20. – ARTERIES

20. – ARTERIES

Arteries (from the Greek ἀρτηρία - artēria, "windpipe, artery"^]) are blood vessels that carry blood away from the heart. This blood is normally oxygenated, exceptions made for the pulmonary and umbilical arteries. The EABV is that ICF fluid which fills the arterial system.

The circulatory system is extremely important for sustaining life. Its proper functioning is responsible for the delivery of oxygen and nutrients to all cells, as well as the removal of carbon dioxide and waste products, maintenance of optimum pH, and the mobility of the elements, proteins and cells of the immune system. In developed countries, the two leading causes of death, myocardial infarction and stroke, each may directly result from an arterial system that has been slowly and progressively compromised by years of deterioration. (See atherosclerosis).

An aneurysm or aneurism (from Greek: ἀνεύρυσμα - aneurusma "dilation", from ἀνευρύνειν -

aneurunein "to dilate") is a localized, blood-filled balloon-like bulge in the wall of a blood vessel. Aneurysms can commonly occur in arteries at the base of the brain (the circle of Willis) and an aortic aneurysm occurs in the main artery carrying blood from the left ventricle of the heart. When the size of an aneurysm increases, there is a significant risk of rupture, resulting in severe hemorrhage, other complications or death. Aneurysms can be hereditary or caused by disease, both of which cause the wall of the blood vessel to weaken.

SYNCOPE

Syncope is defined as a transient, self-limited loss of consciousness with an inability to maintain postural tone that is followed by spontaneous recovery. The term syncope excludes seizures, coma, shock, or other states of altered consciousness

.

ORTHOSTATIC HYPOTENSION

Orthostatic hypotension, also known as postural hypotension, and colloquially as head rush or dizzy spell, is a form of hypotension in which a person's blood pressure suddenly falls

when standing up or stretching. The symptom is caused by blood pooling in the lower extremities upon a change in body position. It is quite common and can occur briefly in anyone, although it is particularly prevalent among the elderly, and those with low blood pressure. It can also cause people to be dizzy on the spot

Signs and symptoms

When orthostatic hypotension is present, the following symptoms can occur after sudden standing or stretching (after standing):

• Dizziness
• Euphoria or dysphoria
• Bodily dissociation
• Distortions in hearing
• Lightheadedness
• Nausea
• Headache
• Blurred or dimmed vision (possibly to the point of momentary blindness)
• Generalized (or extremity) numbness/tingling and fainting
• Coat hanger pain (pain centered in the neck and shoulders)
• And in rare, extreme cases, vasovagal syncope (a specific type of fainting).

They are consequences of insufficient blood pressure and cerebral perfusion (blood supply). Occasionally, there may be a feeling of warmth in the head and shoulders for a few seconds after the dizziness subsides.

VARICOSE VEINS

Varicose veins or arteries are veins that have become enlarged and tortuous. The term commonly refers to the veins on the leg, although varicose veins can occur elsewhere. Veins have leaflet valves to prevent blood from flowing backwards (retrograde flow or reflux). Leg muscles pump the veins to return blood to the heart (the calf muscle pump mechanism), against the effects of gravity. When veins become varicose, the leaflets of the valves no longer meet properly, and the valves do not work (valvular incompetence). This allows blood to flow backwards and they enlarge even more. Varicose veins are most common in the superficial veins of the legs, which are subject to high pressure when standing. Besides cosmetic problems, varicose veins are often painful, especially when standing or walking. They often itch, and scratching them can cause ulcers. Serious complications are uncommon.
Varicose veins, commonly referred to as "varicosities", represent enlarged collaterals (branches) of so-called saphenous venous system affected by a disease called "superficial venous insufficiency of lower extremities". Varicosities, therefore, constitute not a disease, but a symptom of superficial venous insufficiency, though not the most frequent symptom. Heaviness, tiredness, swelling, pain, muscle cramps, difficulties walking and even standing are some of other symptoms of the above disease.

Non-surgical treatments include sclerotherapy, elastic stockings, elevating the legs, and

exercise. The traditional surgical treatment has been vein stripping to remove the affected veins. Newer, less invasive treatments which seal the main leaking vein on the thigh are available. Alternative techniques, such as ultrasound-guided foam sclerotherapy, radiofrequency ablation and endovenous laser treatment, are available as well. Because most of the blood in the legs is returned by the deep veins, the superficial veins, which return only about 10 per cent of the total blood of the legs, can usually be removed or ablated without serious harm.
Secondary varicose veins are those developing as collateral pathways, typically after stenosis or occlusion of the deep veins, a common sequel of extensive deep venous thrombosis (DVT). Treatment options are usually support stockings, occasionally sclerotherapy, and rarely limited surgery.
Varicose veins are distinguished from reticular veins (blue veins) and telangiectasias (spider veins), which also involve valvular insufficiency, by the size and location of the veins. Many patients who suffer with varicose veins seek out the assistance of physicians who specialize in vein care or pheripheral vascular disease. These physicians are called phlebologists or interventional radiologists.

STROKE

A stroke, or cerebrovascular accident (CVA), is the rapid loss of brain function(s) due to disturbance in the blood supply to the brain. This can be due to ischemia (lack of blood flow) caused by blockage (thrombosis, arterial embolism), or a hemorrhage. As a result, the affected area of the brain cannot function, which might result in an inability to move one or more limbs on one side of the body, inability to understand or formulate speech, or an inability to see one side of the visual field.

A stroke is a medical emergency and can cause permanent neurological damage, complications, and death. Risk factors for stroke include old age, hypertension (high blood pressure), previous stroke or transient ischemic attack (TIA), diabetes, high cholesterol, cigarette smoking and atrial fibrillation. High blood pressure is the most important modifiable risk factor of stroke. It is the second leading cause of death worldwide.

An ischemic stroke is occasionally treated in a hospital with thrombolysis (also known as a "clot buster"), and some hemorrhagic strokes benefit from neurosurgery. Treatment to recover any lost function is termed stroke rehabilitation, ideally in a stroke unit and involving health professions such as speech and language therapy, physical therapy and occupational therapy. Prevention of recurrence may involve the administration of antiplatelet drugs such as aspirin and dipyridamole, control and reduction of hypertension, and the use of statins. Selected patients may benefit from carotid endarterectomy and the use of anticoagulants