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  Definition Acute arterial thrombosis of the right legCyanosis is defined as a bluish discoloration, especially of the skin and mucous membranes due to excessive concentration of deoxyhemoglobin in the blood. Differential diagnosis Cyanosis is divided in to two main types: central (around the core and lips and peripheral (only the extremities are affected. Cyanosis can occur in the fingers, including underneath the fingernails, as well as other extremities (called peripheral cyanosis, or in the lips and tongue (central cyanosis. Central cyanosis Central cyanosis is often due to a circulatory or ventilatory problem that leads to poor blood oxygenation in the lungs. !t develops when arterial saturation of blood with oxygen is #$%. Cyanosis may not be detected until saturation is &$% in dark'skinned individuals.Acute cyanosis can be a result of asphyxiation or choking, and is one of the surest signs that respiration is being blocked.Causes. Central )ervous *ystem: ã !ntracranial hemorrhage ã Cerebral anoxia ã Drug overdose (e.g. +eroin . -espiratory *ystem: ã ronchiolitis ã ronchospasm (e.g. Asthma ã /ung disease ã 0ulmonary +ypertension ã 0ulmonary embolism ã +ypoventilation ã C10D (emphysema and chronic bronchitis  ã -espiratory syncytial virus2. Cardiac Disorders: ã Congenital heart disease (e.g. 3etralogy of 4allot, -ight to left shunts in heart or great vessels ã +eart failure ã +eart valve disease ã 5yocardial infarction6. lood: ã 5ethemoglobinemia ã 0olycythaemia$. 1thers: ã +igh altitude ã +ypothermia ã Congenital cyanosis (+b5 oston arises from a mutation in the 7'codon which results in a change of  primary se8uence, + 9 . 3yrosine stabilises the 4e(!!! form (oxyhaemoglobin creating a permanent 3'state of +b. ã 1bstructive sleep apnea 0eripheral cyanosis 0eripheral cyanosis is the blue tint in fingers or extremities, due to inade8uate circulation. 3he  blood reaching the extremities is not oxygen rich and when viewed through the skin a combination of factors can lead to the appearance of a  blue color . All factors contributing to central cyanosis can also cause peripheral symptoms to appear, however peripheral cyanosis can  be observed without there being heart or lung failures. *mall blood vessels may be restricted and can be treated by increasing the normal oxygenation level of the blood.Causes ã All common causes of central cyanosis ã Arterial obstruction ã Cold exposure (due to vasoconstriction  ã -aynaud;s phenomenon (vasoconstriction ã -educed cardiac output (e.g. heart failure, hypovolaemia ã <asoconstriction ã <enous obstruction (e.g. deep vein thrombosis Differential cyanosis Differential cyanosis is the bluish coloration of the lower but not the upper extremity and the head. 3his is seen in patients with a patent ductus arteriosus. 0atients with a large ductus develop progressive pulmonary vascular disease, and pressure overload of the right ventricle occurs. As soon as pulmonary pressure exceeds aortic pressure, shunt reversal (right'to'left shunt occurs. 3he upper extremity remains pink because the brachiocephalic trunk, left common cartoid trunk and the left subclavian trunk is given off proximal to the 0DA.
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