Obliterative diseases of the lower limbs (lecture vasilevsky v.p
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This document discusses obliterative atherosclerosis of the lower limbs. It begins with definitions of atherosclerosis and discusses prevalence rates that increase with age. Two main theories of pathogenesis are described. Risk factors include disorders of the vessel wall, receptor changes, immunity, homocysteinemia, and genetics. Clinical manifestations include pain, numbness, weakness, and color/texture changes in the limbs. Stages of the disease are classified using the Fontaine system. Diagnostic tools mentioned are reovasography, ultrasound, duplex scanning, angiography, MRI/CT, and transcutaneous oxygen tension measurements. Palpation of lower limb arteries is also described.
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Atherosclerosis
Atherosclerosis is the most common and rapidly growing disorder in this new world because of the modern age lifestyle people are adopting. But it can easily be prevented if not easily cured.The right knowledge can always help prevent atherosclerosis and save our lives from its deadly outcomes.
As it is always RIGHTLY said "Prevention is better than cure"
Neuropathic (Charcots) joints
Jean-Martin Charcot first described neuropathic arthropathy in 1868. It is a progressive joint condition characterized by dislocations, fractures, and deformities that results from sensory or autonomic neuropathy from various conditions like diabetes, MS, alcoholism, etc. The pathophysiology involves both repetitive microtrauma from loss of sensation and an inflammatory process induced by neurovascular changes. It commonly affects the foot, knee, and hip. Diagnosis is made clinically and radiographically, showing features like joint destruction and deformity. Treatment involves casting, bracing, and surgery like fusion for advanced cases.
6.pathology of upperlimb & lower limb arterial system.pptx
This document discusses various arterial diseases of the lower and upper limbs. It begins by classifying limb ischemia using the Fontaine and Rutherford classifications which grade the severity of ischemia from asymptomatic to tissue loss. It then discusses specific arterial diseases like atherosclerosis, thromboangiitis obliterans (TAO), and vasculitis. For atherosclerosis and TAO, it covers risk factors, pathogenesis, clinical features and complications. It also discusses related conditions like Raynaud's phenomenon and thoracic outlet syndrome. In particular, it provides detailed descriptions of giant cell arteritis and Takayasu's arteritis, two types of vasculitis.
Cardiovascular Pathophysiology- Coronary Atherosclerosis and Arteriosclerosis
This document defines and compares arteriosclerosis and atherosclerosis. Arteriosclerosis is a hardening and loss of elasticity of the arteries, while atherosclerosis is a specific type caused by buildup of plaques in the artery walls. The document lists the main risk factors for atherosclerosis as smoking, high cholesterol, hypertension, and lifestyle factors. It describes the potential signs and symptoms depending on the affected artery, such as chest pain for coronary artery disease or leg pain for peripheral artery disease. The complications can include heart attack, stroke, or limb loss if left untreated. Prevention strategies include controlling blood pressure, managing diabetes, exercising, not smoking, and maintaining a healthy diet.
Diagnostic Imaging of Osteonecrosis & Osteochondrosis
This document discusses osteonecrosis and osteochondrosis. It defines osteonecrosis as bone death due to interruption of blood supply and describes its common causes and radiographic features including MRI appearance. Specific types discussed include Kienbock's disease, Preiser's disease, and Legg-Calve-Perthes disease. Osteochondrosis is defined as abnormal bone and cartilage development, with subtypes including Scheuermann's disease, Osgood-Schlatter disease, and Blount's disease caused by repetitive stress without necrosis, as well as osteonecrosis conditions. Radiographic features of each condition are provided.
OA for undergraduates: diagnosis & treatment.
Osteoarthritis is a slowly progressive degenerative disease leading to gradual loss of articular cartilage. It affects not only cartilage but other joint tissues as well, including bone, ligaments, capsules, and synovial membrane. Risk factors include age, obesity, joint injury, genetics, and occupational factors. Symptoms include joint pain, stiffness, crepitus, and deformity. Diagnosis is based on clinical features and confirmed with x-rays showing bone spurs and joint space narrowing. Treatment involves lifestyle changes, medications for pain/inflammation, injections, and surgery for advanced cases.
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17. A 64-year-old woman has had several episodes of transient ischemic attacks (TIAs).
Aspirin would be a preferred treatment, but she has a history of severe “aspirin
sensitivity” manifest as intense bronchoconstriction. Which group aspirin belongs to?
Side effects of aspirin. What would be a suitable alternative to the aspirin? Mechanism
of action of this drug, indications, routes of administration.
19. A 42-year-old man with an acute MI is treated with alteplase. What is the
mechanism of main desired effect? Which group drug belongs to? Routes of alteplase
administration. Mechanism of action and major indications. Which group and what
drugs may counteract effects of alteplase?
