Module 11 Part 2- Peripheral Vascular System and Lymphatic System

Question 1

what are vessels?

Answer 1

tubes that transport fluid, such as blood or lymph

Question 2

what is ischemia?

Answer 2

deficiency in the supply of oxygenated arterial blood to a tissue, caused by obstruction of a blood vessel

Question 3

what is complete and partial blockage?

Answer 3

complete obstruction: leads to death of distal tissue
partial obstruction: causes supply to be insufficient and ischemia may only be apparent with exercise (when O2 needs to increase)

Question 4

are veins or arteries a low pressure system and why?

Answer 4

veins are low-pressure unlike arteries because they don’t have a pump to generate blood flow. Veins need a mechanism to keep blood moving

Question 5

what are the 3 mechanisms to keep blood moving?

Answer 5

1. the contracting skeletal muscles that move blood proximally toward heart
2. the pressure gradient caused by breathing in which inspiration makes the thoracic pressure decrease and abdominal pressure increase
3. the intraluminal valves which ensure one direction of blood flow. Each valve is a paired semilunar pocket that opens toward the heart and closes tightly when filled to prevent backflow of blood

Question 6

what is venous flow?

Answer 6

venous structures have a lower pressure and the diameter is larger and therefore can expand/hold more blood when volume increases. This is a compensatory mechanism to reduce stress on heart. Because of veins ability to stretch, they are called capacitance vessels.

Question 7

what can cause venous disease internally? and how can this occur?

Answer 7

problems with contraction of skeletal muscles, incompetent valves in the veins, and a non patent lumen. This is causes by prolonged standing, sitting, or bed rest because of the absence of the milking action that walking accomplishes

Question 8

what is the function of lymphatic vessels?

Answer 8

retrieves excess fluid from the tissues spaces and returns to blood stream

Question 9

what are the two main trunks where lymphatic vessels drain?

Answer 9

1. Right lymphatic duct empties into the right subclavian vein. It drains the right side of the head and neck, right arm, right side of thorax, right lung and pleura, right side of heart and right upper section of liver
2. The thoracic duct drains rest of body and it empties into left subclavian vein

Question 10

functions of the lymphatic system?

Answer 10

A) Conserve fluid and plasma proteins that leak out of the capillaries
B) To form a major part of the immune system that defends body against disease
C) Absorb lipids from intestinal tract

Question 11

How does the immune system detect and eliminate foreign pathogens (from environment and those arising from inside (abnormal or mutant cells))?

Answer 11

It accomplishes this by phagocytosis (digestion) of the substances by neutrophils and by monocytes or macrophages. Also by production of specific antibodies or specific immune responses by the lymphocytes.

Question 12

what are lymph nodes?

Answer 12

small oval clusters of lymphatic tissue located at intervals along vessels and they filter fluid before it is returned to the bloodstream and filter out microorganisms that could be harmful to the body

Question 13

what are lymphocytes?

Answer 13

they are disease fighting cells that defend the body against infection

Question 14

what are the four functions of the spleen?

Answer 14

Destroy old red blood cells, produce antibodies, store RBC’s, and to filter microorganisms from the blood.

Question 15

why is the thymus gland important?

Answer 15

important in developing the T lymphocytes of the immune system in children (but serves no function in adults)

Question 16

where do T and B lymphocytes originate and mature?

Answer 16

originate in bone marrow and mature in lymphoid tissue

Question 17

what are the developmental considerations for infants and children?

Answer 17

• this system has same function in children as it does in adults.
• lymph nodes are large in children and superficial ones are often palpable even in healthy children

Question 18

what are the developmental considerations for older adults?

Answer 18

-Peripheral blood vessels grow more rigid with age which results in arteriosclerosis
○ This condition produces the rise in systolic blood pressure
-Atherosclerosis= deposition of fatty plagues on the intima of the arteries
-As a result of the loss of lymphatic tissue, fewer numbers of lymph nodes present in older people and size of remaining nodes decrease

Question 19

what is the subjective data for peripheral?

Answer 19

1. Leg pain or cramps
2. Skin changes on arms or legs
3. Swelling in arms or legs
4. Lymph node enlargement
   Medication

Question 20

when is a doppler stethoscope used?

