Peripheral Vascular Assessment

  1. What do arteries do for the blood and body tissues?
    Supply oxygen
  2. What kind of fibers do the arteries contain?
    Elastic and muscle
  3. Why do the walls of the arteries need to be strong?
    Because it is a high pressure system
  4. What do veins do for the blood and tissues?
    Drain de-oxygenated blood and its waste products from tissues and return it to the heart
  5. Why are veins walls thinner than arteries?
    Low pressure system
  6. What is the mechanism that keeps blood moving?
    Competent, unidirectional valves
  7. Which are the deep veins?
    Femoral and iliac
  8. Which are the superficial veins?
    great and small saphenous
  9. What three situations cause venous stasis?
    • Calf muscle contraction is insufficient
    • Incompetent valves
    • Occluded lumens
  10. Who is at risk for venous stasis?
    • People with…
    • Prolonged standing, sitting or bedrest
    • Hypercoagulable states
    • Vein wall trauma
    • Varicose veins
  11. What is post-thrombotic syndrome?
    Clot causes venous wall trauma
  12. What do lymphatics do for blood and tissues?
    Retrieves excess fluid from tissue spaces and returns it to bloodstream
  13. What do axillary lymph nodes drain?
    Breast and upper arm
  14. What do Epitrochlear lymph nodes drain?
    Hand and lower arm
  15. What do Inguinal lymph nodes drain?
    Lower extremity, external genitalia and anterior abdominal wall
  16. What is difference between arteriosclerosis and atherosclerosis?
    Hardening of arteries (arteriosclerosis) versus plaque build up in arteries (atherosclerosis)
  17. What is dependent edema?
    Edema caused by prolonged standing
  18. What is claudication?
    Pain with exertion
  19. Why is pain of venous stasis worse at the end of the day?
    Because fluid builds up throughout the day
  20. What is hemocsiderin?
    Staining from iron buildup when venous stasis is present
  21. What do you inspect for when assessing peripheral vascular system?
    • Extremities for color
    • Clubbing
    • Edema
    • Ulceration
    • Hair distribution
    • Symmetry of extremities
    • Scars
  22. What do you palpate for when assessment peripheral vascular system?
    • Temperature
    • Warmth
    • Tenderness
    • Edema
    • Capillary refill
    • Lymph nodes
  23. What do you auscultate when assessing peripheral vascular system?
    • Temporal, Carotid and femoral pulses
    • Bruits (none should be present)
  24. What do you note when palpating arterial pulses?
    • Rate
    • Rhythm
    • Amplitude
    • Symmetry
  25. What is the Allen test?
    Testing perfusion of ulnar artery by occluding both and releasing the radial artery
  26. What is bilateral edema a symptom of (usually)?
    Chronic disease or heart disease
  27. Unilateral edema?
    hemi-acute, lymphedema
  28. What is lymphedema?
    Damage to lymph vessels and fluid cannot be drained
  29. What is brauny edema?
    Hardening of lymph vessels
  30. What is Homan’s sign?
    Pain upon dorsi-flexion of the foot, which indicates DVT
  31. What is compression test?
    Tests for venous insufficiency by compressing distal and proximal ends of varicose vein, releasing proximal end and feeling for wave.
  32. Signs of arterial deficit?
    • Palor
    • Cyanosis
    • Thickened/absent nails
    • Cool extremities
  33. What is dependent rubor?
    Severe peripheral arterial disease causes loss of vasomotor flow causing deep blue/red tone
  34. When is a full/bounding pulse found?
    After exercise, fright, hyperthyroidism or anemia
  35. What is pulsus begminus?
    Regular beat followed by premature beat. Occurs with conduction disturbances and often do not perfuse to extremities
  36. What is pulsus alternans?
    Regular pulse with alternating strong and weak beats, indicative of heart failure
  37. What are signs of PVD/peripheral arterial disease?
    • Ulcers or sores on legs and feet that don’t heal, pale and dry
    • Hairlessness on legs, shiny legs, thickened nails
    • Absent or weak pulse
    • Prolonged capillary fill
    • Coldness/pallor in lower legs and feet
  38. What are symptoms of PVD/peripheral arterial disease?
    • Claudication pain
    • Pain aggravated with elevation, relieved with dependency
  39. What are signs of Venous insufficiency?
    • Varicose veins/post thrombotic leg syndrome
    • Ulcers (granulation tissue present, highly exuding, uneven wound edge)
    • Edema (upside down champagne bottle)
    • Hemosiderin
  40. What are symptoms of venous insufficiency?
    • Pain: increases at end of day, aching/tiredness, relieved with elevation
    • No symptoms of claudication pain
  41. What is main treatment of venous insufficiency?
    Compression wrap the leg (make sure arterial blood flow is good)
  42. What are the causes for DVT?
    • Prolonged bedrest
    • Varicose veins or injury
    • Infection
    • Cancer
    • Clotting disorders
    • Estrogen therapy
  43. Signs of DVT?
    • Increased warmth
    • Unilateral edema
    • Erythema
  44. Symptoms of DVT?
    • Sudden onset of intense pain
    • Homan’s sign
    • Pain to palpation of calf
Card Set
Peripheral Vascular Assessment
Health Assessment lecture on peripheral vascular system