Chapter 21- PVS and Lymphatic System

Question 1

The major artery supplying the arm is the __, which runs in the biceps-triceps furrow of the upper arm and surfaces at the antecubital fossa in the elbow medial to the biceps tendon.

Answer 1

brachial artery

Question 2

The brachial artery bifurcated into the __ and __ .

Answer 2

ulnar and radial

Question 3

Peripheral artery disease affects ___ vessels and refers to arteries supplying the limbs.

Answer 3

noncoronary

Question 4

The major artery to the leg is the ___, which passes under the inguin ligament.

Answer 4

femoral artery

Question 5

At the lower thigh, the femoral artery courses posteriorly which then it is called the ___.

Answer 5

popliteal artery

Question 6

The anterior tibial artery travels down the front of the leg on the dorian of the foot, where it becomes the ____.

Answer 6

dorsalis pedis.

Question 7

The the back of the leg, the ___ artery travels down behind the medial malleolus and forms the plantar arteries in the foot.

Answer 7

Posterior tibial

Question 8

The function of the arteries is to ___.

Answer 8

supply oxygen and essential nutrients to the cells.

Question 9

a deficient supply of oxygenated arterial blood to a tissue caused by obstruction of a blood vessels.

Answer 9

Ischemia

Question 10

The course of veins is ___ to the course of arteries.

Answer 10

Parallel

Question 11

Body has more ___, and they lay ___ to the skin.

Answer 11

veins

closer

Question 12

Function: to drain deoxygenated blood and it’s waste products from tissue and return it to the heart.

Answer 12

veins

Question 13

veins are called capacitance vessels because ___

Answer 13

of their ability to stretch.

Question 14

Deep veins in the leg:

Answer 14

the femoral and popliteal veins

Question 15

Superficial veins in the leg:

Answer 15

the great and small saphenous

Question 16

Perforator veins:

Answer 16

connecting veins that join the deep and superficial veins.

Question 17

The veins do not have a pump to generate their blood flow so they need a _____

Answer 17

mechanism to keep blood moving

Question 18

The mechanism is accomplished by:

Answer 18

contracting skeletal muscles, pressure gradient caused by breathing, and intraluminal valves.

Question 19

In the legs, the mechanism for venous flow is called ____

Answer 19

calf pump or peripheral heart.

Question 20

Dilated and tortuous (varicose) veins create ____ valves leading to increased venous pressure, which further dilated the vein.

Answer 20

incompetent

Question 21

Lymphatic system retrieves what and from/to where?

Answer 21

excess fluid and plasma proteins from the interstitial spaces and returns them to the bloodstream.

Question 22

Caused by the pumping action of the heart and pushed somewhat more fluid out of the capillaries than the venules can absorb.

Answer 22

Hydrostatic pressure

Question 23

pulls interstitial fluid back into the venules

Answer 23

colloid osmotic pressure

Question 24

The right lymphatic duct empties into the ____.

Answer 24

subclavian vein. It drains the Right side of the head, neck, right arm, right side of the thorax, right lung, and pleura, right sid rod the heart, and right upper section of the liver.

Question 25

The thoracic duct drains the ____ and empties it into the ___.

Answer 25

Rest of the body, and empties into the left subclavian vein.

Question 26

Lymphatic system functions:

Answer 26

Conserve fluid and plasma proteins that leak out of capillaries Form a major part of immune system that defends body against disease absorbs lipids from intestinal tract

Question 27

small oval clumps of lymphatic tissue located at intervals along vessels

Answer 27

lymph nodes

Question 28

the ___ groups of nodes are accessible to inspection and palpation and give clues to the status of the lymphatic system.

Answer 28

superficial

Question 29

located in the left upper quadrant of the abdomen

Answer 29

spleen

Question 30

spleen’s four functions:

Answer 30

destroy old red blood cells produce antibodies store red blood cells filter microorganisms from the blood

Question 31

located at the entrance to the respiratory and gastrointestinal tracts and respond to local inflammation

Answer 31

tonsils

Question 32

the flat, pink-gray gland located in the superior mediastinum behind the sternum and in front of the aorta

Answer 32

thymus

Question 33

lymph nodes are relatively ___ in children and the superficial ones are palpable even when the child is healthy.

Answer 33

large

Question 34

Hormonal changes in pregnant women cause ___ and the resulting drop in ___.

Answer 34

vasodilation | blood pressure

Question 35

the growing uterus obstructs drainage of the ___ and the ___.

Answer 35

iliac veins | inferior vena cava

Question 36

the pregnant women has a ___ chest cage and ___ estrogen.

Answer 36

wider | increased

Question 37

Peripheral blood vessels grow more rigid with age, termed ____.

Answer 37

arteriosclerosis

Question 38

The deposition of fatty plaques on the intima of arteries

Answer 38

Atherosclerosis

Question 39

What is intermittent claudication (IC) ?

Answer 39

cramping in arms or legs

Question 40

Aging produces a progressive ___ of the intramuscular calf veins.

Answer 40

enlargement

Question 41

Loss of ___ leads to fewer numbers of lymph nodes in older people and to a decrease in the size of remaining nodes.

