Exam 4 (Nov. 15) Flashcards
1
Q
peripheral Vascular & lymphatic system included (note for with PPT done)
A
2
Q
Peripheral Vascular System:
When we think about the head and neck, what arteries are we looking at (2)
A
temporal and carotid
3
Q
what arteries are in the arm? (3)
A
brachial
Ulnar
radial
4
Q
What arteries are in the leg? (4)
A
- femoral
- popliteal
posterior tibial
dorsalis pedis
5
Q
what are the veins in the arm? (2)
A
Superficial and deep
6
Q
What veins are in the leg (3)
A
femoral
popliteal
great/small saphenous
7
Q
Arteries:
____ pressure system that delivers _______ blood to body system
A
High; oxygenated
8
Q
Arteries:
_____, tough walls withstand ____ pressure
A
Strong; High
9
Q
Arteries:
what do they allow?
(stretching)
A
allows walls to stretch w/ systole and recoil w/ diastole
10
Q
What controls the amount of blood delivered to tissue?
A
Muscle fibers (VSM)
11
Q
A pressure wave created by the heartbeat is called what?
A
A Pulse
12
Q
The simple function of the Arteries:
A
Supply oxygen and nutrients to tissues
13
Q
What is ischemia?
A
Low supply of oxygenated blood to tissue
14
Q
Simple Function of Veins
A
Drain deoxygenated blood from tissues and return to heart
15
Q
Veins have what kind of valves?
A
one-way valves
16
Q
Venous return depends on pressure gradient caused by what? (3)
A
- breathing
- skeletal muscle contraction
- competent valves in veins
17
Q
Peripheral Vascular: Veins
What is the vessel name that can stretch and hold more blood when volume increases? This also reduces stress on the heart
A
Capacitance Vessels
18
Q
The simple function of the Lymphatic system
A
Retrieves fluid from the interstitial space and returns it to the blood stream
19
Q
Without the lymphatic system there would be what?
A
edema
20
Q
How is lymph flow propelled?
It is propelled by….
A
- propelled by contracting skeletal muscle
- Pressure change secondary to breathing
- Contraction of vessel walls
21
Q
What are lymph nodes?
(What are they, not what their function is)
A
- clumps of lymphatic tissue, bead-like at interval along vessels
22
Q
function of Cervical lymph nodes?
A
drains fluid from head and neck
23
Q
function of Axillary lymph nodes
A
Drains fluid from breast and upper arm
24
Q
Function of Epitochlear lymph nodes
A
Drains fluid from hand and lower arm
25
Function of Ingual lymph nodes
drains the fluid from the lower extremity, external genitalia, and anterior abdominal wall
26
Change in perfusion can show what types of changes or pain? (8) Just a general thing, don't study too hard
- Changes in skin: color, temperature, texture
Pain/Cramping in legs?
Aching in legs?
Contorted, bulging leg veins?
Sores/open wounds on legs?
Edema in bilateral lower extremities?
Swollen glands or lymph nodes?
Difficulty achieving or maintaining an erection?
27
what is intermittent claudication?
First symptom of what?
lower extremity skeletal muscle pain that occurs during exercise. It is relieved with rest
The first symptom of peripheral arterial disease
28
edema in bilateral lower etremities is a sign of what?
veinous insufficiency
29
edema in one leg is a sign of
Deep vein thrombus
30
swollen lymph nodes also know as what?
lymphadenopathy
31
(Peripheral and vascular) Personal Health History: What questions do we ask to the patient?
We asked about any problems in the past with peripheral circulation
- history of blood clots, cold feet, swelling, any hair loss?
32
Peripheral Vascular & Lymphatics:
For Family history, what would we ask the patient?
Family illness history of what?
Deep vein thrombus
Diabetes
Hypertension
Coronary Heart Disease
Intermittent claudication
Hyperlipidemis
33
Peripheral Vascular & Lymphatics:
For Lifestyle and Health Practices, what questions do we ask the patient when it comes to lifestyle? (8)
Smoking? Tobacco?
Exercise?
Oral or transdermal contraceptive use?
Stress?
Circulatory problems interfering with ability to
function?
Self-image
Medications
Support stockings
34
Peripheral Vascular & Lymphatics:
Health Promotion Opportunities for Patient
- Smoking
- Exercise
- Support stockings
- Foot care (TAKE CARE OF FEET)
35
What to inspect for when looking at feet?
How to take care of feet (8)
- skin changes/lesions
- look at the bottom of the feet
- exercise
- Massage
- quit smoking
- raise legs when sitting
- Wear comfortable shoes
- Practice good skin care
36
what are the 10 risk factors for PERIPHERAL ARTERIAL DISEASE (need to know for exam!!!)
