7.2 Peripheral Circulation Anatomy and Physiology Flashcards
The pressure created by the heart pushes through the _____
arteries
The pressure inside the arteries is directly related to the patient’s _____
blood pressure
The pressure in the veins is _____
very low
high pressure=
Arteries
low pressure=
Veins
Veins are divided into 2 subgroups:
- Superficial
- Deep
show considerable
individual variation
Superficial Veins
subcutaneous in the fasciae and are easily palpable
Superficial Veins
Superficial Veins:
- Cephalic vein
- Basilic vein
- Median vein
in the dorsal venous
network on the dorsum of the hand (radial aspect)
Cephalic vein
in the dorsal venous network and ascends along the posterior ulnar side of the wrist
Basilic vein
drains the palmar venous arch
Median vein
accompany arteries
Deep veins
Deep veins:
- Radial vein
2. Ulnar vein
usually in pairs on either side of the artery and are connected by short crosslinks
Deep veins
they are not advised for use for routine IV access due to their close proximity to arteries and veins
Deep veins
run alongside the
radial artery
Radial vein
run alongside the
ulnar artery
Ulnar vein
A localized dilation or
bulging in the wall of a blood
vessel, usually an artery
Aneurysm
Thickening, hardening, and
loss of elasticity of artery
walls
Arteriosclerosis
A form of arteriosclerosis involving changes in the intima of the artery due to accumulation of lipids and so on
Atherosclerosis
Obstruction of a blood vessel
by an embolus
Embolism
Air, mass of undissolved
matter circulating in the
bloodstream
Embolus
Varicose veins in the rectal area
Hemorrhoids
Inflammation of a vein
Phlebitis
Inflammation of a vein along with thrombus (blood clot) formation
Thrombophlebitis
A blood clot in a blood vessel
Thrombus
Swollen, knotted superficial veins
Varicose veins (varices)
There are two ways to locate a vein:
- Visual inspection
2. Palpation
The scrutiny of the veins in both arms is essential prior to choosing a vein
Visual Inspection
Veins to avoid:
– Veins close to an infection
– Veins close to bruising and
phlebitis
– Edematous limbs as there
is danger of stasis of lymph, predisposing to
such complications as phlebitis and cellulitis
- Areas of previous
venipuncture should be avoided as a build
up of scar tissue can cause difficulty in
accessing the vein and can result in pain
- Avoid veins that have
thrombosis
- Do not use the affected
arm in CVA or mastectomy patients
– A vein sited in the region of
a drip site should never be used as it may
result in the collection of a diluted samples
CVA
Cerebrovascular Accident
removal of breast
Mastectomy
determines the location and
condition of the veins
Palpation
distinguishes veins from arteries and tendons
Palpation
identifies the presence of valves
Palpation
feel soft and bouncy and will
refill when depressed
Healthy veins
Improving venous access
- Application of a Tourniquet
- Opening and closing of the fist
- Light tapping of the vein
- The use of heat
- Lowering the arm below the level of the
heart
promotes venous distension
Application of a Tourniquet
should be tight enough to impede venous return but not restrict arterial flow
tourniquet
The tourniquet should be placed about ____ above the venipuncture site
7 – 8 cm
The muscles will force
blood into the veins and encourages
distension. However this action may affect
certain blood results, e.g. potassium
Opening and closing of the fist
May be useful but can be painful and may result in the formation of a hematoma in patients with fragile veins
Light tapping of the vein
In the form of warm pack to encourage venodilatation and venous filling
The use of heat
Inappropriate site for Venipuncture
- Arm on side of Mastectomy
- Edematous areas
- Hematomas
- Arm in which blood is being transfused
- Scarred areas
- Arms with fistulas or vascular grafts
- Sites above an IV cannula
is vital when
performing venipuncture as the skin is
breached and a foreign device is introduced
into a sterile circulatory system
Asepsis
is a controversial subject and it is acknowledged
that a cursory wipe with an alcohol swab
does more harm than good as it disturbs the
skin flora
Skin cleaning
Inability to obtain specimen due to:
- Inappropriate choice of vein
- Thrombosed vein (due to previous or repeated attempts)
- Inexperience of operator
- Patient shocked, cold or dehydrated causing vasoconstriction
Formation of hematoma due to:
– Poor technique
– Pressure not being applied
to puncture site following removal of needle
If an artery is punctured: release
the tourniquet, remove the needle and apply
firm pressure for a minimum of 5 minutes.
Cover the site with a dressing once bleeding has stopped. Re-check for signs of bleeding
in 20 minutes
Puncture of an artery
