Raynaud’s Disease

Raynaud’s Disease

Introduction

Raynaud’s disease is a condition, which is not familiar to many people around the world. The disease is associated with stress or cold conditions, which bring spasms in the blood vessels, thus restricting the flow of blood to ears, nose, toes, and fingers. The result of this situation is changing the body parts to be extremely cold or turning to purple or blue color. However, there are possibilities of the changed parts to return to their normal conditions when blood begins flowing into them. Raynaud’s disease is explored to act as an artifact to provide an understanding that students have demonstrated the attainment of competent skills in scientific literacy. This insight is gained through the analysis of Raynaud’s disease concerning the description of the pathology, the normal anatomy, and the major body system affected, mechanism of pathophysiology, prevention, and treatment.

Description of the pathology

Scientifically, Raynaud’s disease is denoted as ray-NOHZ in which the illness is known to cause various body parts, such as toes and fingers, to feel cold and numb in response to stress and temperatures. This disease narrows the digital arteries, which transport blood to the skin, hence restricting blood circulation, a situation called vasospasm. Cyanosis and vasospasm are used to establish the statistics of Raynaud’s disease in which it is dominant in women at a rate between 3-20%, while in men, it occurs at 3-14% (Daftardar, 2017). The variation results from changes across the world in terms of climate and population. This statement is reinforced by the view that ray-NOHZ is common in central Europe compared to African, Asian, and American populations. Also, the condition is more prevalent in younger women who are in the median age of 24 years and in members of families who have established ray-NOHZ (Daftardar, 2017). Approximately about 25% of people develop the symptoms first at 40 years (Daftardar, 2017). The major signs and symptoms of the condition are pricking feeling upon stress relief or warming, color changes in the skin, and cold toes or fingers. Besides, during the attack of ray-NOHZ, the affected body parts change first to white, blue, and then turns to normal upon improvement in circulation of blood and warm.

Additionally, there are two types of ray-NOHZ; primary and secondary Raynaud’s.  Here, primary ray-NOHZ is not necessarily due to the associated medical condition since it can be moderate, making patients not seek treatment. On the other hand, secondary Raynaud’s is a result of an underlying problem. Despite secondary ray-NOHZ being a rare condition, it is more dangerous compared to the primary one. However, the signs and symptoms of secondary ray-NOHZ occur at the age of forty years. Secondary ray-NOHZ results from various causes, including connective tissue diseases due to the resultant effect of scarring and hardening of the skin (Stringer & Femia, 2018). Also, artery diseases cause ray-NOHZ since there is the development of plaques in atherosclerosis, leading to inflamed hand and feet vessels. Similarly, carpal tunnel syndrome is where pressure occurs in the nerve, which produces pain and numbness in hands, making them vulnerable to ray-NOHZ.

Normal anatomy of the major body system affected

When attacked by ray-NOHZ, the blood areas of the affected body parts, especially the toes or/and fingers, become narrower within a short period. This situation restricts the free flow of blood, making the toes or fingers numb and cold, which then changes to blue or white (Stringer & Femia, 2018). Similarly, when the blood returns to these body parts, they also change to red. In general, primary ray-NOHZ is associated with healthy people, whereby the anatomy of their digital arteries is not different from healthy vessels. However, the secondary condition is linked with the dominance of ray-NOHZ symptoms, which entail connective-tissue diseases, neurovascular entrapment syndromes, and occlusive arterial disease.

Normal physiology of the major body system affected

In people with ray-NOHZ, one or more of their body parts encounter great vasospasm, with progressive hyperemia and color change. Here, there are three change stages from the first to the last and entails; vasoconstriction (white), cyanosis (blue), and rapid blood reflow (red) (Stringer & Femia, 2018). According to these statements, vasospasm is associated with constriction of vessels, which limits tissues to obtain enough blood. From earlier discussions, an acute attack of ray-NOHZ is brought by three progressive stages, which are associated with pallor, cyanosis, and rubor as a result of emotive or cold stimuli. A well-separated pallor is brought by a series of vasospasm, which is assumed to be a resultant of spastic constriction of the digital arterioles or arteries.

On the other hand, progressive cyanosis is attached to the delayed flow of blood in dilated digital venules and capillaries. Consequently, after some time, reactive hyperemia is encountered, which leads to the occurrence of rubor. However, the three stages do not occur in all patients, whereby some may only encounter cyanosis or pallor. Generally, the normal physiology of ray-NOHZ occurs in stages, where the ischemic phase is associated with diaphoresis and dysesthesias, while recovery is linked to throbbing pain (Stringer & Femia, 2018). The severe cases of this condition are linked to changes, such as sclerodactyly.

Mechanism of Pathophysiology

Raynaud’s phenomenon is closely associated with systemic sclerosis since it is recognized by the presence of serum in which there is a mixture of connective-tissue disease by a protein antibody of ribonuclear. In this situation, patients with ray-NOHZ exhibit characteristics of systemic sclerosis, dermatomyositis, or systemic lupus erythematosus (SLE) (Hughes & Herrick, 2016). Basing on the etiology of this health condition, therefore, its pathophysiological changes impact the flow of blood through variations in blood viscosity, vessel caliber, or pressure gradient. Besides any structural variations that lower vessel calibre, their diameter rests on physiological mechanisms, which control the vasomotor tone. Biologically, the arteries occupy a central role in the control of both blood flow and body temperature.