20. A 60-year-old woman with deep-vein thrombosis (DVT) is given a bolus of heparin,
and a heparin drip is also started. 30 min later, she is bleeding profusely from the
intravenous site. The heparin is stopped, but the bleeding continues. Which drug may
reverse the adverse effect of heparin? What is mechanism of heparin action? Side
effects of heparin and routes of administration. Which group heparin belongs to?
Varicose venous disease of lower limbs (lecture vasilevsky v.p.)
This document discusses varicose veins of the lower limbs, including:
- Varicose veins affect 1 in 5 women and 1 in 15 men worldwide.
- They are often caused by genetic factors and weakness of the venous walls and valves.
- Diagnosis involves functional tests to evaluate venous valves and detect incompetent perforator veins.
- Treatment ranges from compression therapy and sclerotherapy to surgical procedures like vein stripping.
- Surgery is recommended for decompensated or complicated cases to prevent issues like bleeding, skin changes, and deep vein thrombosis.
Seronegative spondyloarthropathies
The document discusses seronegative and seropositive spondyloarthropathies. It describes the key characteristics of several types of spondyloarthropathies including ankylosing spondylitis, reactive arthritis, psoriatic arthritis, and arthritis associated with inflammatory bowel disease. Imaging findings are an important part of diagnosis and include changes in the sacroiliac joints and spine seen on radiography as well as MRI findings. HLA-B27 positivity is also discussed as a predictor for some types.
Avascular necross
This document discusses avascular necrosis (also known as osteonecrosis), which is the death of bone tissue due to impaired blood supply. It affects over 20,000 new patients per year in the US, most commonly males ages 30-60. Risk factors include steroid use, alcoholism, blood clotting disorders, and autoimmune diseases like SLE. Symptoms may include joint pain. Diagnosis involves imaging modalities like x-ray, CT, MRI, and bone scans. Treatment aims to delay disease progression and prevent joint breakdown, and may include nonsurgical options or eventually joint replacement if collapse occurs.
Peripheral arterial diseases
PERIPHERAL ARTERIAL DISEASES- INTRODUCTION- Limb Ischemia
Dear Viewers,
Greetings from “Surgical Educator”
Today I am uploading an introductory video on “Peripheral Arterial Diseases”. In this video I have discussed the surgical anatomy, modes of presentation, symptoms, signs, investigations and a diagnostic algorithm of Peripheral Arterial Diseases. In the subsequent three videos I will discuss about chronic lower limb ischemia, acute lower limb ischemia and upper limb ischemia. I hope you will enjoy these series of teaching videos. You can watch these videos in the following links:
surgicaleducator.blogspot.com
youtube/c/surgicaleducator
Thank you for watching the video.
Osteoarthritis
1) Osteoarthritis is a progressive degenerative disease affecting synovial joints that results from stresses that damage joint tissues.
2) It is most common in people over 40 and prevalence increases with age, making it a major cause of disability in the elderly.
3) Treatment involves both non-pharmacologic options like exercise and weight loss as well as pharmacologic options like acetaminophen, NSAIDs, and opioids to manage pain.
58632-1702-195651-1-10-20210201.pdf
This document provides an overview of acute limb ischemia (ALI), including its diagnosis and management. ALI is a sudden decrease in blood flow to the limbs caused by thrombus or embolism. Diagnosis involves assessing the patient's history, symptoms of pain and reduced pulses, and imaging tests like duplex ultrasound, CT angiography, or digital subtraction angiography to identify clot location. Treatment may involve anticoagulation, thrombolysis drugs, endovascular procedures to remove clots, or surgical revascularization procedures to restore blood flow if limbs are severely threatened. Both pharmacological and interventional techniques are discussed as options to reperfuse ischemic limbs within 24 hours and prevent limb loss.
Wiki powerpoint
Atherosclerosis is a disease where plaque builds up inside arteries, restricting blood flow. It most commonly affects major arteries like the aorta, coronary, and cerebral arteries. Symptoms vary depending on which arteries are blocked, and can include chest pain, weakness, or loss of vision. Atherosclerosis is the leading cause of death in many countries. While the hardening of arteries cannot be reversed, lifestyle changes like a healthy diet, exercise, and not smoking can help prevent atherosclerosis from worsening. Current research focuses on developing new treatments using natural sources like plants, as well as promoting prevention through lifestyle modifications.
Similar to Obliterative diseases of the lower limbs (lecture vasilevsky v.p (20)
Presentation1.pptx, radiological imaging of upper limb ischemia.
Presentation1.pptx, radiological imaging of upper limb ischemia.
