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Health Assessment Rain > Chapter 20 Peripheral Vascular System and Lymphatic System > Flashcards

Chapter 20 Peripheral Vascular System and Lymphatic System Flashcards

1
Q

When a question says peripheral always think-

A

Legs

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2
Q

Intermittant Claudication

A

Always think Arteries-

Think smoking, diabetes, athlosclerosis, hypertension as possible causes.

Intermittent claudication- is a clinical diagnosis given for muscle pain (ache, cramp, numbness or sense of fatigue), classically in the calf muscle, which occurs during exercise, such as walking, and is relieved by a short period of rest.

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3
Q

The nurse is assessing a patient’s risk for developing a deep vein thrombosis (DVT). The patient considered at the highest risk is a 60-year-old patient who:

A. has been on bed rest for 3 days.

B. has been receiving physical therapy for left knee replacement.

C. has calf and thigh measurements that have less than an inch of variation on both legs.

D.was admitted to the hospital with asthma exacerbation.

A

A. has been on bed rest for 3 days.

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4
Q

Mechanisms that keep blood moving toward the heart

A

Skeletal muscles
Valves
Pressure gradient created by respirations

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5
Q

PERIPHERAL VASCULARDevelopmental Considerations-Pregnancy

A

Total blood volume increases 40%

Blood pressure changes

Increased venous pressure and venous pooling causing peripheral edema, varicosities, and hemorrhoids

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6
Q

Lymphatic System Functions:

A

Production of lymphocytes within the lymph nodes, tonsils, adenoids, spleen and bone marrow

Production of antibodies

Phagocytosis

Maintenance of fluid balance thru movement of lymph fluid

Note: Is also a pathway for spread of malignant diseases.

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7
Q

LYMPH SYSTEM

Developmental Considerations

A

Infants: lymph nodes are generally not palpable

Children: nodes up to 1cm in the cervical or inguinal areas are usually no concern (Cervical nodes larger than 1 cm are considered abnormal)

Older adults: lymph nodes become more fibrotic

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8
Q

Thrombophlebitis-

A

Thrombophlebitis is phlebitis (vein inflammation) related to a thrombus (blood clot).

The following symptoms are often (but not always) associated with thrombophlebitis:

pain in the part of the body affected
skin redness or inflammation (not always present)

swelling (edema) of the extremities (ankle and foot)

palpable cord-like veins

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9
Q

PERIPHERAL VASCULAR & LYMPH SYSTEM

Subjective Data-

A

Leg pain or cramps

Skin changes on arm or legs

Swelling

Lymph node enlargement

Medications

Dizziness?

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10
Q

PERIPHERAL VASCULAR & LYMPH SYSTEM

PMH subjective data-

A

SB, HTN, DM, AF
Surgery
Recurrent infections
Thrombophlebitis

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11
Q

PERIPHERAL VASCULAR & LYMPH SYSTEM

Family History subjective data-

A

Malignancy: Hodgkin’s disease, Lymphoma

Tuberculosis

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12
Q

PERSONAL/SOCIAL HISTORY

A 
TOBACCO USE…
NUTRITION…
EXERCISE…
ALCOHOL USE…
OTC DRUGS…
OCCUPATION
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13
Q

PERIPHERAL VASCULAR

OLDER ADULTS - HISTORY

A

LEG EDEMA?…

CLAUDICATION?…

CAROTID STENOSIS?…

VARICOSE VEINS…

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14
Q

Peripheral Arteries Accessible to Exam are-

A 
Arteries
     Temporal artery
     Carotid artery
     Arteries in the arm 
                     Brachial
                     Ulnar
                     Radial
     Arteries in the leg
                      Femoral
                      Popliteal
                      Dorsalis pedis
                      Posterior tibial
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15
Q

Pulse Deficit-

A

is the difference between the apical and radial pulses

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16
Q

Orthostatic Hypotention change should be no more than ______mmHg from lying to standing.

A

15mmHg

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17
Q

There should not be a change greater than ______mmHg from right to left arm.

A

10mmHg

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18
Q

Structure and function Temporal artery:

A

The temporal artery can be palpated in front of the ear

ch 13 pg 267, temporal arteries may look twisted and prominent in some elderly adults

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19
Q

Structure and function Carotid artery:

A

The carotid artery is palpated in the groove between the sternomastoid muscle and the trachea.

The corotid artery is a central artery (it is close to the heart) so its timing closely coincides with ventricular systole. p463

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20
Q

Structure and function of the Arteries in the arm-

A

Brachial artery- is the major artery that supplies the arm. It runs in the bicep-triceps furrow of the upper arm and surfaces at the antecubital fossa in the elbow medial to the bicepts tendon.

Immediately below the elbow, the brachial artery bifurcates into the radial and ulnar arteries. These run distally and form the two arches that supply the hand.

Ulnar artery is difficult to feel.

Radial artery pulse lies just medial to the radius on the wrist.

pg 500

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21
Q

Artery blood flow from neck to hands:

A

common carotid artery -> Subclavian artery -> Axillary artery -> Brachial artery -> (brachial pulse site) -> brachial splits into radial and ulnar arteries at the pulse site and travels to the hands.

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22
Q

Structure and function of the arteries in the leg:

A

The major artery in the leg is the femoral artery which passes under the inguinal ligament. It travels down the thigh, and when it gets to the lower thigh it courses posteriorly. When this happens it becomes the popliteal artery.

Below the knee, the popliteal artery divides into the anterior and posterior tibial arteries.

The anterior tibial artery runs down the front of the shin onto the dorsum of the foot where it then becomes the dorsal pedis.

The posterior tibial artery travels down the medial malleous (back of the leg, calf area) and in the foot forms the plantar arteries.

23
Q

Function of arteries:

A

The function of the arteries is to supply oxygen and essiential nutrients to the tissues.

