Induration, edema, and hyperpigmentation are common associated findings with which of the
following?
C.
The most prominent component of the jugular venous pulse is the
D.
During a routine prenatal visit, Ms. T was noted as having dependent edema, varicosities of the legs, and hemorrhoids. She expressed concern about these symptoms. You explain to Ms. T that her enlarged uterus is compressing her pelvic veins and her inferior vena cava. You would further explain that these findings
D.
Vascular changes expected in the older adult include
A.
You are examining Mr. S, a 79-year-old diabetic man complaining of claudication. Which of the following physical findings is consistent with the diagnosis of peripheral arterial disease?
D.
You are performing a physical examination on a 46-year-old male patient. His examination findings include the following: positive peripheral edema, holosystolic murmur in the tricuspid region, and a pulsatile liver. His diagnosis is
C.
A characteristic distinguishing primary Raynaud phenomenon from secondary Raynaud phenomenon includes which of the following?
D.
In primary Raynaud phenomenon, there is triphasic demarcation of the skin—white, cyanotic, and reperfused—and vasospasm that lasts a minutes to less than an hour, areas of cold, and an achy feeling that improves with rewarming. In secondary Raynaud phenomenon, there is intense pain from digital ischemia.
In children, coarctation of the aorta should be suspected if you detect
B.
Which of the following statements is true regarding the development of venous ulcers in older adults?
B.
When examining arterial pulses, the thumb may be used
B.
To assess a patient’s jugular veins, the patient should first be placed in which position?
A.
You are assessing Mr. Z’s fluid volume status as a result of heart failure. If your finger depresses a patient’s edematous ankle to a depth of 6 mm, you should record this pitting as
B.
A bounding pulse in an infant may be associated with
D.
In infants or small children, a capillary refill time of 4 seconds
B.
the a wave
(of the jugular vein's pulse)
The upward a wave, the first and most prominent component, is the result of a brief backflow of blood to the vena cava during right atrial contraction.
c wave
(of the jugular vein's pulse)
The upward c wave is a transmitted impulse from the vigorous backward push produced by closure of the tricuspid valve during right ventricular systole.
the v wave
(of the jugular vein's pulse)
The upward v wave is caused by the increasing volume and concomitant increasing pressure in the right atrium. It occurs after the c wave, late in ventricular systole.
x slope
(of the jugular vein's pulse)
The downward x slope is caused by passive atrial filling. This ends with the initiation of the v wave.
y slope
(of the jugular vein's pulse)
The y slope following the v wave reflects the open tricuspid valve and the rapid filling of the right ventricle.
signs of venous insufficiency
varicose veins
spider veins
hyperpigmentation
edema
Temporal Arteritis (Giant Cell Arteritis)
An inflammatory disease of the branches of the aortic arch, including the temporal arteries
Arterial Aneurysm
A localized dilation, which is generally defined as 1.5 times the diameter of the normal artery, caused by a weakness in the arterial wall
Peripheral Arterial Disease
Stenosis of the blood supply to the extremities by atherosclerotic plaques
Peripheral Arterial Disease Subjective Data
• Pain in muscle after exercise that disappears with rest
• Amount of exercise needed to cause discomfort is predictable (e.g., occurring each time the same distance is walked)
Peripheral Arterial Disease Objective Data
• In claudication, the limb appears healthy, but pulses are weak or absent.
• Progressive stenosis results in severe ischemia, in which the foot or leg is painful at rest, is cold and numb, and has skin changes (e.g., dry and scaling, with poor hair and nail growth).
• Edema seldom accompanies this disorder, but ulceration is common in severe disease, and the muscles may atrophy.
Tricuspid Regurgitation
The backflow of blood into the right atrium during systole
Kawasaki Disease
An acute small vessel vasculitis that may result in the development of coronary artery aneurysms
Coarctation of the Aorta
A stenosis seen most commonly in the descending aortic arch near the origin of the left subclavian artery and ligamentum arteriosum
