Health

ATHEROSCLEROSIS OF LEG’S ARTERIES

The most common location for atherosclerosis, other than in the heart, is in the arteries that feed the legs. Blood leaving the heart flows into the large aorta, which carries blood to all parts of the body. As the aorta passes down into the abdomen, it divides into two large iliac arteries that supply the pelvis and the legs. When the iliac arteries enter the thighs, their name changes to femoral arteries. The femoral arteries then branch into smaller and smaller vessels that eventually supply the feet and toes. Any of these blood vessels can be affected by atherosclerosis, from the largest (the aorta) to the smallest arteries in the feet.
Arteriosclerosis obliterans is the medical name applied to inadequate blood supply to the legs. The process can also occur in the arms, but does so infrequently. The main symptom that develops in the legs is pain, particularly in the calves, when the person is walking or running. The reason for this is simple. When a person walks or runs, the muscles of his legs are exercising and require more blood flow to supply food and oxygen to the muscles. The heart beats faster and more blood is pumped through the arteries. Just as the heart produces the pain of angina pectoris if it does not get an adequate blood supply during exercise, the leg muscles cause pain if they are getting insufficient blood supply. When the disease process becomes more advanced, the pain in the legs may become constant, occurring even at rest. At this stage, walking is practically impossible.
Another symptom that may be noticed is coldness of the legs and feet, or pain in the legs and feet when they are exposed to cold. For this reason, the afflicted person may keep his feet covered with extra stockings. They may appear very red, or even bluish, when the person is standing or sitting. Another common finding is the disappearance of hair on the feet and toes and slow growth of the toenails.
A mistake is commonly made at this point. Feeling cold in the feet and legs, people frequently wrap their legs with hot water bottles, hot towels or heating pads. The mistake is the application of heat, because the skin and other tissues are easily damaged by outside heat, and it is very easy to “cook” the tissue.
The subject of damaged tissue introduces the next problem. People with inadequate blood supply to the legs do not heal as fast as normal, because the process of healing requires blood flow. If a blister develops on the foot, or if the toe is cut when the nails are trimmed, or if athlete’s foot develops, healing will be considerably delayed. Extra care is therefore necessary to avoid wounding these tissues and to prevent infection.
A stratagem can be followed that will assist healing. The blood flow to the leg is greater when the person is lying down or sitting with his legs up than when he is on his feet or sitting in the usual manner. This is because gravity tends to hold the blood down in the leg and resists its return to the heart. When a person is walking, the muscles of the legs are pumping the blood in the veins back to the heart. The veins of the legs have special one-way valves inside them to facilitate this pumping action. When the leg is elevated, the effect of gravity is cancelled, and the total blood flow to the leg is increased.
If the larger blood vessels (iliac arteries) in the pelvis are affected by atherosclerosis, the person will frequently notice that the pain that he feels when he walks is located in the thighs rather than in the calves. For men, another frequent symptom of blockage in this location is the loss of the ability to have an erection. The process of erection is dependent upon an increased flow of blood into the penis. The artery that supplies this blood is a branch of the iliac vessels.
The ultimate problem that can occur with this condition in the legs is the development of gangrene. This death of tissue caused by inadequate blood flow results in part of the toe or the entire leg turning black. The process usually starts in the toes, and it is frequently immediately preceded by an infection or injury of the tissue in the area. If the blockage is extensive, the gangrene may progress to involve the entire foot or part of the leg. When the disease has progressed to this point, amputation is the only recourse.
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ATHEROSCLEROSIS OF LEG’S ARTERIESThe most common location for atherosclerosis, other than in the heart, is in the arteries that feed the legs. Blood leaving the heart flows into the large aorta, which carries blood to all parts of the body. As the aorta passes down into the abdomen, it divides into two large iliac arteries that supply the pelvis and the legs. When the iliac arteries enter the thighs, their name changes to femoral arteries. The femoral arteries then branch into smaller and smaller vessels that eventually supply the feet and toes. Any of these blood vessels can be affected by atherosclerosis, from the largest (the aorta) to the smallest arteries in the feet.Arteriosclerosis obliterans is the medical name applied to inadequate blood supply to the legs. The process can also occur in the arms, but does so infrequently. The main symptom that develops in the legs is pain, particularly in the calves, when the person is walking or running. The reason for this is simple. When a person walks or runs, the muscles of his legs are exercising and require more blood flow to supply food and oxygen to the muscles. The heart beats faster and more blood is pumped through the arteries. Just as the heart produces the pain of angina pectoris if it does not get an adequate blood supply during exercise, the leg muscles cause pain if they are getting insufficient blood supply. When the disease process becomes more advanced, the pain in the legs may become constant, occurring even at rest. At this stage, walking is practically impossible.Another symptom that may be noticed is coldness of the legs and feet, or pain in the legs and feet when they are exposed to cold. For this reason, the afflicted person may keep his feet covered with extra stockings. They may appear very red, or even bluish, when the person is standing or sitting. Another common finding is the disappearance of hair on the feet and toes and slow growth of the toenails.A mistake is commonly made at this point. Feeling cold in the feet and legs, people frequently wrap their legs with hot water bottles, hot towels or heating pads. The mistake is the application of heat, because the skin and other tissues are easily damaged by outside heat, and it is very easy to “cook” the tissue.The subject of damaged tissue introduces the next problem. People with inadequate blood supply to the legs do not heal as fast as normal, because the process of healing requires blood flow. If a blister develops on the foot, or if the toe is cut when the nails are trimmed, or if athlete’s foot develops, healing will be considerably delayed. Extra care is therefore necessary to avoid wounding these tissues and to prevent infection.A stratagem can be followed that will assist healing. The blood flow to the leg is greater when the person is lying down or sitting with his legs up than when he is on his feet or sitting in the usual manner. This is because gravity tends to hold the blood down in the leg and resists its return to the heart. When a person is walking, the muscles of the legs are pumping the blood in the veins back to the heart. The veins of the legs have special one-way valves inside them to facilitate this pumping action. When the leg is elevated, the effect of gravity is cancelled, and the total blood flow to the leg is increased.If the larger blood vessels (iliac arteries) in the pelvis are affected by atherosclerosis, the person will frequently notice that the pain that he feels when he walks is located in the thighs rather than in the calves. For men, another frequent symptom of blockage in this location is the loss of the ability to have an erection. The process of erection is dependent upon an increased flow of blood into the penis. The artery that supplies this blood is a branch of the iliac vessels.The ultimate problem that can occur with this condition in the legs is the development of gangrene. This death of tissue caused by inadequate blood flow results in part of the toe or the entire leg turning black. The process usually starts in the toes, and it is frequently immediately preceded by an infection or injury of the tissue in the area. If the blockage is extensive, the gangrene may progress to involve the entire foot or part of the leg. When the disease has progressed to this point, amputation is the only recourse.*42/309/5*

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