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NSG2317 - health assessment > Peripheral Vascular Assessment > Flashcards

Peripheral Vascular Assessment Flashcards

1
Q

Arteries

A

Pump oxygenated blood to the body tissues
- the pumping of the heart
makes the arteries a high
pressure system
- elastic recoil of stretched
arteries propel blood
forward, creates pressure
waves (the pulse)

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2
Q

Composition of Artery Walls (2)

A

a. Elastic Fibres - allow the walls of the arteries to stretch with systole and recoil with diastole

b. Muscle Fibres - (vascular smooth muscle) change vessel diameter to control the amount of blood delivered to the tissues and control the rate of blood flow

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3
Q

Palpable Arteries in the Arm (3)

A

a. brachial artery
b. ulnar artery
c. radial artery

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4
Q

Palpable Arteries in the Leg (4)

A

a. femoral artery
b. popliteal artery
c. dorsalis pedis artery
d. posterior tibial artery

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5
Q

Veins

A

Veins return deoxygenated blood and its waste products to the heart → to be returned to the lungs for gas exchange
- low pressure system
- body has more veins (to
facilitate venous return)
and they are closer to the
skin

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6
Q

Composition of Vein Walls

A

thinner, larger in diameter, more distensible = CAPACITANCE VESSELS
- can expand to hold more
blood when blood volume
increases
- compensatory mechanism
to reduce stress on the
heart

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7
Q

Mechanisms for Forward Blood Flow Through Veins (3)

A
  1. Contraction of skeletal
    muscles - milk blood
    through veins
  2. pressure gradient created by
    breathing
  3. intraluminal valves
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8
Q

Veins in the Arms (2)

A
  • superficial veins
  • deep veins
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9
Q

Veins in the Legs (3)

A
  • deep veins
  • superficial veins
  • perforators
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10
Q

Risks for Venous Disease

A
  • prolonged standing, sitting or bed rest
  • hypercoagulable states
  • vein wall trauma
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11
Q

Lymphatic System

A

Lymphatics function to remove excess fluid from tissue spaces, filter it, and return it to the bloods
- returns fluid that leaks from
veins
- prevents edema

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12
Q

Ducts of the Lymphatic System (2)

A
  1. Right Lymphatic Duct
  2. Thoracic Duct
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13
Q

Right Lymphatic Duct

A

Empties into the right subclavian vein

Drains:
- right side of the head, neck,
and head
- the right arm, lung and
pleura
- the right upper section of
the liver

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14
Q

Thoracic Duct

A

Empties into the left subclavian vein

Drains:
- the rest of the body

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15
Q

Functions of the Lymphatic System

A
  1. Conserve fluid and plasma proteins that leak out of the capillaries
  2. Form a major part of the immune system
  3. Absorbs lipids from the intestinal tract
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16
Q

Important Nodes (4)

A
  1. Cervical Node
  2. Axillary Node
  3. Epitrochlear Node
  4. Inguinal Node
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17
Q

Cervical Node

A

drains the head and neck

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18
Q

Axillary Node

A

drains the breast and uper arm

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19
Q

Epitrochlear Node

A

drains the lower arm and hand

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20
Q

Inguinal Node

A

drains the lower extremities, external genitalia, and anterior abdominal wall

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21
Q

Related Organs

Lymphatic System

A
  1. Spleen
  2. Tonsils
  3. Thymus Gland
  4. Bone Marrow
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22
Q

Spleen

A

located in the LUQ

4 functions
(a) destroy old RBCs
(b) create antibodies
(c) store RBCs
(d) filter microorganisms from
blood

23
Q

Tonsils

A

located in the entrance of the respiratory and GI tracts
- functions to respond to local
inflammation

24
Q

Thymus Gland

A

located at the superior mediastinum, dorsal to the sternum and anterior to the aorta (between the sternum and aorta)
- important function in
children, no function in
adults

25
Q

Bone Marrow

A

located in the center of bones
- functions to create T and B
lymphocytes in the mature
adult

26
Q

Past Medical History

Peripheral Vascular System

A
27
Q

Subjective Data

Peripheral Vascular System

A
28
Q

Physical Exam Techniques (2)