Answer 20

this device is used to

• detect a weak peripheral pulse
• to monitor BP in infants/children
• measure a low BP
• BP in a lower extremity

Question 21

how do you use a doppler?

Answer 21

first make sure patient is in supine position with legs externally rotated so medial ankles are accessible.
-place gel on transducer and place transducer on pulse site where you swivel it at 45 degrees

Question 22

why is foot care important?

Answer 22

to check for sores and wounds

Question 23

what can foot problems mean?

Answer 23

arthritis, diabetes, nerve/circulatory disorders

Question 24

what does good foot care entail?

Answer 24

• checking feet everyday and asking for help if you cant on your own
• keep blood flowing to your feet by increasing activity (walking)
• wearing shoes that fit and are comfortable
• keep skin soft and smooth

Question 25

what represents pitting edema and what is the scale?

Answer 25

if finger pressure leaves indent in skin

1+ mild pitting, slight indentation, remains for short time and leg looks swollen
2+ moderate pitting, indentation subsides rapidly
3+ deep pitting, indentation remains for a short time, leg looks swollen
4+ very deep pitting, indent lasts very long time, leg is very swollen (these are somewhat subjective ratings)

Question 26

what is bilateral edema?

Answer 26

when edema is present in both legs or both sides of somewhere

Question 27

what can localized swelling to calf mean?

Answer 27

deep vein thrombosis (clotting)

Question 28

what are unexpected outcomes?

Answer 28

• pulsations, vibrations are palpable
• extra heart sounds are auscultated
• murmur is heard
• HR is irregular (less than 60 or greater than 100)
• pulse deficit is noticed

Question 29

what is the function a a SCD sleeve?

Answer 29

it prevents DVT!

Question 30

how often should an SCD sleeve or compression stocking be left on for?

Answer 30

should be changes atleast once per shift (every 12 hrs)

Question 31

what occurs when skin is exposed to hot temperature?

Answer 31

vasodilation/perspiration occur to promote heat loss

Question 32

what occurs when skin is exposed to cold temperature?

Answer 32

systemic response includes vasoconstriction and piloerection to preserve heat

Question 33

how does vasoconstriction help with cold temperature?

Answer 33

it slows the bleeding into damaged tissues by reducing blood flow, reduces fluid accumulation and slows hematoma formation associated with trauma

Question 34

what temperature reduces edema?

Answer 34

cold

Question 35

what are the advantages of moist application? and what are some examples?

Answer 35

reduces drying of skin, penetrates deep in tissue layers, lessens sweating and insensible fluid loss
examples: hot water packs and baths

Question 36

what are the disadvantages of moist application?

Answer 36

cools rapidly b/c of moisture evaporation, greater risk for burns to skin b/c moisture conducts heat

Question 37

what are the advantages of dry application and what are some examples?

Answer 37

less likely to burn skin, retains temperature longer b/c not influenced by evaporation
examples: electric heating pads

Question 38

what are some disadvantages of dry application?

Answer 38

increases insensible fluid loss through sweating , doesn’t penetrate into tissue, causes increased drying of skin

Question 39

what is the PRICE method?

Answer 39

its used for sprains and strains to limit amount of swelling at injury site and promote healing 
P-protect from further injury
R-rest activity
I-ice
C-compression
E-elevating

Question 40

what does cold therapy do?

Answer 40

it reduces pain, spasm, metabolism, blood flow, inflammation, edema

Question 41

what is a normal and abnormal artery like?

Answer 41

normal: elastic, easily palpable
abnormal: hard, inelastic, and calcified

Question 42

what is strength of a pulse measure by?

Answer 42

measurement of the force at which blood is ejected against arterial wall

Question 43

what is tissue perfusion?

Answer 43

condition of skin, mucosa, and nail beds offers data on staus of circulatory blood flow
-clubbing= insufficent oxygen

Question 44

what occurs on skin if arterial OCCLUSION is present?

Answer 44

has signs resulting from an absence of blood flow

The P’s: pain, pallor, pulselessness, paresthesias, and paralysis

Question 45

what is phlebitis? and when is it most common?

Answer 45

inflammation of a vein that occurs after trauma to vessel wall, infection, immobilization, and prolonged insertion of IV catheters. Common with unilateral edema

Question 46

what are signs of venous insufficiency or right-sided heart failure?

Answer 46

edema is present around feet and ankles and brown pigmentation