CV/PV Assessment Flashcards
Risk Factors of Cardiovascular
- Family history
- Increased age
- Elevated cholesterol
- High blood pressure
- High blood sugar/diabetes
- Ethnicity
- Obesity
- Cigarette smoking
- Sedentary lifestyle
- High sodium
Risk Factors of Coronary Artery Disease (CAD)
- Menopause
- Family history
- Increased age
- Ethnicity
Signs of Cardiovascular Problem
- Pain (chest, jaw, neck, left arm)
- Shortness of breath
- Dyspnea
- Orthopnea
- Paroxysmal nocturnal dyspnea
- Cough
- Diaphoresis
- Lightheaded
- Leg pain (calf pain)
- Ulcers on lower extremities
- Nausea & vomiting
- Edema
- Chest pressure
- Nocturia
- Racing heart
- Indigestion
- Heart burn
- Palpitations
- Dysrhythmia
- Fatigue
- Fainting (syncope)
Orthopnea
Inability to breath while lying down
Paroxysmal Nocturnal Dyspnea
- Waking in night
- Due to inability to breath
Diaphoresis
- Sweating
- Lack of blood flow
Light-headedness
- Lack of blood flow to brain
Cardiovascular History
- Demographic (SDoH)
- OLDCARTSS
- Current/recent symptom
- Associated symptoms
- Respiratory concerns
- Risk factors
- Family history
- Past medical history, medications, allergies
- Social history
- Functional ability (IADL & ADL)
Physical Assessment Steps
- Vital signs
- Compare results
- Context of patient
- Relation between vital signs
- Urgent action/monitoring
Inspection
- General survey
- Skin colour
- Respirations
- Speech pattern
- Diaphoresis
- Thorax size & shape
- Fingers (nailbeds)
- Landmarks
- Abnormal pulsations
Pulse
- Rate
- Rhythm
- Strength
- Symmetry
Pulse Strength
- Absent
- Weak
- Thready
- Normal
- Bounding
Carotid Pulse Assessment
- Carotid Artery
- Located in neck
- Should be quiet/soft
Unexpected Heart Sounds
- Murmurs (swooshing/blowing sound)
- Any sounds outside of LUB/DUB
Heart Murmurs
- swooshing/blowing sound
- result of cardiac abnormalities/turbulent blood flow
S3 & S4 Sounds
- Additional sounds to LUB/DUB
- Heart murmur sounds
- Incomplete closure of valve
Cardiac Abnormalities
- Increased blood velocity
- Structural valve defects
- Valve malfunction
- Abnormal chamber openings (septal defects)
Landmarking Areas of Heart Sounds
- S2 pulmonic area
- S1 mitral area
Listening Areas of Heart Sounds
- Aortic
- Pulmonic
- Erb’s point
- Tricuspid
- Mitral
S1 Sound
- Loudest at apex (bottom)
- Av valve closing
- Beginning of systole
S2 Sound
- Loudest at base (top)
- Aortic valve closing
- Beginning of diastole
Aging Effects on Heart
- Increase in collagen
- Decrease in elastin
- Decreased contractability & HR
- Thicker & stiffer valves (lipid accumulation)
- Decrease in pacemaker cells of SA node
- Bradycardia & heart block
- Decrease sympathetic nervous system control
- Thickening of arterial blood vessels
- Increase blood pressure
Neurovascular Assessment Reasons
- Trauma/limb injury
- Cast/protective device
- Limb wound
- Varicose veins
- Conditions causing poor circulation (heart failure)
- Discomfort/pain in limb
- Circulation & nerve conduction
Poor Neurovascular Circulation Risk Factors
- Smoking
- Arterial/venous insufficiency
- Extreme edema (compartment syndrome)
- Hypothermia
Arterial Insufficiency
- Disease artery
- Oxygenated blood difficulty getting to tissue
Arterial Insufficiency Symptoms
- Pain with exertion
- Intermittent claudication
- Pain with elevation, rubor with dependency
Arterial Insufficiency Relief
- Short rest
Venous Insufficiency
- Elevation
Insufficient Arterial Findings
- Pale
- Cool
- Decreased/absent pulse
- Mild edema
- Think/shiny skin
- Thickened nails
- Decreased hair growth
Arterial Insufficiency Ulcers
- Deep
- Distal location (toes)
- Defined edges
- Dry/pale wound bed
- Necrotic/eschar tissue
Insufficient Venous Findings
- Dark discoloration around ankle
- No temperature change
- Palpable pulse
- Present - serve edema
- Venous stasis
Venous Insufficiency Ulcers
- Shallow
- Distal
- Irregular edges
- Moisture in wound
- Granulation tissue
- Slough
Peripheral Vascular Assessment Components
- Movement
- Temperature
- Sensation
- Blanching
- Colour
- Edema
- Pulse
Edema Grading Scale
- 0, no pitting
- 1, mild pitting & 2mm depression
- 2, moderate pitting & 4mm depression
- 3, moderately severe pitting & 6mm depression
- 4, severe pitting & 8mm depression
Veninous Insufficiency
- Leaky valves in lower limbs
- Blood pools in lower legs
- Vessels fail to hold shape
- VEINS
Clubbing
- Rounded overgrowth
- Chronic hypoxia (lack of adequate oxygen)
Palpation of Neuro Component
- Sensation
- Motion
- Look for limiting factors (pain/inability)
Sensation Peroneal Nerve
- Touch web space
- Between great & second toe
Motion Peroneal Nerve
- Dorsiflex & extend toes
- At metatarsal joint
Sensation Tibial Nerve
- Touch medial & lateral surfaces
- Sole of foot
Motion Tibial Nerve
- Plantar flex
- Ankle & toes
Sensation Radial Nerve
- Touch web space
- Between thumb & index finger
Motion Radial Nerve
- Hyperextend thumb, wrist
- Hyperextend 4 fingers at metacarpal joints
Sensation Ulnar Nerve
- Touch distal small pad
- Small finger
Motion Ulnar Nerve
- Abduct all fingers
Sensation Median Nerve
- Touch distal surface
- Index finger
Motion Median Nerve
- Oppose thumb & small finger
- Note wrist flex
Median Motor Supply
- Abductor pollicis brevis
- Flexor pollicis brevis
- Opponens pollicis
- Lumbricals index & middle finger
Ulnar Motor Supply
- Flexor capri ulnaris
- Flexors of distal phalanx (ring & little fingers)
- Intrinsic hand muscles
Radial Muscle Supply
- Triceps
- Brachioradialis
- Supinator
- All extensors of wrist, thumb, fingers
Acute Neurovacular Assessment
- Arterial occlusion
- Deep venous thrombosis (DVT)
- Compartment syndrome
- Excruciating pain
Compartment Syndrome
- EMERGENCY
- Crushing injury
- Fasciotomy
Circulation Assessment Components
- Pain
- Pulse
- Pallor
- Paralysis
- Paresthesia