Answer 41

Loss of lymphatic tissue

Question 42

Environmental risk factors for PAD patients:

Answer 42

smoking, diabetes, and hypertension. | also elevated levels of cholestrol and obesity.

Question 43

__ have twice the burden of PAD than do Caucasians.

Answer 43

African Americans

Question 44

the ___ is the first-line noninvasive test (screening tool) for PAD.

Answer 44

ankle-brachial index (ABI)

Question 45

___ are most at risk for PAD.

Answer 45

Non-hispanic blacks

Question 46

Increased DVT and subsequent pulmonary embolism is a result of :

Answer 46

prolonged bed rest, immobilization, and heart failure.

Question 47

AHA considers PAD a CAD risk equivalent, thus ___ are essential.

Answer 47

screening and treatment

Question 48

For Peripheral Vascular System: take vitals and examine ___ in the beginning while person is still sitting.

Answer 48

arms

Question 49

Inspecting and palpating the arms: lift the person’s both hands in your hands. Then:

Answer 49

inspect, then turn the persons hands over, noting color of skin and nail beds; temperature, texture, and turgor of skin; and the presence of any lesions, edema, or clubbing.

Question 50

how do you detect early clubbing?

Answer 50

profile sign (viewing finger from side to side)

Question 51

Radial pulses numbers and what they mean:

Answer 51

3+ increased, full bounding 2+ normal 1+ weak 0 absent

Question 52

What test can provide information about adequacy of collateral circulation?

Answer 52

Modified Allen Test

Question 53

Insepecting and Palpating the legs:

Answer 53

palpate for temperature along legs down to feet using bilateral comparison. palpate lied extremity pulses using bilateral comparison use of monofilament to assess neurovascular status.

Question 54

How to locate femoral artery:

Answer 54

Locate them just below inguinal ligament halfway between pubis and anterior superior iliac spines

Question 55

How to locate popliteal pulse:

Answer 55

With leg extended but relaxed. anchor your thumbs on knee, and curl your fingers around into popliteal fossa

Question 56

How to locate posterior tibial pulse:

Answer 56

curve your fingers around medial malleolus and feel the tapping right behind it in groove between malleolus and Achilles tendon

Question 57

How to locate Dorsalis pedis:

Answer 57

normally it is just lateral to and parallel with extensor tendon of big toe

Question 58

How do you check for a pretibial edema?

Answer 58

firmly depress skin over tibia or medial malleolus for five seconds and release

Question 59

Scale for grading a pitting edema:

Answer 59

1+ : mild pitting/ slight indentation, no perceptible swelling 2+ : moderate pitting, indentation subsides rapidly 3+ : Deep pitting, indentation remains, leg looks swollen 4+ : Very deep pitting, indentation lasts long time, leg grossly swollen and distorted

Question 60

If you suspect an arterial deficit, raise the legs ___ off the table and ask the person to wag the feet for about __ to drain off venous blood. The skin color now reflects only the contribution of arterial blood.

Answer 60

30 cm | 30 seconds

Question 61

Use this device to detect a weak peripheral pulse, to measure low blood pressure or blood pressure in lower extremity.

Answer 61

Doppler Ultrasonic Probe

Question 62

Wells Score for Deep Vein Thrombosis facts:

Answer 62

Higher the score, greater the risk. 0-3. 0 low probabaility 1-2 moderate probability 3+ high probability Combination of assessment findings categorized into low, moderate, or high probability of DVT.

Question 63

Vaccinations can produce local ____,

Answer 63

lymphadenopathy

Question 64

In pregnant women, expect ___ pitting edema in the lower extremities especially at the end of the day.

Answer 64

Bilateral

Question 65

Pregnant women: third trimester common findings

Answer 65

peripheral pitting edema | varicose veins

Question 66

Finding in older adults: | __ and ___ pulses may become more difficult to find.

Answer 66

DP and PT

Question 67

Strophic changes associated with arterial insufficiency may be seen: (occur normally)

Answer 67

think, shiny skin thick, ridged nails loss of hair on lower legs

Question 68

Water-Hammer (Corrigan) Pulse 3+ :

Answer 68

Greater than normal force, then collapsed suddenly.

Question 69

Difference between: 1. Pulses Bugeminus 2. Pulses Alternans 3. Pulses Paradoxes 4. Pulses Bisferiens

Answer 69

1. rhythm coupled, every other best comes early or normal beat is followed by a premature beat 2. Rhythm regular, but force varies 3. beats have weaker amplitude with inspiration, stronger with expiration 4. each pulse has two strong systolic peaks with a dip in between

Question 70

Caused by the chronic gradual buildup of (in order) fatty streaks, fibroid plaque, calcification of the vessel wall, and thrombus formation.

Answer 70

Occlusion

Question 71

a sac formed by dilation in the artery wall

Answer 71

Aneurysms

Question 72

Arterial disease causes symptoms of ___.

Answer 72

Oxygen Deficit

Question 73

Venous disease causes symptoms of ____.

Answer 73

metabolic waste build up