Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Health Assessment > Exam 4 - Peripheral Vascular System > Flashcards

Exam 4 - Peripheral Vascular System Flashcards

1
Q

What is the purpose of the vascular system?

A

Transport fluid such as blood or lymph
Delivers oxygen and nutrients
Eliminates carbon dioxide and waste products

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Function of the arteries

A

Pump O2 rich blood to all body tissues

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is a pressure wave?

A

Pulse.
Created by each heartbeat
Which makes the arteries expand and then recoil
The recoil propels blood through, like a wave

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Accessible pulse locations:

A 
Temporal
Carotid
Brachial
Femoral
Popliteal
Dorsal is pedis
Posterior tibial
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Major artery to the leg

A

Femoral artery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Artery behind knee

A

Popliteal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Artery on dorsum of foot (spelling)

A

Dorsalis pedis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Artery behind medial malleolus and forms plantar arteries in the foot (spelling)

A

Posterior tibial

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Function of veins

A

Absorb CO2 and waste products from periphery and carry them back to the heart

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is ischemia?

What is it caused by?

A

Deficient blood supply of oxygenated arterial blood to a tissue.
Caused by obstruction of blood vessel

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What does a complete arterial blockage cause?

A

Death of distal tissue

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What does a partial arterial blockage cause? And when does this become apparent?

A

Insufficient blood supply, and the ischemia may be apparent only at exercise when oxygen needs increase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Which arteries are affected with peripheral artery disease (PAD)?

A

Affects no coronary arteries and usually refers to arteries supplying the limbs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What usually causes PAD?

A

Atherosclerosis

Sometimes an embolism, hypercoagulable states, or arterial dissection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Veins accessible to examination

A

Jugular veins
Veins in the arm
Veins in the legs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is intermittent claudication?

A

Cramping/pain in legs that comes and goes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What should you ask your patient about intermittent claudication?

A

“Does it get worse with walking and better after sitting (for 2 mins)?”

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is intermittent claudication a symptom of?

A

PAD (peripheral arterial disease)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is claudication distance?

A

The distance pt can walk before having pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Examples of skin changes we look for on arms or legs

A

Arteries not good at pumping to peripheries = cool, pale, cyanotic skin

Varicose veins: during pregnancy, obesity, or due to genetics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Main thing to note if pt has swelling

A

Unilateral or bilateral?

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What can unilateral swelling be due to?

A

Injury

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What can bilateral swelling be due to?

A

Cardiac related
Lymphedema
Blood clot
Infection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Which medications are we most concerned with regarding the peripheral vascular system?

A

Hormone replacement therapy
Birth control pills
(Can cause blood clots)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Function of the lymphatic system:

A

1- Conserve fluid and plasma proteins that leak out of the capillaries
2- Form a major part of the immune system that defends the body against disease
3- Absorb lipids from the small intestine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What can lymph node enlargement tell us?

A

If swollen, body may be fighting something above it (inguinal would mean something is going on with legs)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

When should you examine pt’s arms and what position should they be in?

A

With vital signs while person is sitting

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What position should pt be in while examining legs?

A

Examine while pt is still supine

Then stand person up to evaluate leg veins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

What should the room temperature be during physical examination and why?

A

22C or 71F and free of drafts

To prevent vasodilation or vasoconstriction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What do we look at while inspecting skin on extremities?

A

Color

Capillary refill

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Normal capillary refill

A

< 1-2 seconds

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Abnormal capillary refill

A

> 2 seconds

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

What does capillary refill tell us?

A

An index of peripheral perfusion and cardiac output

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

What is profile sign?

A

Viewing the finger from the side to detect clubbing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Measurement of a normal nail bed

A

160 degrees

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

If a patient has clubbing, what could it mean?

A

Congenital cyanotic heart disease
Lung cancer
Pulmonary diseases (chronic lung inflammation)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

What should you do if pt’s capillary refill is greater than 2 seconds?

A

If pt has 2+ pulse, don’t panic, just need to investigate further

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

What do we do during palpation?

A

Palpate pulses
Note rhythm
Elasticity of vessel wall
Check for equal force

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

Upper extremity pulses to palpate

A

Brachial
Radial
Ulnar

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

Which upper pulse do we use to note the rate of pulse?

A

Radial

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

What should you do if you can’t find ulnar pulse?

A

Hard to find, so test capillary refill. If that’s ok, have someone else come try to find pulse

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

How to grade force on a 3 point scale

A

3+ increased, full, bounding
2+ normal
1+ weak
0 absent

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

What could cause a 3+ pulse force?

A

Hyperthyroidism
Anxiety
Just finished exercise

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

When would a 1+ pulse force be considered normal?

A

Elderly

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

Go to pulse to measure on babies

A

Brachial

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

Test used for checking collateral blood flow

A

Modified Allen test

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

What is the modified Allen test used for?

