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Funds > Assessment of the Peripheral Vascular System > Flashcards

Assessment of the Peripheral Vascular System Flashcards

1
Q

the ____ carry oxygenated, nutrient-rich blood to capillaries

A

arteries

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2
Q

the arteries have a ____ pressure system and ___ walls

A

high; thick,layered walls

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3
Q

____ = force of blood against arterial walls felt with heart beat

A

pulse

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4
Q

name the major arteries of the arm

A

brachial, radial, ulnar

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5
Q

name the major arteries of the leg

A

femoral, popliteal, posterior tibial, dorsalis pedis

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6
Q

______ carry deoxygenated, nutrient-depleted, waste-laden blood from the tissues back to the heart

A

veins

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7
Q

name the major veins of the arm

A

cephalic, basilic, median cubital

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7
Q

veins have a ___ pressure system

A

low

(have no force that propels blood flow)

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8
Q

name the major veins of the leg

A

femoral, great saphenous, popliteal, small saphenous

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9
Q

what are the 3 mechanisms that propel blood back to the heart

A

valves, muscular contraction, pressure gradient

(failure in mechanisms results in impeded venous return; venous stasis)

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10
Q

when inspecting the arms what should you observe

A

arm size, venous patterning, edema

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11
Q

normal findings when inspecting the arm

A
  • arms are bilaterally symmetric with minimal variation in size and shape
    no edema or prominent venous patterning
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12
Q

________ results from blocked lymphatic circulation, which may be caused by breast surgery

A

lymphedema

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13
Q

lymphedema usually affects ONE extremity and causes what

A

induration and nonpitting edema

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14
Q

what are precautions to take when someone has lymphedema

A

no blood pressure or blood draws can be done on the affected arm

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15
Q

prominent venous patterning with edema may indicate _____

A

venous obstruction

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16
Q

when inspecting the hands what should be observed

A

coloration

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17
Q

normal finding when inspecting hands for color

A

equal bilaterally

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18
Q

abnormal finding when inspecting hands for coloration

A

Raynaud’s disease -vascular disorder caused by vasoconstriction or vasospasm of fingers or toes

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19
Q

what is a normal finding when palpating a patient’s fingers, hands, and arms for temperature

A

skin should be warm bilaterally from fingertips to upper arms

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20
Q

what is an abnormal finding when palpating for temp

A
  • a cool extremity (can be a sign of atrial insufficiency)
  • cold fingers are common with Raynaud’s disease
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21
Q

normal findings when palpating the radial pulse

A

-equal strength bilaterally (2+)
-resilient/elastic quality

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22
Q

abnormal findings when palpating the radial pulse

A

diminished or absent pulse (suggests partial or complete arterial occlusion)

23
Q

when should you palpate the ulnar pulse

A

when you suspect arterial insufficiency

24
Q

normal finding when palpating the ulnar pulses

A

non-detectable (or normal pulse findings)

25
Q

abnormal findings when palpating the ulnar pulse

A

lack of resilience (can indicate arteriosclerosis)

26
Q

normal findings when palpating the brachial pulse

A

equal strength bilaterally

27
Q

abnormal finding when palpating the brachial pulse

A

increased, diminished, absent

28
Q

where should you check capillary refill and what is brisk and sluggish capillary refill

A
  • check at base of nail at fingers/toes
  • brisk < 2sec
  • sluggish > 2sec
29
Q

the ____ test evaluates the patency of the radial or ulnar arteries

A

Allens

(implemented when patency is questionable)

30
Q

how do you perform Allens test

A
  • assess ulnar patency
    -Have client rest hand palm side up and make a fist
  • Use your thumbs to occlude the radial and ulnar arteries
  • Continue pressing to keep both arteries occluded and have client release fist
  • Note that the palm remains pale
  • Release the pressure on the ulnar artery, watch for color to return
  • To assess radial patency, repeat the last step, release pressure on the radial artery
31
Q

normal findings when inspecting the legs for color

A

pink color for lighter-skinned clients and pink or red undertones visible under darker-pigmented skin

