Brainscape's Knowledge GenomeTM

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


See full index

Health Assessment Exam 3 > Lymphatic System & Peripheral Vascular > Flashcards

Lymphatic System & Peripheral Vascular Flashcards

1
Q

Inspection technique of lymphatic system

A
  • Visible nodes
  • Edema
  • Erythema
  • Streaking
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Lymphatic palpation technique of…

A
  • Lymph nodes: noting…
    • size
    • consistency
    • mobility: worse if unmovable and stuck to underlying tissue ⇒ indicates malignancy or chronic infections
    • borders
    • tenderness
    • warmth
  • lower extremity specific nodes to palpate for…
    • inguinal nodes: can be enlarged due to STIs
    • popliteal
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Peripheral vascular technique of taking VS specifics…

A
  • standard VS
  • assess for orthostatic hypotension: drop in BP w/ change in position
    • Steps: measure BP and HR in 3 diff positions (laying down, sitting upright, standing up) w/ time between each measurement
      • causes: autonomic dysfunction, volume issues
  • Ankle Brachial Pressure Index (ABI) Screening: for pts who have risk factors for PAD
    • steps: take BP on both arms brachial & get systolic #s → take BP on ankle above malleoli & get systolic #s → divide higher systolic pressure from legs from by higher brachial systolic pressure from arms = ABI (higher ankle systolic pressure/higher brachial systolic pressure)
    • norm: 0.8 - 1
    • abnorm: <0.6 / 0.7 ⇒ suggests ischemia (lower it is from 1 = more severe ischemia is
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

peripheral vascular palpations of pulses…

A
  • Carotid: If pt is middle age or older and suspect cerebrovascular disease ⇒ listen for bruit that suggests arterial narrowing and increases risk for CVA
  • brachial
  • radial
  • femoral: Exaggerated, widened femoral pulse ⇒ suggests femoral aneurysm (pathologic dilation of artery)
    • Femoral aneurysm uncommon and usually caused by atherosclerosis and occurs mostly in >50 yo
  • Popliteal: Exaggerated, widened popliteal pulse ⇒ suggests aneurysm of popliteal artery
    • Atherosclerosis (arteriosclerosis obliterans) commonly obstructs arterial circulation in thigh ⇒ femoral pulse normal but popliteal pulse decreased or absent
    • Popliteal aneurysm uncommon and usually caused by atherosclerosis and occur mostly in >50 yo men
    • If you have hard time feeling this pulse but can still feel pedal pulses ⇒ be assured that foot is still getting blood flow ⇒ so palpate distal pulses first then proximal
  • posterior tibial
  • dorsalis pedis: Decreased or absent pedal pulses (assuming in warm environment) w/ normal femoral and popliteal pulses ⇒ suggests occlusive disease in lower popliteal artery or its branches (often seen in DM)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Auscultation for bruits in…

A
  • Carotid artery
  • Abdominal aorta
  • Renal artery
  • Iliac artery
  • Femoral artery
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Lymphedema

A
  • What: soft, pitting edema that becomes indurated, hard, non-pitting / inadequate lymph drainage leading to edema
  • Causes:
    • Interstitial accumulation of protein-rich fluid when lymph channels and nodes are infiltrated or obstructed by tumor, fibrosis, or inflammation
    • Disrupted by axillary node dissection and/or radiation
    • Removal of lymph nodes
  • Occurs often in: BIL in feet and toes
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Lymphedema Stages

A
  • 0:
    • Have some internal changes– latent or subclinical condition where swelling not evident despite impaired lymph transport
    • Subtle alterations in tissue fluid/composition
    • Changes in subjective Sxs
  • 1: Early accumulation of fluid relatively high in protein content that subsides w/ limb elevation
  • 2: Pitting may or may not occur as tissue fibrosis develops + Limb elevation alone rarely reduces tissue swelling
  • 3: Lymphostatic elephantiasis where pitting is absent + Trophic skin changes like acanthosis, alterations in skin character and thickness, fat deposits and fibrosis, warty overgrowths often develop
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Lymphoma

