Chapter 21 Flashcards
Allen Test
Test that determines the patency of the radial and ulnar arteries by compressing one artery site and observing return of skin color as evidence of patency of the other artery
Aneurysm
Defect or sac formed by dilation in artery wall due to atherosclerosis, trauma, or congenital defect
Arrhythmia
Variation from the heart’s regular rhythm
Arteriosclerosis
Thickening and loss of elasticity of the arterial walls
Athrosclerosis
Plaques of fatty deposits formed in the inner layer (intima) of the arteries
Bradycardia
Slow heart rate, less than 50 beats per minutes in the adult
Bruit
Blowing, swooshing sound heard through a stethoscope when an artery is partially occluded
Cyanosis
Dusky blue mottling of the skin and mucous membranes due to excessive amount of reduced hemoglobin in the blood
Diastole
The heart’s filling phase
Ischemia
Deficiency of arterial blood to body part due to constriction or obstruction of a blood vessel
Lymph nodes
Small oval clumps of lymphatic tissue located at grouped intervals along lymphatic vessels
Lymphedema
Swelling of extremities due to obstructed lymph channel, nonpitting
Pitting edema
Indentation left after examiner depresses the skin over swollen edematous tissue
Profile sign
Viewing the finger from the side to detect early clubbing
Pulse
Pressure wave created by each heartbeat, palpable at body sites where the artery lies close to the skin and over a bone
Pulsus alternans
Regular rhythm but force of pulse varies with alternating beats of large and small amplitude
Pulsus bigeminus
Irregular rhythm; every other beat is premature; premature beats have weakened amplitude
Pulsus paradoxus
Beats have weaker amplitude with respiratory inspiration, stronger with expiration
Systole
The hearts pumping phase
Tachycardia
Rapid heart rate, more than 95 beats per minute in an adult
Thrombophlemitis
Inflammation of the vein associated with thrombus formation
Ulcer
Open skin lesion extending into dermis, with sloughing of necrotic inflammatory tissue
Varicose veins
Dilated tortuous veins with incompetent valves
Three mechanisms that help return blood to the heart (venous flow)
Valves - ensure unidirectional flow
Muscle contractions - milk blood proximally
Pressure gradient - negative pressure vacuum created on inspiration
Capacitance vessels
The ability of the veins to stretch.
Helps when blood volume increases to reduce preload on the heart
Risk factors for venous stasis
Hypercoaguability No body movement (prolonged sitting, standing, bed rest) Endothelial injury (smoking, hypertension)
Functions of the lymphatic system
Conserve fluid that leak out of the capillaries
Major part of the immune system
Absorb lipids from small intestine
Organs related to the lymphatic system
Spleen
Tonsils
Thymus
Characteristics of an arterial ulcer
Pallor Defined edges No bleeding Dry On bony prominences
Characteristics of a venous ulcer
Bleeding Beefy red Uneven edges Weepy Hemosiderin staining Granulated
If a patient has 3+ pitting edema what characteristics would they present?
Deep pitting, indentation remains for a short time
Raynaud Phenomenon
Tricolor (white, blue, red) change of the hands/feet in response to cold, stress, or vibration
A function of the venous system includes:
Holding more blood when blood volume increases
Mrs, T has come in for a prenatal visit. She reports dependent edema, varicosities in the leg, and hemorrhoids. Normal/Abnormal
Normal
The symptoms are caused by the pressure of the growing uterus on the veins
A patient’s pulse is 3+ this means the pulse is ___ ___
Full and bounding
Inspection of the right hand reveals it is red and swollen, what is the next step?
Palpate the epitrochlear node
To screen of a DVT you would:
Measure the widest point of the calf with a tape measure
After checking for elevation pallor, you ask the patient to swing their legs off the table. What are you looking for?
Color to return within 10 sec Dependent rubor (bad sign)
Sking changes associated with arterial insufficiency
Thin, shiny skin with loss of hair
Intermittent claudication
Muscular pain brought on by exercise
Peripheral Artery disease (PAD) caused by:
Atherosclerosis (most common)
Embolism
Hypercoagulable states
Arterial dissection
Deep veins on the legs
Femoral
Popliteal
Superficial veins in the legs
Great saphenous
Small saphenous
What is also known as the peripheral heart?
The calf pump
Venous pooling occurs most commonly in what 2 kinds of people?
Obese
Women following multiple pregnancies
The right lymphatic duct drains what parts of the body?
The right side of the head, neck, right arm, right thorax, right lung, right side of the heart, and upper section of the liver
The thoracic duct drain what parts of the body?
Left side of the head, left arm, both legs (All other part that the right lymphatic duct does not drain)
Cervical lymph nodes drain:
The head and neck
Axillary lymph nodes drain:
Breast and upper arm
Epitrochlear lymph nodes drain:
Antecubital fossa
The hand
Forearm
Inguinal lymph nodes drain:
Groin area
Most of the lower extremities
External genitalia
Anterior abdominal wall
What symptoms may present with excessive lymphoid response in a child?
Abdominal pain with unrelated problems (inflammation of mesenteric lymph nodes of abdominal wall)
Upper respiratory infection
Claudication distance
The number of blocks walked or stairs climbed to produce pain
Night leg pain may be in indicator of ___ in the aging adult
PAD
What are the 2 main risk factors for PVD?
Diabetes
Smoking
What kind of clothing should a person avoid with peripheral arterial disease?
Tight or compression clothing
It further impedes blood flow
What kind of medication may cause hypercoaguable states?
Oral contraceptives
Hormone replacements
Normal capillary refill time
Less than 2 seconds
What pulse grade would occur with shock and PAD?
1+ weak and thready
What is the normal blood refill time for the Allen test?
Less than 7 seconds
Bilateral edema occurs with:
Systemic illnesses
Unilateral edema occurs with:
DVT (usually)
If the femoral pulse is weak or diminished what should you do next?
Auscultate for bruit
Bilateral dependent pitting edema occurs with:
Heart failure
Diabetes neuropathy
Hepatic cirrhosis
What should you do next if you find bilateral pitting edema?
Examine the neck veins
Varicosities usually occur where?
The legs (usually the saphenous veins)
What occurs with arterial deficit extremities?
Motor and sensory loss
An ABI of 0.91-1 is:
Borderline cardiovascular risk
An ABI less than 0.90 indicates ___
PAD
ABI of 0.40 - 0.30 is:
Severe PAD
What kind of people will have a falsely high ABI?
Diabetes mellitus and Chronic kidney disease
May have calcified arteries that give a false high
That scale do you use to assess the risk of a patient having a DVT?
The Wells Score
Patent ductus arteriosus
Congenital defect - opening between aorta and pulmonary artery.
Causes full and bounding pulses
Diminished or absent femoral pulses in a child could be an indicator of:
Coarctation of Aorta (congenital defect)
A pregnant patient presenting with generalized edema and hypertension Normal/Abnormal
Abnormal Suggests Preeclampsia (dangerous condition)
Pulsus paradoxus is common with what other symptoms?
Cardiac Tamponade
Acute Asthma