A

ABG (arterial blood gas) collection

Evaluate the adequacy of collateral circulation before cannulating the radial artery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

Steps to perform the modified Allen test

A

1) Firmly occlude both the ulnar and radial arteries of one hand while the person makes a fist several times (this causes the hand to blanch)
2) Ask the person to open the hand without hyperextending it, then release pressure on the ulnar artery while maintaining pressure on the radial artery (adequate circulation is suggested by a palmar blush)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

What is a palmar blush?

A

Return to the normal color of the hand in less than 7 seconds

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

What do we look at for inspection of lower extremities?

A 
Skin
Hair distribution
Venous pattern
Size (any swelling or atrophy)
Skin discoloration, ulcers, or gangrene
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

Why is it important to look at hair on lower extremities?

A

Need good blood flow for hair so if it’s sparse or missing, it means there is a problem with an artery

52
Q

What do we do while palpating lower extremities?

A

Palpate pulses
Note rhythm
Elasticity of vessel wall
and Equal force

53
Q

Which arteries do we palpate during lower extremity palpation?

A

Femoral
Popliteal
Posterior tibial
Dorsalis pedis

54
Q

How should we palpate the popliteal artery?

A

Pt sitting, cup behind knee

May be difficult to feel

55
Q

When should you use a Doppler?

A

If you can’t find a pulse that should be easily felt

56
Q

Where is pretibial edema found?

A

Over tibia or medial malleolus

57
Q

How should you check for pretibial edema?

A

Firmly depress skin over tibia or medial malleolus for 5 seconds and release

58
Q

Normal vs abnormal results of pretibial edema?

A

Normal: finger leaves no indentation
Abnormal: Pitting edema

Pitting may be normal if person has been standing all day or is pregnant

59
Q

1+ edema

A

Mild pitting, slight indentation, no perceptible swelling of leg

60
Q

2+ edema

A

Moderate pitting, indentation subsides rapidly

61
Q

3+ edema

A

Deep pitting, indentation remains for short time, leg looks swollen

62
Q

4+ edema

A

Very deep pitting, indentation lasts a long time, leg very swollen

63
Q

What do you assess when a person is standing to assess venous system?

A

Note any visible, dilated, and tortuous veins (look like a rope)

64
Q

What can varicose veins cause patient to feel?

A

Pain
Swelling
Fatigue
Cramping

65
Q

What happens to arteries with arterial insufficiency?

A

Thickening and loss of elasticity of arterial walls

66
Q

What does venous insufficiency cause?

A

Chronic incompetent valves in deep veins or clot

Risk of infection

67
Q

Skin color with arterial insufficiency

A

Pale
Cyanotic
Mottled

68
Q

Skin color with venous insufficiency

A

May be reddish-blue

69
Q

Skin temperature with arterial insufficiency

A

Cool to cold

70
Q

Skin temperature with venous insuffiency

A

Warm

71
Q

Skin characteristics with arterial insufficiency

A

Thin, shiny skin
Dependent rubor
Elevation pallor of foot

72
Q

Skin characteristics with venous insufficiency

A 
Firm
Brawny
Brownish pigmentation in area between medial and lateral malleolus
Skin thickened and tough
Cyanosis when dependent
73
Q

Nails with arterial insuffiency

A

Thickened and ridged

74
Q

Nails with venous insufficiency

A

Not thickened

75
Q

Distribution of hair with arterial insufficiency

A

Loss of hair over toes and dorsum of foot

76
Q

Distribution of hair with venous insufficiency

A

Present

77
Q

Edema with arterial insufficiency

A

None or minimal

78
Q

Edema with venous insufficiency

A

Moderate to severe
Pitting
Ankle, foot, lower leg

79
Q

Pulses with arterial insufficiency

A

Decreased or absent

80
Q

Pulses with venous insufficiency

A

Present but may be difficult to palpate through edema

81
Q

Type of pain with arterial insufficiency

A

Intermittent claudication (relieved by rest)

82
Q

Type of pain with venous insufficiency

A

Aching
Cramping
Feeling of fullness
Relieved by elevation

83
Q

Ulcers with arterial insufficiency

A

Between toes or tips of toes
Heels
Lateral malleolus

Well-defined edges
Deep
Circular ulcer base-black or gangrene
Non-bleeding

84
Q

Ulcers with venous insufficiency

A

Medial malleolus
Lower leg

Uneven edges
Superficial
Ulcer base- granulation tissue - beefy red to yellow
Bleeding
May or may not be painful
85
Q

What is raynaud phenomenon?

A

Episodes of abrupt, progressive tricolor change of the fingers in response to cold

86
Q

What does Raynaud phenomenon look like?

A

1) White (pallor)
2) Blue (cyanosis)
3) Red (rubor)

87
Q

What does Raynaud phenomenon feel like?

A

Pallor or cyanosis stage: cold, numbness, pain

Rubor stage: burning, throbbing pain, swelling

88
Q

Most effective therapy of Raynaud phenomenon

A

Avoidance of cold

89
Q

What is lymphedema?

