb elevation, and occurs when there is insufficient blood flow to maintain basic metabolic requirements of the tissues and nerves of the distal extremity. Complications of pad include nonhealing ulcers over bony prominences on the toes, feet, and lower leg, and gangrene. Amputation may be required if blood flow is not restored. Tests used to diagnose pad include doppler ultrasound with segmental blood pressures at the thigh, below the knee, and at ankle level. A falloff in segmental bp of more than 30 mm hg indicates pad.