Peripheral Vascular System

A
  1. Inspection
  2. Palpation
29
Q

Physical Exam Points

Peripheral Vascular System

A

a. circulation
b. motor
c. sensation
d. symmetry
e. dermatology

30
Q

Physical Exam - Circulation

A
  • colour
  • temperature
  • capillary refill
  • lymph nodes
  • pulse (rate, rhythm, force)
31
Q

Physical Exam - Motor

A
  • presence of pain with
    movement
  • strength tests (legs)
32
Q

Physical Exam - Sensation

A
  • presence of paresthesia
  • presence of anesthesia
33
Q

Paresthesia

A

Numbness, pins and needles

34
Q

Anesthesia

A

Complete lack of sensation

35
Q

Physical Exam - Symmetry

A

presence or absence of edema
- degree (1+ to 4+)
- location
- atrophy

36
Q

Edema

A

the accumulation of excess fluid in tissue space

Causes:
- increased pressure in the
capillaries
- decreased venous return
- heart failure
- medications
- kidney disease
- surgery

37
Q

Lymphedema

A

usually only present on one side, only swells

Measurement: using non-stretch tape measure, measure the widest point and compare to the same spot on the other limb

38
Q

Pitting Edema

A

graded on a scale of 1-4 due to the presence of pitting

Measurement: push on the skin for 5 seconds using 2-3 fingers, and release

39
Q

Grade 1+ Pitting Edema

A

Mild pitting, slight indentation, no perceptible swelling of the leg

40
Q

Grade 2+ Pitting Edema

A

Moderate pitting, indentation subsides rapidly

41
Q

Grade 3+ Pitting Edema

A

Deep pitting, indentation remains for a short time (<5 mins), leg looks swollen

42
Q

Grade 4+ Pitting Edema

A

Very deep pitting, indentation lasts a ong time (>5 mins), leg is very swollen and distorted
- “Distorted” because the
pressure of the excess fluid
physically moves muscles
to create more space,
resulting is a changed leg
appearance

43
Q

Physical Exam - Dermatology

A
  • texture
  • turgor
  • scars
  • nail bed
  • lesions
  • hair distribution
  • venous patterns
44
Q

Physical Exam - nail bed

A

should be 160 degrees
- an angle less than 160 could
indicate clubbing (low
perfusion)

45
Q

Physical Exam - hair distribution

A

hair will not grow in regions of low perfusion

46
Q

Physical Exam - turgor

A

elasticity of the skin

47
Q

Deep Venous Thrombophlebitis

A

an inflammatory process causing blood clot formation in multiple veins, usually affecting the legs
- increased blood flow + pooling in one area

48
Q

Arterial Occlusions

A
49
Q

Arterial Aneurysms

A
50
Q

Older Adult Considerations

A
  1. Arteriosclerosis
  2. Peripheral Artery Disease (PAD)
  3. Deep Vein Thrombosis (DVT)
  4. Lymphatic System
51
Q

Arteriosclerosis

Older Adult Considerations

A

a condition in which peripheral vessels become hard, rigid, and thick
- produces a rise in systolic
blood pressure via
increased resistance

52
Q

Peripheral Artery Disease (PAD)

Older Adult Considerations

A

a condition caused by atherosclerosis - the deposition of fatty plaque in the arteries (narrowing of the arteries)
- silent = underdiagnosed and
undertreated
- major risk factor for lower
extremity amputation (low
perfusion, necrosis)

53
Q

Deep Vein Thrombosis (DVT)

Older Adult Considerations

A

blood clot formation in a deep vein, usually in the lower extremities
- can lead to a pulmonary
embolism if left untreated

Risk Factors:
- progressive enlargement of
intramuscular calf veins
- increased bed rest
(sedentary behaviour)
- decreased physical activity
- heart failure

54
Q

Lymphatic System

Older Adult Considerations

A

as adults age, they lose lymphatic tissue
- results in a decreased
quantity of lymph nodes
and a decreased size of the
remaining nodes
- decreased ability to respond
to pathogens
- increased risk of edema

NSG2317 - health assessment (18 decks)

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