Arterial Insufficiency- Signs and symptoms Adderley gagnon Waechter atheroma thrombus artery vessel diameter hardening blockage artery embolism left atrium thrombus plaque rupture
resistance to flow circulation to tissues distal to occlusion narrowing tissue perfusion positive Allen’s test ABI absent pulses cool extremity pallor dependent robor O2 availability muscle cell metabolic needs exercise demand supply transient ischemia anaerobic metabolism lactic acid buildup muscles intermittent claudication reproducible cramp-like pain alleviated by rest blood velocity poiseuille’s law turbulent flow bruits over time arterioles maximally vasodilator and desensitized to pro-vasodilatory stimuli loss ability compensate reduced vessel diameter chronic limb ischemia atrophic changes hair loss muscle atrophy thin shiny skin nail thickening fungus critical limb ischemia end stage chronic thrombo-embolic event stroke ischemic limb ischemic clotting cascade initiated tissue necrosis pain at rest ulcers big toe heel underside foot gangrene amputation nerve infarction hyporeflexia paraesthesia thromboembolic