peripheral vascular

Question 1

function of arteries

Answer 1

supply oxygen and essential nutrients to tissues

Question 2

which arteries are accessible to examination?

Answer 2

temporal, carotic, brachial, ulanr, radial, femoral, popliteal, anterior tibial, dorsalis pedis, posterior tibial

Question 3

peripheral arterial disease affects…

Answer 3

noncoronary vessels and refers to arteries afecting the limbs

Question 4

function of veins

Answer 4

drain deoxygenated blood and its waste products from tissues and return it to heart

Question 5

structure of veins

Answer 5

ability to stretch, capacitance vessels

Question 6

which veins are accesible to examination

Answer 6

femoral, popliteal, great and small saphenous, connecting veins that join two sets, jugular veins

Question 7

venous flow low pressure system

Answer 7

mechanism to keep blood moving by contracting skeletal muscles, pressure gradient caused by breathing and intraluminal valves, in the legs it is the calf pump or peripheral heart

Question 8

what is varicose vein affect on veins

Answer 8

creates incompetent valves leading to increased venous pressure, further dilating the valve

Question 9

functions of lymphatic system

Answer 9

conserve fluid and plasma proteins that leak out of capillaries, form major part of immune system that defends the body against disease, absorb lipids from intestinal tract

Question 10

what are lymph nodes

Answer 10

small oval clumps of lymphatic tissue located at intervals along vessels

Question 11

spleen

Answer 11

destroys old RBCs and stores RBCs, produces antibodies, filters microorganisms from the blood

Question 12

tonsils

Answer 12

located at entrance to respiratory and digestive tracts and respond to local inflammation

Question 13

thymus

Answer 13

behind sternum and in front of aorta

Question 14

vascular vs. lymphatic

Answer 14

vascular moves blood, lymphatic moves plasma proteins from the tissues to the blood

Question 15

inguinal lymph nodes

Answer 15

can be palpated, should be small, less than 1 cm, moveable and non-tender
SHOULD NOT BE: enlarged, tender, fixed

Question 16

epitrochlear lymph nodes

Answer 16

not palpable, SHOULD NOT BE: enlarged, palpable

Question 17

inspection of the arms

Answer 17

• note color of skin and nail beds, temperature, texture, turgor, presence of lesions or clubbing
• check cap refill
• check radial pulses

Question 18

inspection of the legs

Answer 18

• measure leg at widest point
• in the presence of ulcers, gangrene, discoloration, note size and exact lcoatino
• palpate lower extremity pulses using bilateral comparison
• palpate for temperature
• use monofilament to asses neurovascular status

Question 19

what arteries should you palpate in the leg

Answer 19

femoral, popliteal, dorsalis pedis, posterior tibial

Question 20

assess pretibial edema

Answer 20

firmly deprss skin over tibia, grade 0-4

Question 21

1+ scale of edema

Answer 21

mild, slight indentatino, no perceptible sweating

Question 22

2+ scale of edema

Answer 22

moderate pitting, indentation subsides rapidly

Question 23

3+ scale of edema

Answer 23

deep pitting, indentation remains, leg looks swollen

Question 24

4+ scale of edema

Answer 24

very deep pitting, indentation lasts a long time, leg grossly swollen and distorted

Question 25

what should you do if you suspect arterial deficit?

Answer 25

have the patient raise legs about 12 inches off table and have them wag their feet for 30 seconds to drain venous blood, color will now only reflect contribution of arterial blood, color should return in 10 seconds or less

Question 26

peripheral artery disease risk factors

Answer 26

smoking, diabetes mellitus, dyslipidemia, hypertension

Question 27

what should you assess during peripheral vascular assessment? (8 things)

Answer 27

cap refill, color changes, edema, hair distribution, lymphatic system, pulses, temperature, ulcers

Question 28

what are the implications for a prolonged capillary refill?

Answer 28

sign of vasoconstriction, decreased cardiac output, low blood pressure, shock

Question 29

abnormal findings of temperature assessment

Answer 29

hyper or hypo thermia

Question 30

what are the implications of localized hyperthermia?

Answer 30

could be trauma, infection, sunburn

Question 31

what are the implications of localized hypothermia?

Answer 31

peripheral arterial insufficiency and Raynaud's disease

Question 32

what should you note during inspection of the legs/arms?

Answer 32

skin color/lesions; hair distribution, venous pattern, size of extremity

Question 33

abnormal findings of color

Answer 33

pallor, ulcers, thin or shiny skin should be appropriate for ethnic background

Question 34

normal venous pattern

Answer 34

veins should be flat and barely visible

Question 35

abnormal venous pattern

Answer 35

varicose veins

Question 36

size of extremities findings

Answer 36

should be symmetric in size; should be no edema unilaterally or bilaterally; or atrophy

Question 37

health promotion

Answer 37

foot care, good shoes, hydrate feet, exercise

Question 38

abnormal pulse findins

Answer 38

weak or bounding; water hammer pulse; pulsus bigeminus, alternans, paradoxus, bisferiens

Question 39

abnormal findings in the arm

Answer 39

raynaud phenomenon; lymphedema

Question 40

abnormal findings of the legs

Answer 40

arterial, venous, or neuropathic ulcer

Question 41

abnormal findings of PVD in the legs

Answer 41

superficial varicose veins; deep vein thrombophlebitis

Question 42

peripheral artery disease abnormal findings

Answer 42

aneurysms, occlusions

Question 43

arterial disease causes symptoms of...

Answer 43

oxygen deficit

Question 44

venous disease causes symptoms of...

Answer 44

metabolic waste build up

Question 45

deep vein thrombus

Answer 45

clot in the leg; unilateral swelling, tenderness, extreme pain and warmth or redness of skin

Question 46

deep vein thrombosis

Answer 46

can lead to pulmonary embolism, needs to be reported to provider

Question 47

neurovascular checklist

Answer 47

6 p's: pain, pulse, pallor, paresthesia, paralysis, pressure check pain, sensation, skin temperatuer, cap refill, pulses, and movement

Question 48

allen's test

Answer 48

helps to see if hand has good blood supply, hand should flush within 15 seconds

Question 49

red flags for neurovascular status

Answer 49

unilateral lower extremity pain, pulselessness, unilateral temperature change, unilateral edema