A
  • What: “liquid tumor” – cancer of immune system that affects lymphocytes T-cells and B-cells
  • Hodgkins: B-cells affected and hits lymph nodes and moves on from one lymph nodes to next + has Reed-Sternberg cells
  • Non-Hodgkins: B-cells and T-cells affected and can see cancer in any of the lymph tissues like spleen and lymph nodes
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

HIV/AIDs

A
  • What: someone newly infected w/ HIV can get generalized lymphadenopathy (enlarged lymph nodes from head to toe)
    • Lymphadenopathy: enlargement of nodes w/ or w/o tenderness
    • Ppl don’t know they’ve been infected during virus’ most infectious time range ⇒ contagious
  • S&S: Flu-like symptoms
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Herpes Simplex (HSV)

A
  • What: enlarged nodes of anterior cervical chain and submandibular node
    • HSV on mouth increases nasal, anterior cervical chain, and submandibular nodes ⇒ signs of infection
  • S&S: Lymph nodes affected often tender but if nontender lymph nodes ⇒ suggests cancer
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

5 Ps of arterial occlusion

A
  • Pallor: bc of loss of blood flow
  • Pain: bc of no O2 to tissues
  • Pulselessness: bc of no blood flow thru arteries
  • Paresthesias: numbness or tingling
  • Paralysis: inability to move affected area
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

acute arterial occlusion

A
  • What: embolism or thrombosis that suddenly blocks peripheral artery
  • Location of pain: distal pain usually foot and leg
  • Onset: sudden + associated Sxs may occur w/o pain
  • S&S: coldness, numbness, weakness, absent-distal pulses
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Chronic arterial occlusion (usually from atherosclerosis) ⇒ causes…

A

intermittent claudication

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

Asymmetric diminished pulses occur with…

A

arterial occlusion from atherosclerosis or embolism

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

Normal Pulse

A
  • Pulse contour: smooth and rounded
  • Notch on descending slope of wave isn’t palpable
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Small & Weak Pulse

A
  • Diminished, weak, small pulse pressure
    • Upstroke may feel slowed + peak prolonged
  • Causes:
    • Decreased SV like in HF, hypovolemia, severe aortic stenosis
    • Increased peripheral resistance like in exposure to cold and severe congestive HF
17
Q

Large & Bounding Pulse

A
  • Increased, strong, bounding pulse pressure
    • rise and fall may feel rapid + peak brief
  • Causes:
    • Increased SV, decreased peripheral resistance or both like in fever, anemia, hyperthyroidism, aortic regurgitation, arteriovenous fistulas, patent ductus arteriosus
    • Increased SV bc of slow HR like in bradycardia and complete heart block
    • Decreased compliance/Increased stiffness of aortic walls like in aging or atherosclerosis
18
Q

Bisferiens

A
  • Increased arterial pulse w/ double systolic peak
  • Causes:
    • Pure aortic regurgitation
    • Aortic stenosis w/ regurgitation
    • Increased arterial pulse
19
Q

Pulsus Altemans

A
  • Alternates in amplitude from beat to beat even though rhythm is regular
  • When difference between stronger and weaker beats is slight
  • Cause: Left ventricular failure w/ left sided S3
  • Can only be detected by sphygmomanometer
20
Q

Bigeminal

A
  • Normal beat then premature contraction
  • Has premature contraction rhythm mimicking pulsus alternans
  • SV of premature beat diminished in relation to that of normal beats ⇒ Pulse varies in amplitude accordingly
  • Cause: normal beat alternating w/ premature contraction
21
Q

Pulsus Paradoxus

A
  • Can feel decrease in amplitude of pulse with inspiration (basically opposite of what you normally expect)
  • Cause:
    • Cardiac tamponade
    • Pericarditis
    • Obstructive airway disease
    • Other serious life-threatening cardiac issues
22
Q

Peripheral Venous Disease (PVD)

A
  • What: inadequate return of venous blood from extremities to heart ⇒ leads to too much fluid build up
  • S&S:
    • Edema that might make pulse harder to palpate
    • Can get wounds but not black eschar wounds
    • Achy cramping in legs w/ pain worsening when standing and improves w/ elevation and activity
    • Sores w/ irregular borders
    • Yellow slough or ruddy skin
23
Q