Smoking
Diabetes
History of CHD
Obesity
HTN
Hyperlipidemia
Increasing age
Family history of PAD, CHD
African American descent
High levels of homocysteine (protein to build tissue)
37
The pulse is the reflection of our what?
heart rate
38
one irregularity commonly found in children and young adults (need to know on exam!!!)
Heart beat speeds up during inhale, slows during exhale
Sinus arrhythmia
39
39
what is BP?
force of blood pushing against side of its container, vessel wall
40
maximum pressure felt on artery during left ventricular contraction
Systolic pressure
41
Elastic recoil, or resting pressure that blood exerts constantly between each contraction
diastolic pressure
42
The difference between systolic and diastolic is called
the pulse pressure
43
The pressure forcing blood into tissues, averaged over cardiac cycle
Mean arterial pressure (MAP)
44
what happens to BP with age
it gradually rises through childhood and into adult years
45
What happens to female's BP after puberty
females BP is lower than males: after menopause, females is higher than males
46
With Black people, what happens with their BP
it tends to be usually higher than a white person's of the same age
Tends to be twice as high than whites
47
What goes away with rest?
Angina
48
If heart pumps more blood into blood vessels, pressure on container walls _________
increases
49
When vessels become smaller or constricted, pressure needed to push becomes ________
greater
50
What is volume of circulating blood referring to?
refers to how tightly blood is packed into arteries; increasing contents in vessels increases pressure
51
When blood vessels become stiff and rigid, pressure needed to push _______
increases
52
What 9 factors affect blood pressure
Age
Exercise
Stress
Race
Gender
Medications
Obesity
Diurnal variations
Disease process
53
When do you take orthostatic or postural vital signs?
When:
You suspect volume depletion
Person is known to have hypertension or taking
antihypertensive medications
Person reports fainting or syncope
Position changed from supine to standing, normally slight decrease (less than 10 mm Hg) in systolic pressure may occur
54
When inspecting skin of arms, what do we look for? (6)
Color
Temperature
Texture
Turgor
Lesions (venous pattern)
Edema
55
When inspecting nailbeds, what do we look for? (2)
- capillary refill
- Clubbing
56
When checking brachial, radial, and ulnar pulse? what are the 4 numbers to consider when leveling the pulse?
3+ = increased, full, bounding
2+ = Normal
1+ = weak
0 = absent
57
Objective Data: what do we inspect for when looking at the legs? (7)
Color of skin
Texture
Turgor
Lesions
Calf muscle
Leg veins
Symmetry
58
What is Homan's Sign
it is doen to assess DVT
59
What is the Edema pitting grading scale?
1+ = mild pitting, slight indentation, no noticeable swelling of leg
2+ = moderate pitting, indentation subsides rapidly
3+ = deep pitting, indentation remains short time, leg looks swollen
4+ = very deep pitting, indentation lasts long time, leg is very swollen
60
Peripheral Vascular:
Developmental considerations for Newborns/infants
Acrocyanosis (blue discoloration in hands and feet in newborn)
- Cyanosis
- Temperature in the periphery
-** Remember that the lymphatic system is established at birth**
61
Peripheral Vascular:
Developmental Considerations for Children
- is there Cyanosis/coolness in the extremities?
- Pulse force same upper/lower, normal, symmetric
- Lymphatic system established by age 6
- Palpable lymph nodes often occur
62
Peripheral Vascular:
Developmental considerations for Pregnancy
Bilateral pitting edema lower extremities end of day, third trimester
- Vasodilation
- Venous pressure increases: edema, hemorrhoids, varicosities
63
Peripheral Vascular:
Developmental considerations for Aging adult
- Dorsalis pedis and posterior tibial are difficult to locate
- Trophic changes with arterial insufficiency
- Arteriosclerosis (rigid artery walls)
64
Raunaud's phenomenon
blood flow is impaired to sites such as a few fingers are white/blue then disappears
65
lymphedema, what is it?
lack of lymph node drainage
66
Deep vein thrombus
blood clot formation in the deep vein
67
if both legs have edema, it is...
heart failure
68
If one leg has edema, it is...
What do you need to measure?
DVT, needs to measure the circumference of the calf
69
Do you smoke? How old are you?
This can assess the risk of what?
Can assess for risk of cardiovascular disease
70
Central Venous Pressure can be the reflection of...
body's fluid volume
71
what is angina?
A type of temporary chest pain, pressure or discomfort
72
contorted or bulging leg veins is also known as what?
Varicose veins
73
when assessing veins for varicosity, have patient...
stand up
74
75
Function of the pericardium?
protects heart, doubled walled sac
76
What is myocardium?
muscular wall
77
what is endocardium?
endothelial tissue lines inner surface of heart chambers and valves
78
what are the right and left atrioventricular valves called?
right: tricuspid
left: mitral
79
What is the right and left semilunar valves called?
right: pulmonic
left: aortic
80
Systole description
Ventricles do what
does it pump or fill?
