Flashcards in Exam #5: Vascular & Lymphatic System Deck (66)
Who is William Garner Sutherland?
Founder of cranial osteopathy
What is the best non-invasive way to visualize the left atrium?
What does abnormally elevated pressure in the left atrium lead to?
What best non-invasive way to visualize the aortic valve?
What is the best diagnostic tool to visualize the patency of the coronary arteries?
What can inappropriate use of carotid sinus massage lead to?
Carotid Sinus Syncope
What can cartoid sinus massage be used as an intervention for?
*****Note that this is no longer considered an appropriate first line intervention.
What is the Allen's Test?
This is a test that MUST be done prior to RADIAL ARTERY CATHETERIZATION
- Occlude radial & ulnar arteries
- Release one artery & visualize blood flow to the hand
- Repeat with other artery
*****Normal is re-establishment of circulation by 3-5 or 4-5 seconds.
Where should the patients hand be when evaluating capillary refill?
Above the heart
What is "normal" when checking capillary refill?
How do you evaluate a patient for JVD?
1) Place patient in examine position: head of bed elevated at 45 degree angle and turned to the right
2) Identify top of venous pulsation in neck (JVP)
3) Identify sternum
4) Measure distance between top of pulsation and sternum
*****Measured in centimeters
What is a normal measurement when examining for JVD?
4 cm or less
What is an abnormal measurement when evaluating for JVD? What is this a possible indication of?
1) Right-sided Heart Failure (most common)
2) Increased Right Atrial Pressure
3) Constrictive Pericarditis
4) Tricuspid stenosis
5) Superior Vena Cava Obstruction
6) Valsalva phenomenon (laughing, coughing)
On auscultation of the lungs, you hear crackles. What is this an indication of?
Fluid leaking out of the circulation
On auscultation of the lungs, you hear a consolidation. What is this an indication of?
You are preparing to start a central line in the patient's femoral vein. How do you remember the anatomic arrangement of the femoral sheath?
NAVEL--From lateral to medial:
What are two signs of a DVT?
1) Homan's sign
2) Increased calf diameter
What is a positive homan's sign?
Positive test= pain in the calf on forceful and abrupt dorsiflexion of the patient's foot at the ankle while the knee is extended
What causes vericose veins?
What is superficial thrombophelbitis?
A thrombosis and inflammation of superficial veins which presents as a painful induration with erythema, often in a linear or branching configuration forming cords
What is Trendelenburg Test?
1) With patient supine, flex leg at hip & elevate leg to empty veins
2) Place superficial tourniquet around thigh to occlude superficial veins
3) Stand patient up
*****Normal= filling from below within 3-5 seconds
*****Abnormal= filling from below due to incompetent valves in DEEP COMMUNICTING VEINS
4) If after 20 seconds no filling, remove tourniquet
*****Sudden filling= incompetent SUPERFICIAL VEINS
What causes the dark discoloration that is seen with LE edema?
What is lymphangitis?
Inflammation or an infection of the lymphatic channels that occurs as a result of infection at a site distal to the channel
*****i.e. red streaks in the skin
What is lymphadenopathy?
Enlargement of the lymph nodes
What is lymphadedema?
Edematous swelling due to excess accumulation of lymph fluid in tissues
Describe the results of a normal lymph node examination.
Non-palpable nodes or very small nodes
Describe the results of an abnormal lymph node examination.
Palpable, shotty (like buck-shot), or tender lymph nodes
Where is the occipital node?
Base of the skull
Where is the posterior auricular node?
Over the mastoid process