Peripheral Arterial Disease (PAD)

A
  • What: narrowing or blockage of vessels that deliver blood from heart to extremities
  • Cause: atherosclerosis– build up of fatty plaque in arteries
  • S&S:
    • Intermittent claudication: cramping muscle pain that comes w/ movement of legs or arms during exercise and relieved by resting
    • Pallor bc of loss of O2
      • As it increases ⇒ will impact pulse and it’ll go from regular to weaker to no pulse ⇒ risk for limb loss
    • Black eschar from poor oxygen circulation
    • Loss of hair bc of lack of O2
    • Round, smooth, shiny leg
    • NO edema
24
Q

What are the Specific Disease of Peripheral Venous

A
  • Chronic Venous Stasis/Insufficiency
  • Varicose Veins
  • Deep Vein Thrombosis (DVT)
  • Pitting Edema
25
Q

Chronic Venous Stasis/Insufficiency (Advanced)

A
  • What: more severe form of chronic venous disease w/ chronic venous engorgement from venous occlusion or incompetency of venous valves
    • If it’s a problem with veins (periphery) ⇒ blood pools and doesn’t return to heart ⇒ lungs and other areas swell bc fluid goes to 3rd space
  • Causes
    • Incompetent vein valves secondary to DVT
    • Prolonged increased venous pressure as seen in prolonged standing or pregnancy ⇒ can lead to varicose veins and skin changes
  • S&S
    • Generalized/Diffuse aching of legs, esp at end of day
    • Decreased wound healing
    • Weak pulse due to edema making it harder to find
    • Chronic edema
    • Pigmentation
    • Swelling
    • Ulceration esp if old age, pregnant, increased weight, prior Hx, trauma
  • Onset: chronic, increasing as day goes on
  • Aggravating factors: prolonged standing or sitting w/ legs dependent
  • Relieving factors: pressure stockings, leg elevation, anything to get blood back to where it needs to be
26
Q

Varicose Veins

A
  • What: dilated and tortuous where their walls may feel somewhat thickened
    • Many varicose veins can be seen in leg
    • Common in backside of legs
      • Tested by having pt rise on tiptoes and inspecting backside of legs to see if veins pop out
    • Is a Sx or result of venous stasis/insufficiency
  • S&S: Can become painful as they grow and go untreated
27
Q

Deep Vein Thrombosis (DVT)

A
  • What: when blood clot forms in deep vein, accompanied by inflammatory response in vein wall
    • Common in lower leg, thigh, pelvis ⇒ risk for pulmonary embolism (PE) ⇒ blocks blood flow to lungs ⇒ life-threatening emergency because it impairs oxygenation 🚩
  • Avoid firm palpation or massage over DVT because it may dislodge clot ⇒ causes pulmonary embolism or death
  • S&S:
    • Painful calf swelling w/ erythema but can be painless
    • Edema: Extent of edema suggests location of occlusion
      • Ie. Popliteal vein may be location when lower leg or ankle is swollen
      • Ie. iliofemoral vein may be location when entire leg is swollen
  • Tx: remove clot or medicate so thrombus can break apart on its own
  • Aggravating factors: immobilization or recent surgery, lower extremity trauma, pregnancy, postpartum state, hypercoagulable state
  • Relieving factors: antithrombotic and thrombolytic therapy
28
Q

What are the Specific Diseases of the Peripheral Arteries?

A
  • Arterial Aneurysm
  • Raynaud’s Disease
29
Q

Arterial Aneurysm

A
  • What: weakness in arterial wall ⇒ stretched artery intima and media ⇒ problem is when it ruptures/opens arterial wall ⇒ blood gets to periphery
    • Aorta is vulnerable place to have aneurysm ⇒ huge blood loss
    • Brain is vulnerable place to have aneurysm ⇒ blood will become trapped and can’t go anywhere
    • Popliteal and femoral aneurysm uncommon and usually caused by atherosclerosis and occur mostly in >50 yo men
    • Exaggerated, widened femoral pulse ⇒ suggest femoral aneurysm
  • Tx: surgery if stretched arterial wall is >5 cm
30
Q