24
Q

Ischemia-

A

is a deficient suppy of oxygenated arterial blood to a tissue caused by obstruction of a blood vessel.

A complete blockage leads to tissue death of the distal tissue.

A partial blockage creates an insufficient supply and the ischemia may be apparent only at exercise when the oxgen needs increase.

25
Q

Allen test

A

determining the patency of the radial and ulnar arteries by compressing one artery site and observing the return of skin color as evidence of patency of the other artery.
173 lab manual

26
Q

Aneurysm

A

defect or sac formed by dilation in artery wall due to atherosclerosis, trauma, or congenital defect.
173 lab manual

27
Q

Arrhythmia

A

variation from the hearts normal rhythm

173 lab manual

28
Q

Arteriosclerosis

A

Thickening and loss of elasticity of the arterial walls

173 lab manual

29
Q

Atherosclerosis

A

plaques of fatty deposits formed in the inner layer of the arteries
173 lab manual

30
Q

Diastole-

A

The hearts filling phase

174 lab manual

31
Q

Systole-

A

The hearts pumping phase

174 lab manual

32
Q

Varicose Vein

A

dilated tortuous veins with imcompetent valves

174 lab manual

33
Q

Pulse-

A

Pressue wave created by each heartbeat, palpable at body sites where an artery lies close to the skin and over a bone
174 lab manual

34
Q

Lymph nodes

A

small oval clumps of lymphatic tissue located at grouped intravals along lymphatic vessels.
174 lab manual

35
Q

Lymphedema

A

swelling of an extremity due to obstructed lymph channel, nonpitting.
174 lab manual

36
Q

Bruit

A

blowing, swooshing sound heard through a stethoscope when an artery is partially occluded.
174 lab manual

37
Q

Cyanosis

A

dusky blue mottling of the skin and mucous membranes due to excessive amount of reduced hemoglobin in the blood.
174 lab manual

38
Q

A function of the venous system is:

a. To hold more blood when blood volume increases.
b. to concerve fluid and plasma proteins that leak out of the capillaries.
c. to form a major part of the immune system than defends the body against disease
d. to absorb lipids from the intestinal tract

A

a. To hold more blood when blood volume increases

lab manual pg178

39
Q

The organs that aid the lymphatic system are

a. liver, lymph nodes, and stomach
b. pancreas, small intestine, and thymus
c. spleen, tonsils, and thymus
d. pancreas, spleen, and tonsils

A

c. spleen, tonsils, and thymus

lab manual pg178

40
Q

Mrs. T has come for a prenatal visit. She complains of dependent edema, varicosities in the legs, and hemorrhoids. The best response is:

A. if these problems persist we will perform an amniocentesis

B. If these symptoms persist we will discuss having you hospitalized

C. the symptoms are caused by a pressure of the growing uterus on the veins. They are the usual conditions of pregnancy.

D. at this time you symptoms are a minor inconvienenve and you should learn to accept them

A

C. the symptoms are caused by a pressure of the growing uterus on the veins. They are the usual conditions of pregnancy.

lab manual pg178

41
Q

A pulse with an amplitude of 3+ would be considered:

A. irregular, with 3 premature beats
B. increased, full
C. Normal
D. Weak

A

B. increased, full

lab manual pg178

42
Q

Inspection of a persons right hand reveals a red swollen area. To further assess for infection, you would palpate the:

A. cervical node
B. Axillary node
C. Epitrochlear node
D. inguinal node

A

C. Epitrochlear node

lab manual pg178

43
Q

To screen for deep vein thrombosis you would:

A. measure the circumfrence of the ankle
B. check the temperaure with the palm of your hand
C. Compress the dorsalis pedis pulse looking for blood return
D. measure the widest point with a tape measure

A

D. measure the widest point with a tape measure

lab manual pg178

44
Q

During the examination of the lower extremities, you are unable to palpate the popliteal pulse. You should:

A. proceed with the examination, it is often impossible to palpate this pulse

B. refer the patient to a vasular surgeon for further examination

C. schedule the patient for a venogram

D. Schedule the patient for an arteriogram

A

A. proceed with the examination, it is often impossible to palpate this pulse

lab manual pg178

45
Q

While reviwing a medical record, a notation of 4+ edema of the right leg is noted. The best description of this type of edema is:

A. Mild pitting, no perceptible swelling of the leg

B. Moderate pitting, indentation subsides rapidly

C. Deep pitting, leg looks swollen

D. Very deep pitting, indentation lasts a long time.

A

D. Very deep pitting, indentation lasts a long time.

lab manual pg178

46
Q

Atrophic skin changes that occur with peripheral arterial insufficiency include:

A

thin, shiny skin with loss of hair.

47
Q

Brawny edema is

A

non pitting

48
Q

Raynauds Phenomenon occurs

A

in hands and feet as a result of exposure to cold, vibration, or stress

49
Q

Unilateral Edema suspect

A

DVT

is Local

50
Q

Bilateral Edema suspect

A

right sided heart failure
chronic liver disease

is central

51
Q

Peyers patches

A

Lymphoid tissue in the intestines (belly area) pg504

52
Q

Chronic venous symptoms

A

chronic pain that increases at the end of the day from sitting or standing to long at work. Hurts all the time

53
Q

Chronic arterial symptoms

A

deep calf muscle pain, hurts only when exercising, rest relieves it.

54
Q

Some Lymph System Abnormals

A

Acute lymphangitis- Lymphangitis is an inflammation or an infection of the lymphatic channels that occurs as a result of infection at a site distal to the channel. The most common cause of lymphangitis in humans is Streptococcus pyogenes (Group A strep),

Lymphomas- supraclavicular nodes enlarge with hodgkins disease

Health Assessment Rain (9 decks)

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