CH: 21 Peripheral Vascular and Lymphatic System Flashcards
arteries in arm?
brachial
radial
ulnar
major artery in arm?
brachial
ulnar is deep and harder to?
palpate
where do ulnar and radial arteries supply?
hands
arteries of the leg?
femoral
popliteal
dorsalis pedis
posterior tibial
major leg artery?
femoral
IV’s are placed in?
venous
right JVD reflects?
heart
do veins have pulse?
no
does venous or arterial have lower pressure?
venous
severed artery vs vein?
vein will bleed less bc of lack of pressure
what can edema be a build up of?
water
lymph
blood
deep veins in leg?
femoral
popliteal
superficial veins in leg?
great saphenous
small saphenous
connecting veins?
perforators
what does the carotid pulse signify?
central perfusion
*should be strong
venous system valves open due to?
pressure, returns based on opening/closing of valves
*not like heart which has electrical pulsations
lymphatics return excess fluid to?
bloodstream
2 major ducts?
right lymphatic
thoracic
function of lymphatics?
filters
absorbs fat
fluid maintenance
big part of immune system (lots of macrophages through lymphs)
where is the main lymph system?
inguinal
*also in axillary, neck, and under chin
is it normal to palpate nodes?
no
*can be normalish after infection or autoimmune
what do nodes feel like?
small
oval groups
1cm
how would a node look if it is responding to pathogen?
local inflammation
swollen
tender
how to assess a lymph node?
circular motion
4 body regions with palpable nodes?
cervical
inguinal
axillary
epitrochlear
cervical nodes supply?
head and neck
axillary nodes supply?
upper arm and breasts
epitrochlear nodes supply?
hand and lower arms
inguinal nodes supply?
groin and lower extremities
where is the epitrochlear node located?
elbow crack, next to brachial pulse
what other organs aid lymphatics? (4)
tonsils
thymus gland
spleen
bone marrow
what can cause one limb to be bigger than another?
accidents, bypass, big surgeries
when is pulse checking extra important?
after vascular procedures
*pre and post angiograms
lymph node enlargement occurs with?
infection
cancer
malignancy
immune disease
what is the modified allen test?
assess the flow and circulation of radial and ulnar
*hold pressure on both arteries, let go of ulnar artery and see if hand gets perfusion
where are blood gases drawn from?
arterial
do we put meds in arterial lines?
never, always in veins
where do you usually check pulse?
radial
*if thready, move up and check brachial
if you cannot feel radial pulse, you can use?
doppler
where does blood shunt when BP is low?
brain
lungs
organs
radial is an extra alternate of blood to get to?
hand
*important because we can now do heart caths in right radial
where do you feel femoral pulse?
in groin
if pain or cramping in legs when walking but stops hurting after stopping walking for 5 mins what is it called?
claudication
*sign of lack of blood flow
*extremity pallor when lifted and rubor when put down
when exercising, what do we need more of?
oxygenated blood
when exercising:
dealing with heart and lungs they will be _____, dealing with vascular system they will be_____?
shortness of breath
cramping or pain bc lack of oxygen
sudden redness and swelling that is ipsilateral?
could mean DVT
*can happen in arms, legs
DVT risk factors?
immobility
fractures or high risk of fractures
post surgery, especially ortho
hormones
cancer (any hypercoagulable state)
genetic disorders
biggest risk from DVT?
traveling to lungs
*its in venous system
treatment for blood clot?
blood thinners/anticoagulants
-coumadin, apixaban, rivaroxaban, heparin
injectable: lovenox
what test done for heparin?
PTT
*dosed based on weight
IV vs SUBQ heparin?
IV: full anticoagulant
SUBQ: prophylactic (preventative)
why do you need a tape measure with peripheral vascular disease?
to measure circumference
what is compartment syndrome?
fluid leaks into tissue
can get so tight that it compromises circulation
for what procedure do we use contrast dye in arteries?
angiograms
heart caths common in which artery?
femoral
*especially if pt had bypass (won’t usually go through radial)
what are we looking for during manual compression tests?
varicose veins
*any venous insufficiencies
what are we looking at with ABIs?
whats the BP in the ankle vs the brachial
*abnormal can signify peripheral vascular disease in legs
*used to assess blood flow, should be around 1
water-hammer pulse? (corrigans)
3+ and collapses suddenly
pulsus bigeminus?
premature ventricular complex
*normal QRS followed by wide QRS
*normal heart beat followed by abnormal firing
*quick pulse
pulsus paradoxus?
BP drops with deep inspiration
*assess with continuous arterial monitoring
systolic pressure will drop by 10 mmHg
what is Raynaud’s syndrome?
less perfusion to hands due to vasoconstriction
*pallor, coldness, decreased cap refill
*usually constricted when cold or stressed
what is lymphedema?
enlarged extremity from lymph system not functioning properly
ischemic ulcer?
dry, more likely to be gangrenous
*arteriosclerosis
what causes ischemic ulcers?
fatty plaque buildup that hardens/calcifies arterial walls
ex. smoking, diabetes, hyperlipidemia, hypertension
venous ulcer?
wet, require changes
*stasis
depress _____ ulcers and elevate _____ ulcers?
depress ischemic (promote blood flow to extremities)
elevate stasis (promote blood flow back to heart)
______ ulcer = deep muscle pain
______ ulcer = aching pain
deep: arterial ischemia
aching: venous stasis
_____ ulcer = lower leg edema
_____ ulcer = intermittent claudication
edema: venous stasis
claudication: arterial ischemia
_____ ulcer = coolness in affected area and pallor
_____ ulcer = irregular borders and brown discoloration
coolness and pallor: arterial ischemia
borders and brown: venous stasis
_____ ulcer = granulation
_____ ulcer = malnutrition signs
granulation: venous stasis
malnutrition: arterial ischemia
_____ ulcer = distal gangrene
_____ ulcer = thickened skin
gangrene: arterial ischemia
thickened skin: venous stasis
_____ ulcer = diminished pulse
_____ ulcer = normal pulse
diminished: arterial ischemia
normal: venous stasis
always check wound ____?
circulation
*in order to heal
what is an aneurysm?
outpouching of vessel wall (weakening)
*blood can pool
most concerning/life threatening aneurysms?
abdominal or brain
*can burst and impede blood flow to body
what affects aneurysms?
blood pressure
*in arterial system
