PV Flashcards Preview

Health Assessment > PV > Flashcards

Flashcards in PV Deck (84)
Loading flashcards...
1

Injury to vascular endothelial cells provokes...

thrombus formation, atheromas (fatty layers), and vascular lesions of HTN

2

atheroma, pathogenesis

  • begins in intima (inner layer of vessels) as lipid-filled foam cells and then becomes fatty streaks. 
  • Complex atheromas are thickened asymmetric plaques that narrow the lumen, reducing blood flow, and weaken underlying media
    • They have soft lipid core and fibrous cap of smooth muscle cells and collagen-riich matrix
  • Plaque rupture may precede thrombosis

3

location of brachial artery

bend of elbow just medial to biceps tendon

4

location of radial artery

lateral flexor surface of forearm

5

location ulnar artery

medial flexor surface of forearm

overlying tissues may obscure ulnar artery

6

location femoral artery

just below inguinal ligament, midway between ASIS and symphysis pubis

7

location popliteal artery

extension of femoral artery that passes medially behind femur, palpable just behind knee

DIvides into dorsalis pedis and posterior tibial

8

location dorsalis pedis artery

dorsum of foot just lateral to extensor tendon of big toe

9

ocation posterior tibial artery

behind medial malleolus of ankle. 

An interconnecting arch between its two chief arterial branches protects circulation to the foot

10

layers of arteries

3 concentric: intima, media, adventitia

11

Where do the veins of the arms, upper trunk, head and neck drain? 

SVC, which empties into the right atrium

12

where do veins of legs and lower trunk drain?

upward into IVC

 

13

Important characteristic of leg veins

weaker wall structure, susceptible to irregular dilation, compression, ulceration, invasion by tumors = warrant special attn

14

intermittent claudication

symptomatic limb ischemia w/exertion

Present in atherosclerotic PAD

15

neurogenic claudication

pain w/walking or prolonged standing, radiating from spinal area into buttocks, thighs, lower legs, or feet

increases likelihood of spinal stenosis if pain is relieved by sitting or bending forward or if bilateral buttock or leg pain is present

16

PAD symptom location and site of arterial ischemia: buttock, hip

aortoiliac

17

PAD symptom location and site of arterial ischemia: erectile dysfunction

iliac-pudendal

18

PAD symptom location and site of arterial ischemia: thigh

common femoral or aortoiliac

19

PAD symptom location and site of arterial ischemia: upper calf

superficial femoral

20

PAD symptom location and site of arterial ischemia: lower calf

popliteal

21

PAD symptom location and site of arterial ischemia: foot

tibial or peroneal

22

abdominal pain, "food fear", and weight loss suggest ...

intestinal ischemia of the celiac or superior or inferior mesenteric arteries

23

ABI

ankle divided by brachial BP

  • >0.9 = normal
  • <0.89 - > 0.60 = mild PAD
  • <0.59 to >0.40 = moderate PAD
  • <0.39 = severe PAD

24

Key components of Peripheral Arterial Exam

  • BP in both arms
  • Carotids: palpate, auscultate
  • Auscultate aortic, renal, femoral 
  • Palpate aorta & determine diameter
  • Palpate brachila, radial, ulnar, femoral, popliteal, dorsalis pedis, posterior tibial arteries
  • Inspect ankles & feet for color, temperature, skin integrity; not ulcerations, hair loss, trophic skin changes, hyper trophic nails

25

Prominent veins and edematous arm suggest...

venous obstruction

26

Grading of pulses

  • 3+ bounding
  • 2+ brisk, expected (normal)
  • 1+ diminished, weaker than expected
  • 0 absent, unable to palpate

27

warmth and redness over calf signal 

cellulitis

28

atherosclerosis most commonly obstructs arterial circulation to...

the thigh. Normal femoral w/diminished to absent popliteal

29

Calf asymmetry, Differential Dx

  • DVT
  • muscle tear or trauma
  • Baker's cyst (posterior knee)
  • muscular atrophy

30

Characteristic of venous cause to edema

venous distention - bilateral present in heart failure, cirrhosis, nephrotic syndrome