6.pathology of upperlimb & lower limb arterial system.pptx
6.pathology of upperlimb & lower limb arterial system.pptx
Cardiovascular Pathophysiology- Coronary Atherosclerosis and Arteriosclerosis
Cardiovascular Pathophysiology- Coronary Atherosclerosis and Arteriosclerosis
Diagnostic Imaging of Osteonecrosis & Osteochondrosis
Diagnostic Imaging of Osteonecrosis & Osteochondrosis
Varicose venous disease of lower limbs (lecture vasilevsky v.p.)
Varicose venous disease of lower limbs (lecture vasilevsky v.p.)
More from Сяржук Батаеў
Acute appendicitis(lecture vasilevsky v.p.)
Acute appendicitis is an inflammation of the appendix that can lead to necrosis or perforation. It is one of the most common surgical conditions of the abdomen. The presentation can vary greatly from mild abdominal pain to symptoms mimicking many other conditions. A definitive diagnosis can be difficult without imaging or surgery. Treatment is an appendectomy, though the surgical approach may vary. Complications can include appendiceal masses, abscesses, and peritonitis if not treated surgically. Both pre-operative and post-operative complications are possible if perforation or infection occurs.
Suppurative diseases of lungs and pleura (lecture vasilevsky v.p.)
1. The document discusses various suppurative lung diseases including pulmonary abscesses, gangrene, bronchiectasis, and empyema.
2. Empyema is defined as pus within the pleural cavity and can be acute or chronic. Treatment options depend on whether it is an acute or chronic case and include thoracentesis, tube thoracostomy, thoracoscopic debridement, and various thoracotomy procedures.
3. The document provides detailed classifications, presentations, and treatment approaches for different suppurative lung conditions. Surgery is indicated in cases of bleeding, foreign objects, or treatment failure, while chronic cases may require more invasive approaches like thoracoscopic procedures or rib resections
Peritonitis (lecture mogilevec e.v
Peritonitis is inflammation of the peritoneum lining the abdominal cavity. It can be caused by infection, injury, or chemical irritation. Acute peritonitis requires prompt treatment to eliminate the infectious source and reduce bacterial load. Treatment involves intravenous antibiotics, surgery to resolve the underlying cause, and intensive care as needed. Prognosis depends on the severity and cause of peritonitis. More severe or generalized cases with organ dysfunction carry a high risk of complications and mortality.
Diseases of aorta and its branches (lecture vasilevsky v.p.)
This document discusses the etiology, diagnosis, classification, and management of non-specific aorto-arteritis (NAA) and impairment of the aorta and its branches. It provides details on the following:
- Causes of NAA including atherosclerosis, non-specific aorto-arteritis, pathological twisting, and fibro-muscular dysplasia.
- Classification of NAA based on disease stage, morphological changes, localization, and organ ischemia.
- Diagnosis involves physical exams, lab tests, and imaging. General principles for management include conservative treatments like anti-inflammatory therapies and surgery for significant damage or complications.
Complications of peptic ulcer
The document discusses complications of peptic ulcers, including perforation, hemorrhage, gastric outlet obstruction, penetration, and malignant change. Perforation is a common complication that occurs when a weak spot in the stomach or duodenal wall ruptures. Symptoms include severe abdominal pain. Treatment involves surgery to repair the perforation along with antibiotics and resuscitation. Bleeding is another major complication that can range from mild to life-threatening. Symptoms include vomiting blood or black stools. Treatment involves endoscopic methods to stop bleeding along with fluid replacement and medications. Surgery may be needed if bleeding cannot be controlled otherwise or for other complications like perforation.
Cholelitiasis and its complications. (lecture vasilevsky v.p.)
1) Gallstones affect over 20 million Americans and cause 300,000 operations and 6,000 deaths annually from complications. The risk increases with age, with 20% of women and 5% of men over 50 affected.
2) Symptoms of gallstones/cholecystitis include pain in the right upper abdomen and back, nausea, vomiting, fever, and tenderness when pressing on the right costal margin or xiphoid process.
3) Treatment options include stone dissolution, lithotripsy, laparoscopic cholecystectomy (removal of the gallbladder through small incisions), and open or laparoscopic surgery on the biliary ducts to remove stones or correct strictures.
Acute pancreatitis (lecture vasilevsky v.p.)
Acute pancreatitis is an inflammatory disease of the pancreas caused by activation of pancreatic enzymes. The document discusses the definition, etiology, clinical presentation, treatment and surgical management of acute pancreatitis. Conservative treatment focuses on pain management, reducing pancreatic stimulation and enzyme inactivation. Surgical intervention is indicated for infected pancreonecrosis, organ failure despite conservative care, or pancreatic parenchymal necrosis over 50%. The goal of surgery is adequate drainage of the abdominal and retroperitoneal spaces.
