Peripheral Vascular System Flashcards
Arteries 3 layers
Intima: innermost layer. Complete of endothelial cells.
Media: smooth muscle cells. Accomodate BP and flow
Adventitia: connective tissue containing nerve fibers
Veins that drain into superior vena cava
Arms, upper trunk, and head
Veins that drain into inferior vena cava
Abdominal wall, liver, lower trunk and legs
Veins that drain into the portal vein
Abdominal viscera
Lymphatic system
Drains lymph fluid and returns it into venous circulation.
Lymph nodes
Plays a role in the immune system. Engulfs bacteria and produces antibodies.
Edema causes
Plasma volume of sodium retention, altered cap dynamics resulting in net filtration, inadequate removal of filtered lymph fluid, lymphatic or venous obstruction, and increased capillary permeability
Lymph edema
Usually not compressible.
Peripheral arterial disease red flags
Fatigue, aching, numbness, or pain that limits walking
Erectile dysfunction
Poorly healing wounds on the legs or feet
Pain present at rest in the legs/feet that changes when standing
Abdominal pain after meals
First degree relatives with abdominal aortic aneurysm
Physical approach to PVD
Quality of pulses
Size of arteries
Temp of extremities
Hair pattern on extremities
Edema
Palpating the abdomen and find a pulsatile mass
AAA
Raynaud disease
Worst pulses are normal, but spasm or the distal arteries cause pallor of fingers
Ankle-brachial index
If pt presents with Hx and findings of PVD such as pain, clarification, numbness, weakness, weak dorsal pediatrician and posterior tibial pulses.
BP of foot/BP of both arms
Portal vein
Nutrient rich superior mesenteric and splenic veins supply 75% of the blood flow to the liver. Supplemented by oxygenated blood from the hepatic artery. These flow into the hepatic sinusoids then to the hepatic veins that empty into inferior vena cava
Weaker structure of leg veins cause…
Irregular dilation, compression, ulceration, and invasion by tumors.
Deep veins of leg compared to superficial
Deep veins cart 90% of the venous return from lower extremities and have support from surrounding tissue. Superficial veins have poor tissue support
Lymphatic plexus
Originate in extra cellular spaces, where capillaries collect tissue fluid, plasma proteins, cells, and cellular debries
What can cause edema
Venous capillary pressure, capillary osmotic pressure, or abnormal fluid balance. Either by exogenous administration or by resorption of the kidney.
PAD (peripheral arterial disease)
Symptomatic limb ischemia with exertion
Neurogenic claudication
Pain with walking or prolonged standing radiating to the spinal area into the butt, thighs, lower legs, and feet.
Mesenteric ischemia
Inadequate blood flow to the small intestine. Food fear due to increased pain with eating (eating causes the abdominal viscera to need greater oxygen supply). Can result in bowel necrosis
Spinal stenosis
Abdominal pain is relieved by sitting or bending forward. Or there is bilateral buttock or leg pain
Upper extremity DVT
Visible venous collaterals, swelling and discoloration.
Aortic regurgitation finding when palpating what artery?
Bounding carotid, radial, and femoral pulses.