AV valves closed or open
S1 or S2
Are aortic/pulmonic valves open or closed?
1/3 cardiac cycle is systole
- ventricles contract
- pumps blood
- AV valve closed
- S1
- Aortic/Pulmonic valve open
81
Diastole description
how long in the cardiac cycle is Diastole?
- fills or pumps blood?
AV valves open or closed
- Aortic/pulmonic valves open or closed
2/3 Diastole
- ventricles relax
- Fills with blood
- AV valves open
- Aortic/Pulmonic valves closed
- S2
O2 delivery
82
S1 is described as what?
the closure of AV valves, signals the beginning of systole
- Mitral and tricuspid fuse as one sound and heard loudest at the apex (bottom)
83
S2 is described as what?
the closure of semilunar valves, signals the end of systole
- Aortic and pulmonic closure heard loudest at the base (top)
84
S3 is described as what?
abnormal heart sounds
- ventricular filling creates vibrations, occurs after S2, stiff ventricles
85
S4 is described as what?
Abnormal heart sound
- Occurs at the end of diastole, before S1
86
What is the name for turbulent blood flow?
murmurs
87
murmurs happen in what situations of the body?
Increase blood flow velocity: exercise
- Viscosity of blood decreases: anemia
- Structural defects in valves, narrowing, incompetence or unusual opening
88
palpitations are
irregular beating of the heart
89
orthopnea heart failure domino chain
heart failure leads to kidney malfunction. This leads to kidneys not being able to perfuse and not do their job and leads to excess fluid = fluid volume overload
90
nocturia
excessive urination at night
easier for kidney to filter when laying down
91
pyrosis
heartburn
92
heart attack or MI have similar symptoms to what?
heartburn (pyrosis)
93
cardiovascular chest pain is what type of pain?
vise-like
94
pulmonary chest painis what type of pain?
dull, aching pain
95
as heart becomes weaker, its heart rate goes up or down?
up to accommodate for the body
96
paroxysmal nocturnal dyspnea is a result of what
heart failure
97
dizziness can result from
lack of blood flow to the brain
98
congenital heart defect is what
something your'e born with
99
what is an acquired disorder
something that was developed after birth
100
rheumatic fever can lead to damage of the
heart tissues
101
dyslipidemia
increased levels of bad cholesterol or LDL
102
increased levels of LDL correlate to developing what (2)
atherosclerosis
coronary heart disease
103
family history question for inc. risk of developing heart disease
- hypertension
- myocardial infarction
- coronary heart disease
- hyperlipidemia
- diabetes mellitus
104
what does smoking do
damages endothelium lining, including heart
Less O2 in hemoglobin
- damage blood vessels = hypertension
105
When auscultating neck, what part of stethoscope do we use?
The diaphragm
106
Jugular Veins what parts do we inspect? (3)
and how do we inspect?
Internal: See pulsation in area suprasternal notch
External: Supine, with HOB 30-45 degrees
distended jugular veins: RED FLAG, volume overload with HF
107
What is apical impulse
How is the pulse created?
pulsation is created as L ventricle rotates against the chest wall during systole
108
What is a heave/lift?
what is the D/T?
forceful thrust of ventricle
d/t ventricular hypertrophy
109
when measuring precordium area, how do we measure
with bone from fingers
110
where is aortic valve located?
right 2nd ICS
111
where is Pulmonic valve located?
Left 2nd ICS
112
where is ERB's point located
Left 3rd ICS where S2 is best auscultated
113
Where is tricuspid valve located
left lower sternal border 4th ICS
114
Where is mitral valve located?
left 5th ICS at left MCL
115
Heart & Neck Vessels:
questions for children?
Growth? good or bad?
Are activity levels normal?
- Are headache or nosebleeds present? (BP issue)
history of upper resp. infections?
116
how much does blood volume increase in a pregnant individual?
by 30-40%
117
for pregnant individual, how much does pulse rate inc.
10-15 beats
118
for pregnant individuals, what happens to BP
it lowers
119
what to monitor on pregnant patient
- if BP goes higher
- any faintness/dizziness (BP may be dropping to quickly)
120
What do we see in vital signs of older adults?
Systole in BP increases
- orthostatic hypotension
121
Systolic murmurs, Diminished pedal pulses, decreased maximal heart rate. This all relates to what age group?
Older adult patient
122
The BP of an older adult patients admitted with pneumonia is 160/70 mm Hg. What is the age-related change contributed to the finding?
Loss of elasticity in arterial vessels
123
difference between angina and MI
angina symptoms increase with increased activity levels and decrease with rest
124
A murmur is an indication of what?
turbulent blood flow across a heart valve
125
a deficit in heart conductivity that impair normal contractility is an indication of what?
Aarythmia or dysrythmia
126