Raynaud’s Disease

A
  • What in General: small arteries in fingers and toes spasm in response to cold or stress ⇒ causes them to turn blue and numb (basically just spasms in vasculature)
  • Primary Raynaud’s: you just have Raynaud’s
    • What: episodic reversible vasoconstriction in fingers and toes, triggered by cold temp
    • S&S: distinct digital color changes of pallor, cyanosis, hyperemia (redness)
  • Secondary Raynaud’s: you have Raynaud’s but there’s another cause of it
    • What: S&S related to autoimmune diseases– scleroderma, lupus, mixed connective tissue disease, cryoglobulinemia, occupational vascular injury, drugs
    • S&S: more severe w/ ischemia, necrosis, loss of digits, distorted capillary loops
  • Causes: stress, cold temp, emotional upset
  • S&S:
    • Can be very painful
    • Affected area gets pale and loose color ⇒ turns cold and blue (if warmth returns to affected part it’ll turn rlly red)
    • Can develop other wounds like gangrenous area from decreased O2
  • Commonly affects: hands and fingers but other parts of body like toes and ears can be affected
  • Management/Prevention: stress management, limit cold exposure
31
Q

Pitting Edema

A
  • What: third spacing of fluids
    • Generalized edema is called anasarca
  • Causes:
    • HF, esp right side bc it causes increase in fluid build up in lower extremities
    • Kidney failure
    • Peripheral vascular problems: Venous insufficiency, DVT
  • Common in: lower extremities
32
Q

Lymphatic Age-related considerations

A
  • Infants: Recurrent infections, trauma, failure to thrive, immunization Hx, maternal HIV, etc. ⇒ suspect problem with lymph system
  • Children: Post auricular and occipital nodes more palpable in <2 yo
  • Older Adults
    • Delayed healing normal bc of slowing and aging of IS
    • Trauma, autoimmune disease ⇒ suspect problem with lymph system
    • Hx of malignancy ⇒ increases risk for cancer
  • Pregnant Women
    • Earlier weeks of gestation more sensitive to fetus so exposure to infectious diseases during this time is dangerous
    • Avoid exposure to cats/cat feces bc they’re toxic to fetus
33
Q

Peripheral Vascular Age-related Considerations

A
  • Infants: Brachial, radial, femoral pulses normally easily palpated
  • Children
    • Most HTN in children due to renal diseases, NOT primary HTN (usual assumption in most adults)
      • Child w/ high BP ⇒ suspect kidney disease and not primary HTN (usual assumption in most adults)
  • Pregnant Women
    • BP fluctuations:
      • BP ↓ til wk 16-20
      • 2nd trimester: > 125/75 abnormal
      • 3rd trimester: >130/80 abnormal
      • BP should be back to norm during term/delivery time
  • Geriatrics
    • Pedal pulses harder to palpate bc vessels become more tortuous and distended
      • If you can’t feel pedal pulse ⇒ feel for temp, color, cap refill, and size differences to find out if they still have circulation
    • Systolic BP (SBP) ↑
34
Q

Pulse Grading

A
  • 0: Absent: absent pulse + unpalpable
  • 1+ : weak:
    • Diminished pulse
    • Weaker than expected pulse
    • Asymmetric diminished pulses occur w/ arterial occlusion from atherosclerosis or embolism
  • 2+: normal: brisk pulse
  • 3+: bounding: Bounding, carotid, radial, femoral pulses occur w/ aortic insufficiency
35
Q

Pitting Edema Measurement Scale

A
  • 1+ / 2mm: Barely noticeable pit
  • 2+ / 4mm: deeper pit + rebounds in few secs
  • 3+ / 5-6mm: deep pit + rebounds in 10-20secs
  • 4+ / 8mm: deeper pit + rebounds in >30secs
36
Q

General Documentation of Lymph Nodes

A
  • If lymph node not palpable ⇒ state “nonpalpable” + location of lymph node
  • If lymph node palpable ⇒ state location, size, shape, consistency, mobility, tenderness

Health Assessment Exam 3 (4 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions