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Health Assessment > Lecture 7.1 - Peripheral Vascular and Lymphatics > Flashcards

Lecture 7.1 - Peripheral Vascular and Lymphatics Flashcards

1
Q

How do the elastic fibers in arteries help maintain blood pressure?

A

They stretch to accommodate systolic pressure so that the heart does not have to increase its workload.
Their elastic recoil also helps to propel blood foward.

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2
Q

The brachial artery branches to form the ____ and ___ arteries.

A

Radial and ulnar arteries.

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3
Q

What are the best four arteries to assess for pulse?

A

Femoral, popliteal, dorsalis pedis, and posterior tibial.

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4
Q

How does the structure of veins differ from arteries?

A

Veins have thinner, more distensible walls with a a larger diameter.
This allows them to serve as blood reservoirs and reduce stress on the heart.

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5
Q

What are three ways blood pressure is maintained in the venous system?

A
  1. Contraction of skeletal muscles
  2. Pressure gradient created by breathing (Decrease thoracic, increase abdominal)
  3. Intraluminar semilunar valves
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6
Q

What is the “peripheral heart”?

A

A pattern of contractility and relaxation of the calf muscles while walking that propels blood forwards

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7
Q

What are the three roles of the lymphatic system?

A
  1. To conserve fluid and plasma proteins
  2. To form a major part of the immune system
  3. To absorb lipids from the intestinal tract
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8
Q

Describe the two main lymphatic trunks:
Where do they empty?
What do they drain?

A

Right Duct
–> Empties into right subclavian vein
–> Drains right side of head, neck and heart; right arm, lung and pleura; and right upper section of the liver

Thoracic Duct
–> Empties into left subclavian vein
–> Drains rest of body

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9
Q

Which lymph node drains the head and neck?

A

The cervical nodes

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10
Q

Which lymph node drains the breasts and upper arm?

A

The axillary

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11
Q

Which lymph node drains the hands and lower arm?

A

The epitrochlear

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12
Q

Which lymph node drains the lower extremities, external genitalia, and anterior abdominal wall?

A

The inguinal

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13
Q

The spleen is an accessory organ of the lymphatic system. Where is it located and what are its four functions?

A

Located in the LUQ
1. Destroys old RBCs
2. Creates antibodies
3. Store RBCs
4. Filter microorgansims from blood

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14
Q

What are the four related organs to the lymphatic system?

A

The spleen, tonsils, thymus, and bone marrow

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15
Q

The tonsils are an accessory organ of the lymphatic system. Where is it located and what is its function?

A

Three places: palatine, pharyngeal, and lingual
–> Responds to local inflammation

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16
Q

The thymus gland is an accessory structure of the lymphatic system. Where is it located and what is its function?

A

Located in the superior mediastinum, dorsal to sternum and anterior to aorta.
No function in adults, but produces T-lymphocytes in children before bone marrow is mature.

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17
Q

The bone marrow is an accessory organ of the lymphatic system. What role does bone marrow have in relation to lymphatics?

A

Creation of T and B lymphocytes

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18
Q

What are the four considerations for the peripheral vascular system of older adults?

A

–>Arteriosclerosis
–> Peripheral Vascular Disease
–> Deep Vein Thrombosis
–> Loss of Lymphatic tissue

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19
Q

Older adults are at risk of developing arteriosclerosis. What is this and how does it affect their health?

A

When peripheral vessels become rigid and thick –> Causes rise in SBP due to loss of elasticity + Heart has to work harder

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20
Q

Older adults are at risk of developing peripheral arterial disease. What is this and how does it affect their health?

A

Atherosclerosis - deposit of fatty plaques in arteries
–> Large cause of morbidity and mortality due to it often being underdiagnosed, misdiagnosed, and undertreated
–> Major risk factor for lower extremity amputation

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21
Q

Older adults are at risk of developing deep vein thrombosis (DVT). What is this and how does it impact their health?

A

A blood clot formation in a deep vein, frequently in calf.
–> Can lead to pulmonary embolism + edema

22
Q

What are some risk factors for developing a DVT?

