Chapter 21-Peripheral Vascular System & Lymphatic System

Question 1

Arteries

Answer 1

-temporal artery
-carotid artery
-arteries in the arm: brachial, ulnar, radial
-arteries in the leg: femoral, popliteal, dorsals pedis, posterior tibial

Question 2

Veins

Answer 2

-low pressure; don’t feel pulse
-jugular veins
-veins in the arm
-veins in the leg
-deep veins: femoral; popliteal
-superficial veins: great saphenous; small saphenous
-perforators (connecting veins)

Question 3

Lymphatics

Answer 3

-fluid maintenance; immune system
-right lymphatic duct
-thoracic duct
-functions of the lymphatic system
-lymph nodes
-related organs to lymphatic system

Question 4

subjective data: health history questions

Answer 4

-leg pain or cramps (claudication; esp. while walking)
-skin changes on arm or legs
-swelling
-lymph node enlargement
-medications

Question 5

objective data-the physical exam

Answer 5

-preparation
-equipment needed (occasionally)
-paper tape measure (measure circumference)
-tourniquet or blood pressure cuff
-stethoscope
-dopple ultrasonic stethoscope

Question 6

objective data: arms

Answer 6

-inspect & palpate
-skin (color)
-profile sign
-capillary refill
-symmetry
-radial pulse
-ulnar pulse
-brachial pulse
-epitrochlear lymph node
-modified Allen test (check circulation)

Question 7

objective data: leg

Answer 7

-inspect & palpate
-skin and hair
-symmetry
-temperature
-calf muscle
-inguinal lymph nodes
-femoral pulse
-popliteal pulse
-posterior tibial pulse
-dorsalis pedis pulse
-pretibial edema
-leg veins
-assess while patient stands
-manual compression test

Question 8

objective data: other test

Answer 8

additional techniques
-color changes
-doppler ultrasonic stethoscope
-ankle-brachial index (ABI) (assessing blood flow)
-calculate ABI by dividing the blood pressure in an artery of the ankle by the blood pressure in an artery of the arm (ratio should be around 1); bp in ankle vs. brachial

Question 9

abnormal findings: variations in arterial pulse

Answer 9

-weak, thready pulse: 1+
-full, bounding pulse: 3+
-water-hammer (corrigan’s) pulse: 3+ collapses suddenly
-pulsus bigeminus
-pulsus alternans
-pulsus paradoxus (bp drops with deep inspiration; pulse/systolic pressure drops by 10 mmHg) (won’t see taking manual)
-pulsus bisferiens

Question 10

abnormal findings: peripheral vascular disease

Answer 10

arms
-raynaud’s syndrome (white; due to vasoconstriction)
-lymphedema (enlargement of extremity)

legs
-arteriosclerosis-ischemic ulcer (dry, gangrenous)
-venous (stasis) ulcer (wet)
-superficial varicose veins
-deep vein thrombophlebitis

occlusions
aneurysms (out pouching of layers of vessel wall; in arterial system)

Question 11

summary checklist

Answer 11

-inspect arms for color, size, or any lesions
-palpate pulses: radial & brachial
-check epitrochlear nodes
-inspect legs for color, size, any lesions, or trophic skin changes
-palpate temperature of feet and legs
-palpate inguinal nodes
-palpate pulses: femoral, popliteal, posterior tibial, and dorsalis pedis
-touch side of foot with microfilament