Lymph Flashcards
When inspecting the skin, paleness suggests what? blue color? purple? red or rust
paleness- lack of arterial supply
blue- lack of oxygenation
purple- venous congestion
brown/rust- Hb pigmentation
What is a thrill indicative of
turbulent flow through an artery consistent with partial obstruction
What is the scale for aterial examination
0 unable to palpate
1 diminished
2 normal briskness
3 bounding
what areas do you auscultate during an arterial examination
carotid, temporal, aorta, renal, iliac
what is a bruit indicative of
turbulent flow through an artery consistent with partial obstruction
What is a normal ankle brachial index, and when does it indicate severe peripheral artery disease
0.9-1.3 normal
less than 0.4 is severe
When must you do an allens test
before taking an arterial blood gas
when checking the return of color in an extremity how long should it take for the skin to return to pink colored
10 seconds
What are common symptoms of arterial disease
pain coldness, numbness, hair loss, color change. no pulse
the 3 Ps: Pain, Pallor, Pulselessness
If patient presents with sudden onset of extreme pain that is unilateral and not aggravated by movement what is most likely your physical findings and possible diagnosis
PE: extremity is pallid, cool and pulseless
thromboemobolus occlusion
Intermitten claudication while walking that is relieved by rest is most likely
peripheral arterial disease
what are signs of chronic PAD
red color on feet and some ischemic ulcers
What is the venous valve competency exam
occlude great saphenous v and ask patient to stain and watch for normal slow venous filling, rapid filling indicates incompetent valves
What is homans sign
bend leg slightly at knee and dorsiflex abruptly and if there is deep calf pain then is a + test
What is virchows triad of DVT
stasis
hypercoagulability
endothelial injury
What is superficial thrombophlebitis
DVT in smaller veins in leg- painful!
less swelling than DVT
What causes varicose vv
valves in vv of lower extremities become incompetent, usually seen in the great saphenous vv
what is a common cause of chronic venous insufficiency
higher venous pressure
What are risk factors of chronic venous insufficiency
DVT varicose vv obesity pregnancy extended periods of standing or sitting age over 50
what are some common symptoms of chronic venous insufficiency
diffuse ach in legs
gradual onset over month
aggravated by prolonged standing
what are common signs of chronic venous insufficiency
pitting edema, rust colored skin
thickened skin hair
moist ulcers
what can cause lympedema
lymph channel obstruction or damage
Where are lymph from lympadenopathy palpated in children? adults
children in the cervical region
adults in the inguinal region
what are signs that lymphadenopathy is malignatn
greater than 1 cm non tender rock hard fixed to area difficult to palpate
tender red streaks in the skin with enlarged lymph nodes with acute onset after skin injury is usually what
lymphangitis due to bacterial infection
How do you grade pitting edemas
1 is 2mm
2 4mm
3 6mm
4 8mm
What is erythema nodosum
inflammation of skin of the shins, gradual onset, recurrent and bilateral
joint pain and fever
What is a common inflammtion of the skin and subcutaneous tissue that has an acute onset presenting with pain, redness and warmth
and in a specific area that is tender to palpation
cellulitis