(no pigmentation changes)

32
Q

abnormal findings when inspecting the legs for color

A
  • pallor (especially when elevated)
  • rubor (suggests arterial insufficiency when dependent)
  • cyanosis (when dependent suggests venous insufficiency)
    _ rush or brownish pigmentation around ankles (suggests venous insufficiency)
33
Q

normal findings when inspecting the legs for hair distribution

A
  • hair covers legs and appears on the dorsal surface of toes
34
Q

abnormal finding when inspecting the legs for hair distribution

A

hair loss (can indicate arterial insufficiency)

  • hair loss occurs with age so it is not always abnormal
35
Q

normal findings when inspecting the legs for ulcers

A

free of lesions or ulcerations

36
Q

abnormal findings when inspecting the legs for lesions or ulcers

A
  • ulcers with smooth, even margins that occur are pressure areas (result from arterial insufficiency)
  • ulcers with irregular edges, bleeding, and possible bacterial infection (result from venous insufficiency)
37
Q

normal findings when inspecting legs for edema

A

equal in size and shape bilaterally; no swelling or atrophy

38
Q

abnormal findings when inspecting lgs for edema

A

bilateral edema (can indicate a systemic problem - CHF, lymphedema)

39
Q

when measuring legs what is unilateral edema characterized by

A

a 1cm difference in measurement at the ankles or a 2cm difference at the calf

40
Q

if edema is noted during inspection you should palpate the area to determine if it is ____ or ____

A

pitting or nonpitting

41
Q

how do you palpate to determine pitting or nonpitting edema

A
  • Press the edematous area with the tips of your fingers, hold for a few seconds, then release
  • If depression does not rapidly refill and the skin remains indented on release, pitting edema is present
42
Q

pitting edema is associated with _____ problems

A

systemic (SHF, hepatic cirrhosis)

(local problems such as venous stasis due to insufficiency, obstruction, prolonged standing/sitting)

43
Q

normal findings when palpating the legs for temperature

A

equally warm temperature bilaterally

44
Q

abnormal findings when palpating the legs for temperature

A

generalized coolness in one leg or a change in temperature from warm to cool as you move down the leg (suggests arterial insufficiency)

(increased warmth can be caused by superficial thrombophlebitis)

45
Q

how should a patient position their knee when one is palpating the femoral pulse

A

bend the knee and move it out and to the side

46
Q

normal findings when palpating the femoral pulse

A

strong and equal bilaterally

47
Q

abnormal finding when palpating the femoral pulse

A

weak or absent pulse (indicated partial or complete arterial occlusion)

48
Q

how should a patients leg be positioned when palpating the popliteal pulse

A

raise the knee partially

49
Q

is it unusual to not be able to palpate the popliteal pulse

A

no - it can be difficult to detect and circulation can still be normal

50
Q

abnormal findings when palpating the popliteal pulse

A

absent pulse can be the result of an occluded artery

51
Q

normal findings when palpating the tibial pulse

A

strong bilaterally

52
Q

abnormal finding when palpating the tibial pulse

A

weak or absent pulse (can indicate partial or complete occlusion)

53
Q

normal finding when palpating the dorsalis pedis pulse

A

strong bilaterally

54
Q

abnormal finding when palpating the dorsalis pedis pulse

A

weak or absent pulse can indicate impaired arterial circulation

55
Q

how do you assess for DVT (Homan’s sign)

A
  • Client should be supine
  • Flex client’s knee about 5 degrees
  • Place your hand under the client’s calf muscle, and dorsiflex the foot
  • Ask the client to report pain or tenderness
  • Repeat on the opposite leg
56
Q

when no pain or tenderness is elicited when assessing for DVT what type of Homan’s sign is this

A

negative Homan’s sign

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