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Raynaud phenomenon p. 484
Raynaud phenomenon p. 484
Buerger disease p. 482
calcium channel blockers for p. 325
presentation p. 718
SLE p. 718
Raynaud phenomenon p. 483
Raynaud phenomenon is a phenomenon where there’s vasoconstriction of arteries near the skin that make a body part, often the fingers, turn white, then blue, and then red in response to a trigger like cold weather.
The phenomenon is named after Auguste Gabriel Maurice Raynaud, a French physician, who first described it.
To clear up some potentially confusing terminology, it’s called Raynaud disease or primary Raynaud phenomenon where the condition occurs alone and is not associated with any other disease, and it’s called Raynaud syndrome or secondary Raynaud phenomenon when it is associated with diseases like systemic lupus erythematosus or scleroderma.
Normally blood flows from large arteries into medium-sized or muscular arteries, and then into small arterioles which carry the blood to capillary beds.
All arterial vessels have three layers: from inside moving out, there’s the endothelium, then the media layer which contains smooth muscle, and finally the adventitia layer which has loose connective tissue and nerves.
Some nerve fibers in the skin function as thermoreceptors, which sense changes in temperature.
The hypothalamus is what triggers the thought – “Hey, it’s pretty cold here. Maybe I should find a friendly llama to snuggle with for warmth.”
For example, normally, there’s a lot of heat energy in the blood, that gets lost to the environment.
Raynaud phenomenon is a condition in which due to cold temperatures or emotional stress, blood vessels in the fingers and toes constrict and restrict blood supply in affected areas. This can cause symptoms like numbness, tingling, brittle nails, and pain in the affected areas. In severe cases, fingers may turn white, reflecting ischemia, and then blue reflecting hypoxia, which is the low oxygen state that occurs after prolonged ischemia.
Raynaud phenomenon is common among pregnant women and people who work in jobs that cause lots of vibration, like using a jackhammer. It may also be a symptom of underlying conditions, such as systemic lupus erythematosus, scleroderma, vasculitides, or Takayasu's arteritis. Treatment includes avoiding triggers like cold temperatures, stress, smoking, and caffeine, and occasionally using a medication like a calcium channel blocker to help with vasodilation of the arteries. In severe cases, surgery may be necessary to cut the sympathetic nerve fibers supplying the affected areas and improve blood flow.
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