Pathologies of the Peripheral Nervous System (PNS)
Popliteal Aneurysm
Definition: A pathological dilation of the popliteal artery due to a weakness or defect in the arterial wall or predisposed by injury.
Causes: The popliteal artery, a continuation of the femoral artery is common side of peripheral aneurysms. Peripheral aneurysms are more common in males especially over the age of 55. It is often predisposed...
Varicose Veins
Definition: Stretched, tortuous or distended veins, usually in lower extremities.
Causes: Varicose veins are formed due to valve incompetence secondary to an inherent weakness in the vein wall causing dilation and separation of venous valve cusps. Risk factors include: older age, parity, obesity Examination: With the patient standing and both legs fully exposed, observe the...
Elevated Jugular Venous Pressure (JVP)
Definition: High blood the pressure in the venous system as blood returns to the right side of the heart before it is sent into the pulmonary circulation. Causes: Congestive heart failure, Superior vena cava obstruction (the veins do no pulsate), Hypervolemia (fluid overload), Pulmonary embolism and Cardiac tamponade. Examination: The patient lies supine and at...
Deep Vein Thrombosis (DVT)
Definition: Formation of a blood clot in a vein, in the lower extremities, which partially or completely impedes blood flow. DVT is a medical emergency. Thrombus dislodgement may precipitate pulmonary embolus.
Causes: Risk factors to look for in the case history include: immobility, trauma, familial thrombophilia, COP/HRT, pregnancy, dehydration, increased age, obesity, male gender, previous...
Abdominal Aortic Aneurysm (AAA)
Definition: Localized dilation or bulge in the abdominal aorta. Risk of rupture is related to the degree of dilation.
Causes: The cause of AAA is degradation of the layers of the aorta, with inflammatory infiltrates in both the intima and tunica media. The major risk factors include: atherosclerosis, smoking, a male gender, increasing age (aneurysms are...
Jugular Venous Pressure
Definition: Evaluating the pressure in the venous system as the blood is returned to the right side of the heart before it is sent into the pulmonary circulation.
Test procedure: The patient lies supine and at 45 degrees. The internal jugular vein is visualised as it ascends the side of the neck between the two...