Additionally, the reflex of local factors relating to chemical arbitrators, such as prostaglandins, serotonin, and sympathetic nervous system, influences the vasomotor tone. The situation causes digital arteries to constrict through the action of adrenergic sympathetic fibres, where dilation is only realized in the presence or removal of the influence. The action of vasodilation is partly explained by serotonin, prostacyclin (PGI2), endothelin-1, thromboxane A2, and E and F classes of prostaglandins (Hughes & Herrick, 2016). Despite Thromboxane A2 and PG12 being an aggregator and inhibitor of platelet, respectively, they are both potent vasoconstrictors.  According to this soluble mediators, there is an associative balance between endothelin and Nitric Oxide (NO), which subdue the role of endothelin (Hughes & Herrick, 2016). The vasodilator impacts of prostacyclins and NO are arbitrated through the nucleotides cGMP and cAMP.

Moreover, the association of thromboxane A2 and PG12 is believed to affect the vasculature by regulating the clearing and laying down of platelet thrombi. Basing on the influence of blood viscosity on ray-NOHZ, the rise in the factor enhances the severity of this health problem. According to the statement, at a body temperature of 27°C, there is a higher viscosity, which inhibits the flow of blood (Hughes & Herrick, 2016). Inflammation of blood vessels also causes ray-NOHZ. Vascular injuries in systemic sclerosis (SSc) may lead to inflammatory responses and prothrombotic and vasospastic constellation, which have a detrimental impact on the vessel walls.

Prevention

In the prevention of ray-NOHZ, dressing for cold using wearing gloves, layers, or heavy socks is highly recommended. Also, individuals are required to wear coats, which have sung cuffs that help to prevent penetration of cold air to the fingers (Stringer & Femia, 2018). Besides, effective prevention of the disease is associated with the use of chemical hand warmers, where the wearing of face mask and earmuffs is required if the earlobe and nose tips are sensitive to cold.

Another prevention of ray-NOHZ is linked to setting up of air conditioners to create warm temperatures. Similarly, the use of drinking glasses, which are insulated with limiting walking in cemented surfaces using bare feet help prevent penetration of cold in fingers and toes. Worth noting, this health problem is also prevented by warming the car using its heater before journeying in cold weather. Consequently, other indoor precautions should be practiced in which when taking freezer or refrigerator foods, there is the necessity of wearing oven mitts, mittens, or gloves.

Treatment

The treatment of Raynaud’s disease relies on pharmacotherapy mechanisms using medications, such as trazodone, quetiapine, and losartan. In this method, losartan is usually a receptor blocker, which is regularly taken as an angiotensin-converting enzyme (Nanda et al., 2018). Administration of this medicine intensifies the circulation of angiotensin II, which leads to decreased vasoconstriction and increases blood circulation. On the other hand, trazodone focuses on inhibition of reuptake, which in turn lowers the concentration of serotonin. In most occasions, serotonin is a vasoactive element, which has a primary function of triggering vasodilation. Besides, quetiapine is an adrenergic and serotonin receptor antagonist, which causes vasodilation (Nanda et al., 2018). Generally, trazodone, quetiapine, and losartan medications result in increasing both flows of blood and vasodilation and reducing platelet aggregation.

Additionally, the severity of this health condition is treated through medication and surgical procedures. This approach is realized through nerve surgery, which is based on the idea that sympathetic nerves in the feet and hand regulate the narrowing and opening of blood vessels in the skin. This surgery is performed by slitting the nerves, which disrupts the exaggerated responses. Here, small cutting is conducted on the affected feet or hands, where a medical practitioner removes some tiny nerves around the blood vessels. Consequently, according to Hirwa (2017), the medical surgery involves a chemical injection, where the usage of Botox (on botulinum toxin type A) or local anesthetics are adopted to block affected sympathetic nerves in hands or feet.

Finally, the treatment of ray-NOHZ is medically managed through the use of vasodilators. In this technique, drugs, which relax the blood vessels, such as nitroglycerin, are adopted and applied to the lower parts of the fingers to heal skin ulcers (Nanda, 2018). Besides, some vasodilators, such as Revatio, Viagra, Prozac (antidepressant fluoxetine), and prostaglandins, are used for the treatment of this disease.

Conclusion

In conclusion, the pathophysiology is a broad medical term, which is undertaken to provide insights about the occurrence of various diseases. The reality of this statement is seen through the use of Raynaud’s disease. This health condition is majorly caused by changes in temperatures and stress, which affects the toes and fingers. According to the normal anatomy of the major body system, Raynaud’s disease affects these body parts by narrowing their blood vessels, which prevents the effective flow of blood. Also, this situation is followed by great vasospasm with progressive hyperemia and color change. Besides, the pathophysiology of Raynaud’s disease is connected to variations in blood viscosity, vessel calibre, or pressure gradient. However, the prevention of this disease focuses on limiting the penetration of cold air into the body. Basing on treatment, drugs that boost the adequate flow of blood are adopted.

References

Daftardar, S. B. (2017). Ultrasound-mediated Topical Delivery of Econazole nitrate for Treating    Raynaud’s phenomenon (Doctoral dissertation, University of Toledo).

Hirwa, G. (2017). Botulinum toxin A versus percutaneous tibial nerve stimulation in idiopathic       overactive bladder: a randomized trial.

Hughes, M., & Herrick, A. L. (2016). Raynaud’s phenomenon. Best Practice & Research   Clinical Rheumatology, 30(1), 112-132.

Stone, L. E., Yellapu, V., Ali, F., Agrawal, S., Singh, A., Garg, L., … & Nanda, S. (2018).   Pathophysiology and management of Raynaud’s phenomenon. International Journal of          Academic Medicine, 4(2), 178.

Stringer, T., & Femia, A. N. (2018). Raynaud’s phenomenon: Current concepts. Clinics in dermatology, 36(4), 498-507.