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What do arteries do for the blood and body tissues?
Supply oxygen
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What kind of fibers do the arteries contain?
Elastic and muscle
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Why do the walls of the arteries need to be strong?
Because it is a high pressure system
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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
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Why are veins walls thinner than arteries?
Low pressure system
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What is the mechanism that keeps blood moving?
Competent, unidirectional valves
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Which are the deep veins?
Femoral and iliac
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Which are the superficial veins?
great and small saphenous
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What three situations cause venous stasis?
- Calf muscle contraction is insufficient
- Incompetent valves
- Occluded lumens
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Who is at risk for venous stasis?
- People with…
- Prolonged standing, sitting or bedrest
- Hypercoagulable states
- Vein wall trauma
- Varicose veins
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What is post-thrombotic syndrome?
Clot causes venous wall trauma
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What do lymphatics do for blood and tissues?
Retrieves excess fluid from tissue spaces and returns it to bloodstream
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What do axillary lymph nodes drain?
Breast and upper arm
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What do Epitrochlear lymph nodes drain?
Hand and lower arm
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What do Inguinal lymph nodes drain?
Lower extremity, external genitalia and anterior abdominal wall
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What is difference between arteriosclerosis and atherosclerosis?
Hardening of arteries (arteriosclerosis) versus plaque build up in arteries (atherosclerosis)
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What is dependent edema?
Edema caused by prolonged standing
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What is claudication?
Pain with exertion
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Why is pain of venous stasis worse at the end of the day?
Because fluid builds up throughout the day
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What is hemocsiderin?
Staining from iron buildup when venous stasis is present
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What do you inspect for when assessing peripheral vascular system?
- Extremities for color
- Clubbing
- Edema
- Ulceration
- Hair distribution
- Symmetry of extremities
- Scars
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What do you palpate for when assessment peripheral vascular system?
- Temperature
- Warmth
- Tenderness
- Edema
- Capillary refill
- Lymph nodes
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What do you auscultate when assessing peripheral vascular system?
- Temporal, Carotid and femoral pulses
- Bruits (none should be present)
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What do you note when palpating arterial pulses?
- Rate
- Rhythm
- Amplitude
- Symmetry
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What is the Allen test?
Testing perfusion of ulnar artery by occluding both and releasing the radial artery
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What is bilateral edema a symptom of (usually)?
Chronic disease or heart disease
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Unilateral edema?
hemi-acute, lymphedema
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What is lymphedema?
Damage to lymph vessels and fluid cannot be drained
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What is brauny edema?
Hardening of lymph vessels
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What is Homan’s sign?
Pain upon dorsi-flexion of the foot, which indicates DVT
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What is compression test?
Tests for venous insufficiency by compressing distal and proximal ends of varicose vein, releasing proximal end and feeling for wave.
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Signs of arterial deficit?
- Palor
- Cyanosis
- Thickened/absent nails
- Cool extremities
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What is dependent rubor?
Severe peripheral arterial disease causes loss of vasomotor flow causing deep blue/red tone
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When is a full/bounding pulse found?
After exercise, fright, hyperthyroidism or anemia
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What is pulsus begminus?
Regular beat followed by premature beat. Occurs with conduction disturbances and often do not perfuse to extremities
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What is pulsus alternans?
Regular pulse with alternating strong and weak beats, indicative of heart failure
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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
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What are symptoms of PVD/peripheral arterial disease?
- Claudication pain
- Pain aggravated with elevation, relieved with dependency
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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
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What are symptoms of venous insufficiency?
- Pain: increases at end of day, aching/tiredness, relieved with elevation
- No symptoms of claudication pain
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What is main treatment of venous insufficiency?
Compression wrap the leg (make sure arterial blood flow is good)
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What are the causes for DVT?
- Prolonged bedrest
- Varicose veins or injury
- Infection
- Cancer
- Clotting disorders
- Estrogen therapy
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Signs of DVT?
- Increased warmth
- Unilateral edema
- Erythema
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Symptoms of DVT?
- Sudden onset of intense pain
- Homan’s sign
- Pain to palpation of calf
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