A

–> Progressive enlargement of intramuscular calf veins
–> Increased bed rest
–> heart failure

23
Q

Older adults are at risk of loss of lymphatic tissue. What does this mean?

A

Less lymph nodes and decreased size of those that remain

24
Q

What medications are especially important to ask about when performing a vascular assessment?

A

HRT + Oral contraceptives –> Increase risk of blood clots, especially in those who are genetically predisposed or smoke.

25
Q

What chronic conditions should you ask about when performing a vasculature assessment?

A

Obesity, DM, CVD

26
Q

What lifestyle factors are important to ask about when performing a vasculature assessment?

A

–> Prolonged standing for work
–> Trauma
–> Pregnancy
–> Smoking
–> Bed rest

27
Q

What is lymphadenopathy?

A

Swelling due to issues with lymphatic drainage - often differs from peripheral edema in that it will not pitt, and the skin of swollen tissue will be taught.

28
Q

How long should capillary refill take?

A

Less than 2 seconds

29
Q

What should be noted when inspecting and palpating circulation during a vasculature assessment?

A

–> Colour
–> Temperature
–> Capp refill
–> Pulse strength
–> Lymph nodes

30
Q

What motor functions should be assessed when performing a vasculature assessment?

A

–> Presence of pain with movement
–> Leg strength

31
Q

How can edema be noticed?

A

By examining for symmetry - often unilateral

32
Q

What can abnormalities in the nail bed tell you about circulation?

A

Clubbing of fingers indicates hypoxemia

33
Q

What might absence of body hair in areas/strange patterns of hair growth indicate?

A

Poor perfusion

34
Q

What might skin turger indicate?

A

Dehydration

35
Q

Which lymph nodes should be should be palpated for?

A

Epitrochlear, inguinal on arm.

*Note that they should not be palpable unless there is an infection or localized inflammation

36
Q

What is edema?

A

Accumulation of excess fluid in tissue.

37
Q

What might cause edema?

A

–> Increased pressure in capillaries
–> Decreased venous return
–> Heart failure
–> Medications
–> Kidney disease
–> Surgery

38
Q

How is lymphedema described/assessed?

A

By using a non-stretchable tape measure to measure the widest point and comparing it to the same place on the other limb

39
Q

How is pitting edema graded?

A

1+ - Mild pitting, slight indentation, no perceptible swelling
2+ - Moderate pitting, indentation subsides rapidly
3+ - Deep pitting, indentation remains for a short time, leg looks swollen
4+ - Very deep pitting, indentation lasts a long time, leg very swollen and distorted

40
Q

Which perceptual changes might a person with edema complain of?

A

Parasthesia

41
Q

What is deep venous thrombophlebitis?
What objective data can be collected?

A

Occlusion of deep vein by thrombus.
–> Swelling (inflammation/edema), cyanosis, redness, possible varicose veins, reduced venous return, clot/blockage might be palpable, warmer than rest of body,

42
Q

What are some risk factors for DVT?

A

Stasis of blood - bed rest
Endothelial dysfunction
Cancer
Infection
Hypercoagulability
History of varicose veins

43
Q

What subjective data is characteristic of DVT?

A

Sudden onset calf pain
Sharp pain on dorsiflexion

44
Q

What are the risk factors for arterial occlusion?

A

Obesity, smoking, HNT, sedentary lifestyle, family Hx, dyslipidemia

45
Q

What are some subjective complains related to arterial occlusion?

A

–> Pain, paresthesia
–> Localized coldness

46
Q

What objective data indicates arterial occlusion?

A

Pallor and Loss of Pulse

47
Q

A new hoarseness of voice, subclavian pain, and SOB can be indicative of what?

A

Thoracic Aneurism

48
Q

What is claudication Distance?

A

The number of blocks walked or stairs climbed that produces muscle pain in an individual with peripheral circulatory issues.

49
Q

Unilateral edema occurs with ____

A

Occlusion of a deep vein.

50
Q

Motor and sensory loss occur with ____

A

Arterial deficit

Health Assessment (14 decks)

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