introduction to the limbs Flashcards
important limb clinical issues: understand the basics of important clinical issues relating to limb anatomy including arterial pulses, venepuncture and phlebotomy, venous graft harvest, deep-vein thrombosis, compartment syndrome, musculoskeletal trauma and pathology, neurological pathology
6 vascular key clinical points relating to limbs
pulses; varicose veins; deep-vein thrombosis; superficial veins for injection, lines, harvesting; arteries for access to cardiac vessels; compartment syndrome
3 neuro-muscular key clinical points relating to limbs
spinal root injury; peripheral nerve injury; muscular deficits after nerve injuries
3 musculoskeletal key clinical points relating to limbs
fractures; tendon/ligament sprains and tears; arthritis and other joint problems
where is an IM injection administered relating to limbs
safe area of buttock (ventrogluteal site: palm of hand over greater trochanter, with fingers facing patient’s head (right hand used for left hip and left hand used for right hip); place index finger on anterior superior iliac spine and run middle finger back along iliac crest; injection given in center of triangle that is formed; provides greatest thickness of gluteal muscle)
where is a common site for phlebotomy or insertion of venous line
superficial veins such as median cubital vein in region of cubital fossa (just in front of elbow; can also be for arterial blood e.g. central line)
what 2 veins does median cubital vein connect, and is it always present
basilic and cephalic veins; median cubital vein not always present
what is the femoral triangle and what is it used for
region of groin where femoral artery is accessed (e.g. access to cardiac vessels to carry out angiograms and angioplasty); pulse can be felt
when do varicose veins occur
when valve in perforating veins connecting superficial and deep veins is compomised (valves only allow flow from superficial to deep, but if compromised blood is pushed from deep to superficial)
describe the calf pump
during walking and running, contractions of layers of calf muscles squeeze thin-walled deep veins and push blood up the veins, with valves in the veins allowing flow only up towards the heart
effect on calf pump of immobility (e.g. long plane journey, bed-ridden), and what it can lead to
less efficient venous return from food and leg, which can lead to deep vein thrombosis
how do elastic surgical socks reduce deep thrombosis risk
compress superficial veins, promoting more vigorous deep venous return
