Peripheral/vascular

Question 1

What are the major functions of the peripheral vascular system?

Answer 1

1. Deliver oxygen and nutrients to the body
2. Tansport carbon dioxide and waste products from the tissue for excretion
3. Remove pathogens by filtering the lymph

Question 2

What is the peripheral vascular system composed of?

Answer 2

• arteries
• veins
• capillaries
• lympathics

Question 3

define arteries

Answer 3

carry oxygen rich blood and nutrients

Question 4

define veins

Answer 4

deliver deoxygenated blood from the periphery back to the heart

-The femoral and popliteal vein carry 90% of venous return

Question 5

define capillaries

Answer 5

exchange nutrients and oxygen between the arterial and venous system

Question 6

define lymphatics

Answer 6

help transport escaped fluid back into the vascular system

• Major role in immunity and defense ( spleen, thymus, Tonsils).

Question 7

what is arterial flow?

Answer 7

blood flow to extremity

Question 8

what is venous flow?

Answer 8

blood flow back to heart

Question 9

what are the common concerns?

Answer 9

• pain (arterial or venous)
• edema
• skin changes
• temperature changes
• numbness and tingling

Question 10

define atherosclerosis

Answer 10

thickening or hardening of the arteries caused by a buildup of plaque in the inner lining of an artery

Question 11

define raynauds

Answer 11

problem that causes decreased blood flow to the fingers

Question 12

define varicose veins

Answer 12

caused by increased blood pressure in the veins which enlarges them

• usually superficial ; twisted and swollen veins and backflow occurs
• Result of incompetent valves that permit the reflux of blood or an obstruction of a proximal vein

Question 13

define thrombus

Answer 13

blood clot that forms in a vein

Question 14

what is the amplitude measurement and what does each number mean?

Answer 14

• measurement of the pulses (0-4)

- 4 bounding, 3 is increased, 2=normal, 1= weak, 0 absent

Question 15

How do you check for edema in lower extremities?

Answer 15

Press on shin bone for 5 seconds

Skin usually puffy and pitted indent stays

Question 16

how do you grade edema?

Answer 16

1+ = 2mm

2+ =4mm

3+ = 6mm

4+ = 8mm

Question 17

what does bilateral edema indicate? One side?

Answer 17

• Bilateral = ride sided heart failure: backflow peripheral

- One sided only could be relate to individual limb

Question 18

What is chronic venous insufficiency?

Answer 18

• Not good enough blood back to heart; due to incompetent valves or heart disease
• Skin discolouration: pigment from breakdown of hemoglobin (pooling of blood)
• Can include venous ulcers, swelling

Question 19

What are risk factors of varicose veins?

Answer 19

• genetics
• gender
• obesity

Question 20

what is DVT?

Answer 20

• deep vein thrombosis

- occlusion of deep vein by a blood clot

Question 21

what is the concern of DVT? What should you do?

Answer 21

• may cause pulmonary embolism (PE)

- do not massage, limit activity until patient is on anticoagulant

Question 22

What is thrombophlebitis?

Answer 22

o Peripheral or local inflammation and clot due to trauma of a vein

Question 23

What are the characteristics of arterial insufficiency?

Answer 23

• diminished or absent pulses
• Shiny hairless skin
• Palor on elevation
• Recolor when dependent
• Deep muscle pain in calf aggravated by activity and elevation.

Question 24

How do you relieve arterial insufficiency?

Answer 24

Relieved with rest and dependence.

Question 25

Where do you find arterial ulcers? Characteristics?

Answer 25

usually on toes, lateral malleolus.

• Ulcer is pale, well defined edges, and no bleeding may be necrotic.

Question 26

Characteristics of venous insufficiency?

Answer 26

• temperature of skin is normal
• Edema is present accompanied by feeling of fullness
• Skin around ankle is thick with brown discoloration
• Pain increased with standing and sitting for long period.

Question 27

How do you relieve venous insufficiency?

Answer 27

• It is relieved by rest and elevation but only after several hours.

Question 28

Where do you find venous ulcers? Characteristics?

Answer 28

• medial malleolus (top of the foot- ankle)

- uneven edges and bleeding minimal pain around the ulcer. Skin surrounding the ulcer is inflamed.

Question 29

What are risk factors for DVT?

Answer 29

• Prolonged bed rest
• History of varicose veins
• Trauma
• Infection
• Cancer
• Use of oral contraceptives

Question 30

What can helps prevent DVT? and how?

Answer 30

thromboembolic stockings help maintain external pressure on muscles of lower extremities, so it helps promote venous return

Question 31

Reasons why you would not use elastic stockings, Why?

Answer 31

if any local condition affects the leg (skin lesion) but application of the stockings may compromise circulation

Question 32

How does a sequential compression device help thrombosis prevention?

Answer 32

• used to prevent blood clots in lower extremities

- decreases venous stasis by increasing venous return through the deep veins of the legs

Question 33

when should the sequential compression device be used?

Answer 33

as soon as possible and maintained until patient becomes fully ambulatory

Question 34

Why is proper positioning important to prevent thrombus?

Answer 34

to prevent pressure on the posterior knee and deep veins and prevent venous pooling

Question 35

what kind of positioning do you have to avoid to prevent thrombus?

Answer 35

Avoid crossing legs, sitting for too long, wearing clothes that constrict the legs or waist, putting pillows under knees, and massaging legs

Question 36

Why should you avoid massaging legs for patients at risk for DVT?

Answer 36

if thrombus is prevent, massaging could dislodge it and occlude blood flow elsewhere in the body

Question 37

How does ROM exercises help prevent thrombophlebitis?

Answer 37

• Reduce risk of contractures and help prevent thrombi
• Activity causes contraction of skeletal muscles, which exerts pressure on the vein to promote venous return, reducing venous stasis
• Ex. Ankle pumps, foot circles, knee flexion

Question 38

when would you hear a softer sound when using a Doppler ultrasound?

Answer 38

o Softer sound might be heard with low BP, infants, obese patients, if blood vessels are partially occluded, or if there is peripheral vascular disease

Question 39

What kind of sound would an artery make compared to a vein when using a doppler?

Answer 39

An artery: produces a higher pitch

A vein: produces a lower pitch