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KN JD NPTE: CARDIAC > Examine Peripheral Vasuclar System > Flashcards

Examine Peripheral Vasuclar System Flashcards

1
Q

Exam for diaphoresis:

Excess sweating can be associated with ______ _____ _____

A

Decreased CO

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2
Q

Exam arterial pulses: decreased or absent pulses can be associated with ___ ____ ___

A

Peripheral artery disease

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3
Q

When examining pulses, start with most ___ pulses

A

Distal

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4
Q

With LE pulses, patient should be _____

A

Supine

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5
Q

Cyanosis is related to decreased ______ _____ or ______

A

Cardiac output

Cold

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6
Q

Pallor is associated with decreased ____ ____ ____

A

Peripheral blood flow

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7
Q

______ is dependent redness with PAD

A

Rubor

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8
Q

Clubbing: curvature of the fingernails with ___ ____ enlargement at base of nail
Associated with ____ ____ ____, _____ ____ ____, or ____ ___

A

Chronic oxygen deficiency
Chronic pulmonary disease
Heart failure

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9
Q

Trophic changes: pale, shiny, dry skin, with loss of ____ is associated with PAD

A

Hair

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10
Q

______ _______ is when the dorsal skin folds of the toes and fingers are resistant to lifting
This is indicative of ____ ____ and _______

A

Stemmers sign

Fibrotic changes and lymphedema

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11
Q

Intermittent claudication: pain and cramping and LE fatigue occurring during ______, and relieved by _____, associated with PAD

A

Exercise

Rest

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12
Q

IC pain is typically in ____. May also be in what other places?

A

Calf

Thigh, hips, buttocks

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13
Q

With IC, pt may experience pain at ____ with severe decrease in arterial blood supply. Typically in ______, Worse at _____

A

Rest
Forefoot
Night

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14
Q

Edema: for regular intervals, measure with _______. For irregular body parts (foot/hand), measure with _______.

A

Tape measure

Volumeter

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15
Q

Pitting edema scale: 1+

A

Mild, barely perceptible indentation

<1/4 inch pitting

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16
Q

Pitting edema scale: 2+

A

Moderate, easily identified depression
Returns to normal within 15 seconds
1/4 - 1/2 inch pitting

17
Q

Pitting edema scale: 3+

A

Severe, depression takes 15-30 seconds to rebound

1/2 - 1 inch pitting

18
Q

Pitting edema scale: 4+

A

Very severe
Depression lasts for > 30 seconds or more
> 1 inch pitting

19
Q

What are two peripheral causes of edema?

A

Chronic venous insufficiency

Lymphedema

20
Q

B/L edema is associated with ___ ___ ___

A

CHF

21
Q

Tests of Peripheral Venous Circulation:

Examine _____ system before _____ system

A

VENOUS before arterial because venous insufficiency tests can invalidate some arterial tests

22
Q

Tests of Peripheral Venous Circulation:
The percussion test determines competence of ____ ___ ____
Describe it

A

Greater saphenous vein

Patient is standing, palpate one segment of vein while percussing vein approx 20 cm higher.
If pulse wave felt by lower hand, the intervening veins are incompetent

23
Q

Tests of Peripheral Venous Circulation:
Trendelenberg test (retrograde filling test): determines competence of _____ ____ and ____ ____
Describe

A

Communicating veins and saphenous systems

Pt positioned in supine with legs elevated to 60 deg (empties venous blood)
Tourniquet places on prox thigh (occludes venous flow in superficial veins)
Pt is then asked to stand
PT notes whether veins fill in normal pattern. Should take approx 30 seconds

24
Q

Tests of Peripheral Venous Circulation:
Venous filling time:
Describe:

What is delayed filling time?

A

Pt supine - passively elevate LE to approx 45 deg for 1 minute
Then placed in dependent position
Note time it takes for veins to refill

Delayed: >15 seconds = indicative of venous insufficiency

25
Q

Tests of Peripheral Venous Circulation:

Doppler US: describe

A

Useful in both venous and arterial diseases
Doppler probe placed over large vessel
US signal given transcutaneously, movement of blood causes an audible shift in frequency
Useful in locating nonpalpable pulses and measuring SBP in extremities

26
Q

Tests of Peripheral Venous Circulation:
Air plethysmography (APG): pneumatic device calibrates to measure _____ of venous system; ______
Cuff is inflated around ____ and attached to pressure transducer and microprocessor
Occludes _____ _____, permits ______ _____
Recorder registers increasing volume with cuff; time to return to baseline with cuff deflation

A

Patency
Volume
Calf
Venous return, arterial inflow

27
Q

Tests of Peripheral Arterial Circulation:

ABI: the ratio of _______ pressure divided by ______ pressure

A

LE / UE

28
Q

Tests of Peripheral Arterial Circulation:
ABI: pt is positioned ______ and at rest for ____ minutes
BP cuff is inflated to occlude blood flow temporarily, the deflated. PT listeners for return of flow
Performed in UE at ______ artery, and LE at ____ ___ and ____ ____ arteries

A

Supine
5 min
Brachial
Dorsalis pedis, posterior tibial

29
Q

ABI assists in risk stratification for CV disease.

< ________ is associated with 2-4x increased risk for CV events and death

A

0.90

30
Q

ABI < _______ increased risk of progression to severe or critical limb ischemia in 1 year

A

0.50

31
Q

ABI index values: list the 5 rows.

A 
>1.40 = non-compliant arteries
1.00-1.40 = normal
0.91-0.99 = borderline
< or = 0.90 = abn
< or = 0.50 = severe arterial disease, may have pain at rest
32
Q

Tests of Peripheral Arterial Circulation:
Rubor of dependency:
Examine ____ ____ in skin during elevation of foot followed by dependency of foot
With insufficiency, _____ develops in elevated position
_______ ________develops in dependent position
Changes that take longer than ____ _____ are also indicative of arterial insuff

A

Color change
Pallor
Reactive hyperemia
30 seconds

33
Q

Tests of Peripheral Arterial Circulation: Intermittent claudication: With treadmill test, have patient walk on _____ grade, __ mph. Note level of claudication pain and time of test when pain was experienced
Examine for coldness, numbness, or ______ in the legs or feet
Loss of _____ over anterior tibial area
Leg cramps may also result from ______ use with hypokalemia

A 
Level 
1 mph
Pallor
Hair
Diuretic
34
Q

IC Pain scale: Grade 1

A

Minimal discomfort or pain

35
Q

IC Pain scale: Grade 2

A

Moderate discomfort or pain

Patient’s attention can be diverted

36
Q

IC Pain scale: Grade 3

A

Intense pain

Pt’s attention cannot be diverted

37
Q

IC Pain scale: Grade 4

A

Excruciating and unbearable pain

38
Q

Lymphatic system: Palp with superficial nodes?

A

Cervical, axillary, epitrochlear, superficial inguinal

39
Q

What two tests can you use that provide info about lymph flow, lymph node uptake, and backflow?

A

Lymphangiography

Lyphoscintography using radioactive agents (x-ray of lymph vessels)

KN JD NPTE: CARDIAC (21 decks)

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