Acute bowel obstuction (lecture mogilevec e.v)
This document discusses acute intestinal obstruction, including classifications, causes, clinical features, investigations and treatments. It classifies obstruction based on origin, method of occurrence, blood flow and clinical course. Mechanical obstruction is distinguished from functional obstruction. Signs of small bowel obstruction include abdominal pain, nausea, vomiting and distention. Large bowel obstruction causes dull abdominal cramps and distention. Treatment involves decompression, fluid resuscitation, antibiotics and surgery to remove obstructions and non-viable bowel segments.
More from Сяржук Батаеў (8)
Suppurative diseases of lungs and pleura (lecture vasilevsky v.p.)
Suppurative diseases of lungs and pleura (lecture vasilevsky v.p.)
Diseases of aorta and its branches (lecture vasilevsky v.p.)
Diseases of aorta and its branches (lecture vasilevsky v.p.)
Cholelitiasis and its complications. (lecture vasilevsky v.p.)
Cholelitiasis and its complications. (lecture vasilevsky v.p.)
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Obliterative diseases of the lower limbs (lecture vasilevsky v.p
- 1. GRODNO STATE MEDICAL UNIVERSITY Department of surgical diseases №1 Obliterative diseases of the lower limbs Assistant lecturer Vasilevsky V.P.
- 3. Atherosclerosis (obliterative atheromatous disease) of the lower extremities Chronic disease with occlusive or stenotic damages of main and middle size peripheral arteries, which is as the result of lipid deposition in their walls. This pathology is evident with insufficiency of arterial blood circulation in lower limbs. It can be of different degree (rate) of manifestation.
- 4. Prevalence of obliterating atherosclerosis More than 20 % in all cardio-vascular pathology; in 1000 men women 45 - 54 years – 1,8 0,6 55 - 64 years – 5,1 1,9 64 - 74 years – 6,3 3,8 5 – 7 % of population in the age of 60 – 70 years; 180 – 250 amputations on 1 million of population in Europe; 1500 amputations on 1 million of population in Russia.
- 5. Theories of atherosclerotic pathogenesis 1. Cholesterol theory (Halatov S.S., 1911). 2. Combinative theory (Anichkov N.N., 20-th years of the XX century). ┬ Realising factor Conditions of (dyslipidemia) development
- 6. Etiology and pathogenesis of obliterating atherosclerosis 1. Disorders of the vessel wall. 2. Functional changes of cell- receptor apparatus. 3. Decreasing of immunity. 4. Homocysteinemia . 5. Genetic (inherited) factor.
- 7. Dyslipidemia There are five main classes of lipoproteins: - chylomicrons , - very low density lipoproteins (VLDL), - low density lipoproteins (LDL), - high density lipoproteins (HDL), - lipoproteins «a» (LP a).
- 8. Clinical manifestations of the peripherial lower limb ischaemia The cardinal features of periferial lower limb ischaemia include: 1. Pain in the limbs. It is the main symptom lower limb ischaemia. Appearance of it is due to ischaemia of the muscles, caused by inadequate oxygenation of tissues. The patient with chronic ischaemia of legs may have 2 types of pain. The first type is when pain is initiated by walking and relieved at rest. The second type is a rest pain.
- 9. Clinical manifestations of the peripherial lower limb ischaemia 2. Coldness, numbness, paraesthesia; 3.Weakness in muscles of the legs; 4. Brittle, flatand ridged nail, and shiny skin; 5. Diminished hair and nail growth on affected limb and digits; 6. Colour changes (blueness or paleness); 7. Atrophy of muscles; 8. Loss of subcutaneous fat;
- 10. Clinical classifications of obliterating atherosclerosis of the lower limbs Stages of chronic arterial insufficiency of the lower limbs according to Rene Fontaine I stage(initial manifestations of the occlusions)- mild pain on walking (“claudication”). II stage (circulative insufficiency in functional load)- severe pain on walking relatively short distances (intermittent “claudication”). III stage (circulative insufficiency at rest conditions)- pain at rest (“night pain”). IV stage (ulcerative necrotic changes of the distal parts of the legs)- tissue loss (gangrene).
- 11. Palpation of the lower limb arteries Common femoral artery (under inguinal ligament; between inner and middle it’s third) Popliteal artery (the middle of the popliteal fossa) Dorsal pedis artery (on cuneiform bones; continuation of the 1st interfinger interval) Back tibial artery (fossa behind the medial ankle)
- 12. Instrumental methods of investigation Reovasography USD (graphy) Dupplex scanning Angio-arteriography Magnetic resonance imaging or computed tomography with vessel enchancement Transcutaneus oxygen tension (TPO2)