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Chronic Limb Threatening Ischemia
Chronic limb-threatening ischemia (CLTI), previously known as critical limb ischemia (CLI), is a severe manifestation of peripheral artery disease that results in significantly reduced blood flow to the lower extremities, leading to ischemic rest pain, non-healing ulcers, or gangrene. It represents the end stage of peripheral artery disease and is associated with a high risk of limb loss and mortality if left untreated. The condition arises due to progressive atherosclerosis, which leads to arterial narrowing or occlusion, impairing circulation and tissue perfusion. Chronic limb-threatening ischemia is diagnosed based on clinical symptoms and objective measures of perfusion, including the ankle-brachial index, toe-brachial index, transcutaneous oxygen pressure, or skin perfusion pressure. Imaging techniques such as angiography, fluorescence imaging, and subcutaneous oxygen biosensors, are emerging tools for assessment and treatment planning. Management of chronic limb-threatening ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Pain
Pain is a distressing feeling often caused by intense or damaging Stimulus (physiology), stimuli. The International Association for the Study of Pain defines pain as "an unpleasant sense, sensory and emotional experience associated with, or resembling that associated with, actual or potential tissue damage." Pain motivates organisms to withdraw from damaging situations, to protect a damaged body part while it heals, and to avoid similar experiences in the future. Congenital insensitivity to pain may result in reduced life expectancy. Most pain resolves once the noxious stimulus is removed and the body has healed, but it may persist despite removal of the stimulus and apparent healing of the body. Sometimes pain arises in the absence of any detectable stimulus, damage or disease. Pain is the most common reason for physician consultation in most developed countries. It is a major symptom in many medical conditions, and can interfere with a person's quality of life and general fun ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Human Leg
The leg is the entire lower limb (anatomy), limb of the human body, including the foot, thigh or sometimes even the hip or Gluteal muscles, buttock region. The major bones of the leg are the femur (thigh bone), tibia (shin bone), and adjacent fibula. There are 30 bones in each leg. The thigh is located in between the hip and knee. The calf (leg), calf (rear) and Tibia#Structure, shin (front), or shank, are located between the knee and ankle. Legs are used for standing, many forms of human movement, recreation such as dancing, and constitute a significant portion of a person's mass. Evolution has led to the human leg's development into a mechanism specifically adapted for efficient bipedalism, bipedal gait. While the capacity to walk upright is not unique to humans, other primates can only achieve this for short periods and at a great expenditure of energy. In humans, female legs generally have greater hip anteversion and tibiofemoral angles, while male legs have longer femur a ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Foot
The foot (: feet) is an anatomical structure found in many vertebrates. It is the terminal portion of a limb which bears weight and allows locomotion. In many animals with feet, the foot is an organ at the terminal part of the leg made up of one or more segments or bones, generally including claws and/or nails. Etymology The word "foot", in the sense of meaning the "terminal part of the leg of a vertebrate animal" comes from Old English ''fot'', from Proto-Germanic *''fot'' (source also of Old Frisian ''fot'', Old Saxon ''fot'', Old Norse ''fotr'', Danish ''fod'', Swedish ''fot'', Dutch ''voet'', Old High German ''fuoz'', German ''Fuß'', Gothic ''fotus'', all meaning "foot"), from PIE root *''ped-'' "foot". The plural form ''feet'' is an instance of i-mutation. Structure The human foot is a strong and complex mechanical structure containing 26 bones, 33 joints (20 of which are actively articulated), and more than a hundred muscles, tendons, and ligaments.Podiatry Chan ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Intermittent Claudication
Intermittent claudication, also known as vascular claudication, is a symptom that describes muscle pain on mild exertion (ache, cramp, numbness or sense of fatigue), classically in the calf muscle, which occurs during exercise, such as walking, and is relieved by a short period of rest. It is classically associated with early-stage peripheral artery disease, and can progress to critical limb ischemia unless treated or risk factors are modified and maintained. Claudication derives . Signs and symptoms One of the hallmarks of arterial claudication is that it occurs intermittently. It disappears after a very brief rest and the patient can start walking again until the pain recurs. The following signs are general signs of atherosclerosis of the lower extremity arteries: * cyanosis * atrophic changes like loss of hair, shiny skin * decreased temperature * decreased pulse * redness when limb is returned to a "dependent" position (part of Buerger's test) The six "P"s of ischemia * Pa ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Arterial Insufficiency
Peripheral artery disease (PAD) is a vascular disorder that causes abnormal narrowing of arteries other than those that supply the heart or brain. PAD can happen in any blood vessel, but it is more common in the legs than the arms. When narrowing occurs in the heart, it is called coronary artery disease (CAD), and in the brain, it is called cerebrovascular disease. Peripheral artery disease most commonly affects the legs, but other arteries may also be involved, such as those of the arms, neck, or kidneys. Peripheral artery disease (PAD) is a form of peripheral vascular disease. Vascular refers to the arteries and veins within the body. PAD differs from peripheral veinous disease. PAD means the arteries are narrowed or blocked—the vessels that carry oxygen-rich blood as it moves from the heart to other parts of the body. Peripheral veinous disease, on the other hand, refers to problems with veins—the vessels that bring the blood back to the heart. The classic symptom is ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Arterial Insufficiency Ulcers
Arterial insufficiency ulcers (also known as ischemic ulcers, or ischemic wounds) are ulcers mostly located on the lateral surface of the ankle or the distal digits. They are commonly caused by peripheral artery disease (PAD). Characteristics The ulcer has punched-out appearance. It is intensely painful. It has gray or yellow fibrotic base and undermining skin margins. Pulses are not palpable. Associated skin changes may be observed, such as thin shiny skin and absence of hair. They are most common on distal ends of limbs. A special type of ischemic ulcer developing in duodenum after severe burns is called Curling's ulcer. Cause The ulcers are caused by lack of blood flow to the capillary beds of the lower extremities. Most often endothelial dysfunction is causative factor in diabetic microangiopathy and macroangiopathy. In microangiopathy, neuropathy and autoregulation of capillaries leads to poor perfusion of tissues, especially wound base. When pressure is placed on the ski ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Gangrene
Gangrene is a type of tissue death caused by a lack of blood supply. Symptoms may include a change in skin color to red or black, numbness, swelling, pain, skin breakdown, and coolness. The feet and hands are most commonly affected. If the gangrene is caused by an infectious agent, it may present with a fever or sepsis. Risk factors include diabetes, peripheral arterial disease, smoking, major trauma, alcoholism, HIV/AIDS, frostbite, influenza, dengue fever, malaria, chickenpox, plague, hypernatremia, radiation injuries, meningococcal disease, Group B streptococcal infection and Raynaud's syndrome. It can be classified as dry gangrene, wet gangrene, gas gangrene, internal gangrene, and necrotizing fasciitis. The diagnosis of gangrene is based on symptoms and supported by tests such as medical imaging. Treatment may involve surgery to remove the dead tissue, antibiotics to treat any infection, and efforts to address the underlying cause. Surgical efforts may include ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Peripheral Artery Disease
Peripheral artery disease (PAD) is a vascular disorder that causes abnormal narrowing of arteries other than those that supply the heart or brain. PAD can happen in any blood vessel, but it is more common in the legs than the arms. When narrowing occurs in the heart, it is called coronary artery disease (CAD), and in the brain, it is called cerebrovascular disease. Peripheral artery disease most commonly affects the legs, but other arteries may also be involved, such as those of the arms, neck, or kidneys. Peripheral artery disease (PAD) is a form of peripheral vascular disease. Vascular refers to the arteries and veins within the body. PAD differs from peripheral veinous disease. PAD means the arteries are narrowed or blocked—the vessels that carry oxygen-rich blood as it moves from the heart to other parts of the body. Peripheral veinous disease, on the other hand, refers to problems with veins—the vessels that bring the blood back to the heart. The classic symptom ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Transcutaneous Oxygen Measurement
Transcutaneous oxygen measurement (TCOM or TcPO2) is a non-invasive method of measuring the oxygen level of the tissue below the skin. Since oxygen is carried by the blood, TCOM can be used as an indirect measure of blood flow to the tissue. Since blood flow is important for wound healing, TCOM is often used to gauge the ability of tissue to effectively heal. To perform the test, one set of electrodes are placed on viable tissue (e.g. the chest) as a control and a second set is placed around the tissue in question (e.g. legs or feet). The electrodes may mildly heat the skin to increase blood flow into the area. Oxygen may also be given to the patient to see if that increases oxygen levels in the tissue. The test takes about 45 minutes. Results are reported either as the absolute values of the tissue in question (in mmHg) or as a ratio of the tissue in question to the control tissue. The normal oxygen tension in the foot is approximately 60 mmHg, and the normal chest/foot ratio is ap ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Buerger's Test
Buerger's test is performed in an assessment of arterial sufficiency. It is named after Leo Buerger. The ''vascular angle'', which is also called ''Buerger's angle'', is the angle to which the leg has to be raised before it becomes pale, whilst lying down. In a limb with a normal circulation the toes and sole of the foot, stay pink, even when the limb is raised by 90 degrees. In an ischaemic leg, elevation to 15 degrees or 30 degrees for 30 to 60 seconds may cause pallor. (This part of the test checks for ''elevation pallor''.) A vascular angle of less than 20 degrees indicates severe ischaemia. From a sitting position, in normal circulation, the foot will quickly return to a pink colour. Where there is peripheral artery disease the leg will revert to the pink colour more slowly than normal and also pass through the normal pinkness to a red-range colouring (''rubor'' - redness) often known as ''sunset foot''. This is due to the dilatation of the arterioles in an attempt to ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Capillary Refill
Capillary refill time (CRT) is defined as the time taken for color to return to an external capillary bed after pressure is applied to cause blanching. It can be measured by holding a hand higher than heart-level and pressing the soft pad of a finger or fingernail until it turns white, then taking note of the time needed for the color to return once pressure is released. In humans, CRT of more than three seconds indicates decreased peripheral perfusion and may indicate cardiovascular or respiratory dysfunction. The most reliable and applicable site for CRT testing is the finger pulp (not at the fingernail), and the cut-off value for the normal CRT should be 3 seconds, not 2 seconds. Assessment In adults CRT can be measured by applying pressure to the pad of a finger or toe for 5–10 seconds. It became popularized in the 1980s when Champion et al. proposed a CRT of less than 2 seconds be deemed normal and included CRT in the Trauma Score. The value of 2 seconds for a normal C ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
