Quiz #3 Peripheral Vascular System and Lymphatics

Question 1

Temporal artery location

Answer 1

In front of the ear

Question 2

Carotid artery location

Answer 2

Between Sternomastoid and trachea

Question 3

Brachial artery location

Answer 3

in the bicepts-triceps furrow of the upper arm, bifurcaes into the ulnar and radial arteries

Question 4

Femoral artery

Answer 4

posterior at lower thigh as the popliteal artery

Question 5

Popliteal artery divides

Answer 5

anterior tibial artery and posterior tibial artery

Question 6

Peripheral artery disease

Answer 6

involves non-coronary arteries located in the limbs.

Usually caused by atherosclerosis

Question 7

Veins in the legs

Answer 7

Deep veins—femoral vein; popliteal vein.

Superficial veins—great and small saphenous veins.

Question 8

Veins keep blood moving by:

Answer 8

contracting skeletal muscles; pressure gradient caused by breathing (thoracic pressure decreases, abdominal pressure increases); intraluminal valves create one-way flow.
Called capacitance vessels due to veins’ ability to stretch.

Question 9

Venous stasis is due to:

Answer 9

problems with contraction of skeletal muscles, and/or incompetent valves in the veins, and/or a patent lumen.

Question 10

Risk for venous disease

Answer 10

Hypercoagulable state
Vein wall trauma
Incompetent valves created by dilated and tortuous veins

Question 11

Lymphatic system function

Answer 11

retrieves excess fluid and plasma proteins from interstitial space—returns it to the circulation.
Conserves fluid and plasma protein
Forms major part of immune system
Absorbs lipids from the small intestine

Question 12

Lymph vessels drain into the venous system at the

Answer 12

subclavian veins

Question 13

Right lymphatic duct drains into

Answer 13

right subclavian vein

Question 14

Thoracic duct

Answer 14

drains most of the body; empties into the left subclavian vein

Question 15

Lymph nodes

Answer 15

where pathogens are exposed to B and T lymphocytes

Question 16

Superficial nodes accessible to palpation

Answer 16

Cervical—head and neck
Axillary—breast and upper arm
Epitrochlear—hand and lower arm
Inguinal—lower extremities, external genitalia, anterior abdominal wall

Question 17

Organs with involvement in the lymph system

Answer 17

spleen, tonsils, thymus gland

Question 18

Lymph in Infants and Children

Answer 18

lymph nodes larger; superficial nodes may be palpable

Question 19

Aging Adult Peripheral vascular system

Answer 19

Arteriosclerosis—increased BP
Enlargement of intramuscular calf veins
29% over 70—have PAD

Question 20

Increased risk for PAD in the aging adult

Answer 20

smoking, DM, dyslipidemia, HTN

Question 21

Increased risk for DVT in the aging adult

Answer 21

prolonged BR, prolonged immobilization, heart failure

Question 22

Subjective data for peripheral vascular system and regional lymphatics (6)

Answer 22

1. Leg pain or cramps
2. Skin changes on arms or legs
3. Swelling in arms or legs
4. Lymph node enlargement
5. Medications
6. Smoking history

Question 23

What to ask about leg pain for subjective assessment

Answer 23

PQRST, symptoms while walking, night pain

Question 24

Night leg pain

Answer 24

Common in aging adults, may indicate ischemic rest pain of PVD, severe night muscle cramping, or restless leg syndrome

Question 25

Claudication distance

Answer 25

The number of blocks walked or stairs climbed to produce pain

Question 26

Arteriosclerosis

Answer 26

Peripheral blood vessels grow more rigid with age.

Question 27

Athersclerosis

Answer 27

the deposition of fatty plaques on the intima of the arteries

Question 28

Lymph nodes in older adults

Answer 28

loss of lymph tissue causes a decrease in the number of nodes and a decrease in the size of remaining nodes

Question 29

Objective data for peripheral vascular system

Answer 29

1. profile sign- check for clubbing 2. capillary refill 3. arm size symmetry 4. radial pulses 5. epitrochlear lymph notes check 6. modified Allen test 7. inspect and palpate the legs

Question 30

Leg exam- inspection (6)

Answer 30

1. Skin color and temperature 2. Hair distribution 3. Venous pattern 4. Size (swelling/atrophy) 5. Symmetry 6. Skin lesions or ulcers

Question 31

Signs of DVT

Answer 31

Acute, unilateral, painful swelling and asymmetry of calves 1cm or more

Question 32

Brown discoloration of the legs

Answer 32

Occurs with chronic venous stasis caused by hemosiderin deposits from red blood cell degradation.

Question 33

Venous ulcers site

Answer 33

medial malleolus, from bacterial invasion of poorly drained tissues

Question 34

Arterial ulcers site

Answer 34

tips of toes, metatarsal heads, and lateral malleoli

Question 35

Unilateral cool foot or sudden temperature drop moving down the leg caused by

Answer 35

arterial deficit

Question 36

Cause of bilateral pitting edema

Answer 36

heart failure, diabetic neuropathy, hepatic cirrhosis. May also occur with excessive standing and pregnany

Question 37

elevational pallor cause

Answer 37

arterial insufficiency

Question 38

Tenderness in the calf may indicate

Answer 38

DVT, superficial phlebitis, lumbosacral disorders, muscle injury

Question 39

Leg objective: palpation

Answer 39

1. Temperature 2. Compress calf muscle for tenderness 3. Palpate inguinal lymph notdes 4. Palpate femoral, popliteal, dorsalis pedis, and posterior tibial arteries. 6. Check for pretibial edema

Question 40

Bruit in femoral arteries indicates

Answer 40

Partial occlusion

Question 41

dependent rubor

Answer 41

deep blue-red color with severe arterial insufficiency

Question 42

Chronic hypoxia due to arterial insufficiency can produce

Answer 42

Vasomotor tone and sensory loss, pooling of blood in the veins

Question 43

Unilateral edema occurs with

Answer 43

Occlusion of a deep vein or lymphatic ovstruction

Question 44

If bilateral pitting edema is present, examine for

Answer 44

Distended neck veins- indicates heart disease or pulmonary hypertension.

Question 45

Objective peripheral vascular and Lymphatic in aging adult

Answer 45

DP and PT pulses may be more difficult to find Trophic changes associated with arterial insufficiency- ie thin, shiny skin, ridged nails, loss of hair- also occur with aging

Question 46

Pulse characterizations

Answer 46

0- absent 1- weak 2- absent 3- increased/bounding

Question 47

Right lymphatic duct empties into the

Answer 47

right subclavian vein

Question 48

Right lymphatic duct drains the

Answer 48

``` right side of the head and neck right arm right side of the thorax right lung and pleura right side of the heart right upper section of the liver ```