Peripheral Vasc Exam

Question 1

pulsus alternans

Answer 1

Amplitude of pulse varies. LV disfunction or failure

Question 2

pulsus bigeminus

Answer 2

Normal pulse followed by a premature beat and a pause

Question 3

External cues to poor circulatory status?

Answer 3

Absence of hair on legs, color (rubber, pallor, brawny colored), varicosities, ulcers, temperature, edema (and whether it is pitting or not), presence of JVP/JVD, claudication

Question 4

What is the pulse scale range?

Answer 4

0-4, 0 = no pulse, 2 = normal pulse

Question 5

What does JVD assess?

Answer 5

The activity of the right side of the heart. If there is distention, this indicates back flow of blood from the right atrium.

Question 6

What is the hepatojugular reflex/abdominojugular reflex?

Answer 6

Another measure of JVD, push on epigastric region and watch to see if there is an increase in JVD.

Question 7

What is jugular venous pressure (JVP?)

Answer 7

Using the jugular veins you estimate right atrium health. Venous pressure rises when the heart is failing. Anything over 9 CM suggests blood is backing up from the atrium.

Question 8

How big should the abdominal aorta be?

Answer 8

2.5 cm

Question 9

Pulse deficit

Answer 9

heart contracts weakly and does not transfer a pulse peripherally

Question 10

What does brawny ankle edema, varicosities, and ankle ulcerations tell you?

Answer 10

Venous insufficiency

Question 11

What does pain, numbness, tingling, weakness tell you in the extremity?

Answer 11

Arterial obstruction

Question 12

What does claudication, absent pulse, pallor on elevation but rubor on dependency, and ulcerations on toes tell you?

Answer 12

Arterial insufficiency

Question 13

What are the pitting grades?

Answer 13

1+ (2mm), 2+ (4mm) 3+ (6mm) and 4+ (8mm)