Peripheral Vascular Exam Flashcards by Love Roa

what type of structure do arteries consist of?

muscular-walled tubes forming part of the circulation
system by which blood (oxygenated) is
conveyed from the heart to all parts of the body

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what is the function of veins & how do they differ from arteries?

tubes forming part of the blood circulation system of the body, carrying in most cases oxygen-depleted blood toward the
heart
* work on vascular system
* dependent on a # of factors in the body

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what does palpation of the peripheral pulses evaluate for? what are the grades for peripheral pulses?

how well the arteries are working based on strength & equality of the pulses 
0= absent
1+ = weak/thready
2+ = normal
3+ = full, bounding

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what pulses are in the upper extremity and why are distal pulses in BUE important in hospital settings?

Carotid
Brachial
Radial -> more superficial, where ABG is done
Ulnar

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what pulses are compared in the Allen Test & why is it important?

Ulnar & radial: Compares patency of blood flow in ulnar and radial arteries
*important to check prior to checking ABG

*if done wrong -> can compromise blood flow to hands

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what pulses are evaluated in the lower extremities?

Femoral
Popliteal
Dorsalis Pedis
Posterior Tibialis

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while the femoral pulse is deferred in adults, what type of patients is it evaluated in?

peds & infants

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True or false:

the abdominal aortic pulse is palpable

True

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which pulses in the abdomen are non-palpable?

• Celiac: esophagus, stomach, duodenum, liver, gallbladder, pancreas
• Superior Mesenteric: small intestine, ascending and transverse colon,
right splenic flexure
• Inferior Mesenteric: descending and sigmoid colon, proximal rectum

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on inspection of the upper & lower extremities, what are you evaluating for?

color: pallor, erythema, rubor, cyanosis
- appropriate skin tone for pt
- same color throughout
hair distribution
skin changes
ex) excoriations, ulcerations, blistering, bullae

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on palpation of BUE & BLE, what are you evaluating for?

• Temperature
-must use back of the hand 
-look for symmetry 
• Edema
• Pulses

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what is pitting edema and when might you see this?

palpable swelling that can be easily moved around

divet will appear when pushing into skin
d/t accumulation of fluid in the interstitial space
pt w/ sprained ankle

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what can pitting edema in the bilateral lower extremities indicate? what should you also look for in these patients?

venous insufficiency

texture of skin
appearance of sock lines
toenails

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how do you do the Brueger test & what is it used to evaluate for?

elevation of pt’s legs x1 minute at 60°

evaluate for color return/venous filling when pt is sitting up
PAD

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what is the normal time for color return and venous filling?

color return: 5-10 seconds

venous return: 10-20 seconds

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on exam of BLE, there is delayed color return and diminished pulses. what do you suspect?

possible PAD

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if a pt presents with leg pain/claudication that is worse w/ exertion & leg elevation, what should you suspect?

PAD

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what is PAD associated with?

• Related to narrowing or decreased oxygenated blood to the

extremities

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what are risk factors for PAD>

age > 65
age >50 with history of DM or smoking
• History of coronary artery disease
• Ethnicity: increased in African American
• Family history of AAA

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what symptoms occur with PAD?

leg pain w/ exertion
non-healing or poorly healed wounds 
fatigue
aching/pain with limited exertion 
abdominal pain
hair loss

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on inspection of the extremities for a pt with PAD, what are typical findings?

Cold, numbness, pallor to extremities
Swelling
Color changes

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if PAD affects the aorto-iliac artery, what might a pt present with?

pain in the buttocks, hip, thigh

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if PAD affects the iliac-pudendal artery, what problem might a pt report?

erectile dysfunction

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if PAD affects the common femoral artery, what might a pt present with?

thigh pain

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if PAD affects the superficial femoral artery, what might a pt present with?

upper calf pain

if PAD affects the popliteal artery, what might a pt present with?

lower calf pain

if PAD affects the tibial or peroneal arteries, what might a pt present with?

pain in feet

if PAD affects the celiac or mesenteric arteries, what might a pt present with? when does this happen?

abdominal pain | -occurs when pt's vessels are being used -> onset of sx after eating due to digestion

Incompetency of valves and weakness of the walls can lead to ____ _____ in the periphery

varicose veins

varicose veins can be linked to ______ BP in the veins

increased

when assessing a pt who has varicose veins, why is there pain upon palpation?

increase of blood pressure to the area

Obesity, constipation, tumors, genetics, and ____ are linked to an increase in BP in the veins which can lead to varicose veins.

pregnancy

what might a pt c/o if they have varicose veins?

swelling aching/heaviness leg cramps itching

on inspection of a pt with varicose veins, the affected veins appear to be blue and _____

bulging

what risk factors are associated w/ varicose veins?

``` Age • Sit or stand for long periods of time • Inactive lifestyle • Obesity or overweight • Family history of varicose veins • Pregnancy ```

in stage 4 of varicose veins, it is common for patients to have varicose eczema & _____

trophic ulcerations

_____ occurs in stages 3-4 of patients with varicose veins

venous stasis

stage 3 of varicose veins will exhibit ____ of the lower legs

edema

on inspection of the lower extremities, pt appears to have reticular/spider veins. what stage is this?

stage 1

stages ____ & ____ in varicose veins skin changes that are associated with chronic venous insufficiency

3 & 4

True or false: compression stockings & surgery cannot reverse the color change in patients with varicose veins.

true

Raynaud's disease affects the _____ & are associated with cold temperatures and/or stress.

distal extremities

what is the physiologic process that occurs in Raynaud's disease?

episodic vasoconstriction that is reversible

In (primary/secondary), Raynaud's disease is related to autoimmune disease.

secondary

what colors will a pt's fingers & toes w/ Raynaud's appear from beginning to end?

pallor -> cyanotic -> red -> pallor

in arterial ulcerations, they are typically _____ or traumatic

distal location

venous ulcerations are typically seen in the _____

posterior ankles

neuropathic ulcerations occur in _____ of the body

pressure points

in bed bound patients that develop bed sores (ulcerations), what pressure point is affected?

sacroiliac

in diabetic patients that are unaware of ulcerations or pain to their feet, this is considered _____

neuropathic

what is the main concern when a pt is diagnosed with a DVT?

thrombus may travel up back to the heart & cause PE

deep veins carry ____ of blood back to the heart which is why a thrombosis is concerning.

90%

True or false: there is a concern for a thrombus developing into a PE in patients diagnosed with superficial phlebitis.

False

what are treatment options for superficial thrombophlebitis?

``` heat ice NSAIDs Celebrex Mobic ```

in superficial thrombophlebitis, there is inflammation and thrombosis to the ____ veins

superficial

what test is used to evaluate for PAD and how is it calculated?

Ankle brachial index | > BP in arms compared to BP in posterior tibialis

Less than ____ is abnormal for an ABI

0.9

the ABI test has ___ sensitivity and ___ specificity

low | high

claudication is a process that affects the ____. patients with PAD will also have hairless, dry, and shiny skin

arteries

Hyperpigmented and erythematous skin can indicate _____

venous insufficiency

in patients with ___, palpation of the extremities will feel cold

PAD

when assessing for pulses, you must use your index or middle finger. why can't you use the thumb?

thumb has a stronger pulse

which pulse is difficult to detect depending on the patient?

dorsalis pedis

the dorsalis pedis pulse is lateral to the ____ tendon

extensor

what is the largest artery in the lower extremities?

femoral

if there is too much pressure upon palpation of the DP pulse, you can ___ the arteries and prevent the pulse.

occlude

when performing the dependent rubor test, pt appears to have pumping up of blood vessels when you are assessing venous filling. what should you suspect based on this?

PAD | > venous filling has nothing to do w/ veins

the rubor test can only be performed when the patient is ____. in patients ___ years old, it is used to r/o PAD.

supine | -over 65

Peripheral Vascular Exam Flashcards

(68 cards)