Module 11: pt.2 Peripheral vascular Flashcards
which are deep veins in the legs
Popliteal, femoral.
do most of venous return
how does venous flow happen
1) Contracting skeletal muscle
2) Pressure gradient by breathing
3) Intraluminal valves (1 Direction flow)
What is the “Calf pump/ Peripheral heart”?
When you’re walking you legs muscles are like systole and diastole moving your blood from the bottom
Effective venous return needs
1) Contracting skeletal muscle
2) Competent valves
3) Patent lumen
what is it called when theres a problem with venous return
Venous stasis
What can cause venous stasis
-Dilated veins or varicose have incompetent valves, lumen is so wide that the valve cusps cannot approximate
(Ppl on bed rest don’t move enough)
What would happen if we didn’t have lymphatic vessels
Buildup of fluid in interstitial space (Edema)
What do lymphatic vessels do
1) Conserve plasma proteins that leak out of capillaries
2) immune function
3) Absorb lipids from intestinal tract
What do lymphatic vessels need to be able to move
- Skeletal muscle contraction
- Breath pressure change
- contraction of blood vessels
lymphatic considerations for infants and children
- Well developed at birth grow until 10-11
- They surpass adult size and atrophy
- lrg nodes can give abdominal pain
considerations for pregnant women
- vasodilaton
- uterus growth can upstruct the drainage of iliac veins
- cause swelling in legs, vulva, hemroids
Considerations for older adults
Prolonged bed rest, sitting heart failure increase risk for deep venous thrombosis, and pulmonary embolism, myocardial infarction
-smaller nodes
Pulse scale?
0- no pulse
+1 weak and thready
+2 normal
+3 full and bounding
Why would a brown colour occur
Chronic venous stasis, result of hemosiderin deposits from red blood cell deviation
Where are venous ulcers most likely to be
Usually medial malleolus because of bacterial invasion, poorly drained tissue
What would be a sign of arterial deficit
ulcers on toes, one foot or leg may be cooler
Will deep vein thrombosis always have symptoms?
No half of all patients with DVT have no clinically detectable signs or symptoms
What could bilateral pitting anemia mean
heart failure, diabetic neuropathy
What could unilateral edema mean
Occlusion of deep vein, notice any visible dialated, tortuous veins
What does dependent rubor look like
Occurs with severe arterial insufficiency
What is chronic hypoxia
Loss of vasomotor tone, blood pool in veins
deficiency in oxygen reaching tissues
What is a arterial ulcer from
Buildup of fatty plaques and hardening and calcification of the arterial wall (Arteriosclerosis)
What is a symptom of arterial ulcer
deep muscle pain in calf food with walking and pain at rest
- coolness, pallor, dependent rubor, diminished pulses, systolic bruits, trophic skin, malnutrition and distal gangrene
- ulcers on feet with no bleeding
- common in diabetics
What is a common chronic venous insufficiency
Venous stasis ulcer
What are the symptoms of a venous stasis ulcer
- Aching, pin, callow leg, worst at end of day with prolonged sitting or standing
- film, brown deem, coarse thick skin, brown petechiae, dermatitis, pressure, RBC leak out and leave iron behind, weepy bleeding ulcers
What are superficial varicose veins
-Incompetent valves that allow reflux
What are the symptoms of varicose veins
aching, heavy in calf, easily fatigued, night leg cramps, dialated veins
What do you need to do if you think someone has deep vein thrombosis
Immediate referral
What is happening when deep vein thrombosis happens
-Deep vein is occluded
who is more at risk for DVT
-prolonged bedrest, history of varicose veins, trauma, infection, cancer, oral contraceptives
What are the symptoms of DVT
- deep, sharp muscle pain, increased with dorsi flexion
- warm, swell, red, cyanosis, tender
in General What are the signs of venous insufficiency
P: Aching, more in evening and dependent on position S: No change in Sensation T: Normal temperature C: Normal or cyanosis (blue C:Cap refill doesn't apply Pulse: Will be present Skin: Brown pigment at ankle Ulcers: Shallow at ankle
in general what are the signs of Arterial insufficiency
P: Burning, throbbing, cramping that increases with exercise
S:Numbness and tingling
Temp: Cool
Color:pale when high, red when lowered
Cap: Will be more than 2 seconds
Pulse: thready or absent
Skin changes: Thin shiny, decreased hair growth, thick nails
Ulcers: Deep, well defined, usually start at toes
When would you not apply a SCD sleeve or compression stocking
- open skin lesions or dermatitis
- Recent skin graft
- Decrease arterial circulation: Cool, Gangreen
- Signs of DVT
What does PRICE stand for
P-Protect from further injury R-Restrict/ rest I-Apply Ice C-Apply compression E-Elevate injured area
What is happening in coagulative disorders (Thrombosis, Embolism)
Blood clot causes mechanical obstruction to blood flow
What is happening in systemic diseases (Arterioscleroisis, atherosclerosis, diabetes)
changes in integrity of arteries
What is atherosclerosis
Buildup of plaque on walls
What is arteriosclerosis
hardening of walls