A

Accumulation of protein-rich fluid in interstitial spaces of arm, following breast surgery or treatment
Resulting of axillary lymph node removal

90
Q

What causes varicose veins?

A

Chronic increased venous pressure, and incompetent valves

91
Q

What is deep vein thrombophlebitis?

What does it cause?

A

A deep vein is occluded by a thrombus

Causing inflammation, blocked venous return, cyanosis, and edema

92
Q

Conditions that can cause deep vein thrombosis?

A 
Prolonged bed rest
History of varicose veins
Trauma
Infection
Cancer
Obesity
Immobility
Heart failure
Use of estrogen hormones
93
Q

What should you do if a pt has deep vein thrombophlebitis?

A

Emergency referral because of risk for pulmonary embolism

94
Q

What would a capillary refill of over 1-2 seconds signify?

Which diseases could this be a symptom of?

A

Vasoconstriction or decreased cardiac output

Hypovolemia, heart failure, or shock

95
Q

What would cause edema of upper extremities?

A

When lymphatic drainage is obstructed after breast surgery or radiation

96
Q

Where are the epitrochlear lymph nodes located?

A

In the depression 2-3 cm above and behind the medial condyle of the humerus

97
Q

How do you check a patient’s epitrochlear lymph nodes?

A

Shake hands with the person and reach other hand under person’s elbow and feel with fingers
Nodes are normally not palpable

98
Q

What would an enlarged epitrochlear node indicate?

A

Infection of hand or forearm

99
Q

What conditions cause enlarged epitrochlear nodes?

A

Conditions with generalized lymphadenopathy:

  • lymphoma
  • chronic leukemia
  • infectious mononucleosis
  • HIV infection
100
Q

How long does it take to show an occlusion while doing the modified Allen test?

A

Over 15 seconds

101
Q

How long does a normal result take during the modified Allen test?

A

8 to 14 seconds

102
Q

When does diffuse bilateral edema of legs occur?

A

With systemic illness

103
Q

What should you do if pt has acute, unilateral, painful swelling and asymmetry of calves 1 cm or more?

A

Abnormal

Refer pt to determine whether DVT is present

104
Q

What is edema with of 1-3 cm with asymmetry in legs called?

A

Mild lymphedema

105
Q

What is edema of 3-5 cm with asymmetry in legs called?

A

Moderate lymphedema

106
Q

What is edema of 5 or more cm with asymmetry in legs called?

A

Severe lymphedema

107
Q

What is a symptom of DVT?

A

Asymmetric calf swelling of 2 cm or more

108
Q

What causes brown discoloration on legs?

A

Chronic venous stasis

Caused by hemosiderin deposits from red blood cell degradation

109
Q

Where and why do venous ulcers usually occur?

A

At medial malleolus because of bacterial invasion of poorly drained tissues

110
Q

Why do ulcers typically form?

A

With arterial deficit

111
Q

Where do ulcers typically form on lower extremities?

A

Tips of toes
Metatarsal heads
Lateral malleoli

112
Q

What could a unilateral cool foot or leg mean?

A

Arterial ischemia

113
Q

Where are the femoral arteries located?

A

Just below inguinal ligament, halfway between the pubis and anterior superior iliac spines

114
Q

How should you palpate the popliteal pulse?

A

Leg extended but relaxed
Anchor thumbs on knee and curl fingers around popliteal fossa
Press fingers forward hard to compress artery against the bone
Is usually just lateral to the medial tendon

115
Q

How should you palpate the posterior tibial pulse?

A

Curve fingers around medial malleolus
Press softly
Tapping will be right behind it in the groove between the malleolus and Achilles’ tendon

116
Q

If you can’t feel the posterior tibial pulse, what should you do?

A

Have pt do dorsiflexion of the foot

117
Q

Where is the Dorsalis pedis pulse?

A

Just lateral to and parallel with the extensor tendon of the big toe
Use very light touch

118
Q

Conditions that could cause bilateral, dependent pitting edema?

A

Heart failure
Diabetic neuropathy
Hepatic cirrhosis

119
Q

What could cause unilateral edema?

A

Occlusion of a deep vein

120
Q

What is brawny?

A

Unilateral or bilateral edema that is no pitting and feels hard to the touch

121
Q

What should happen next if pt has bilateral pitting edema?

A

Exam in the neck veins

122
Q

What if pt has bilateral pitting edema and neck veins are abnormally distended?

A

May be related to heart disease or pulmonary hypertension

123
Q

Which veins do varicosities occur?

A

Saphenous veins

124
Q

How is valvular incompetency examined?

A

By Doppler

125
Q

What does elevational pallor indicate?

A

Arterial insufficiency

126
Q

What causes dependent rubor?

A

Severe arterial insufficiency

127
Q

What causes delayed venous filling?

A

Arterial insufficiency

Health Assessment (17 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions