Peripheral/vascular Flashcards
What are the major functions of the peripheral vascular system?
- Deliver oxygen and nutrients to the body
- Tansport carbon dioxide and waste products from the tissue for excretion
- Remove pathogens by filtering the lymph
What is the peripheral vascular system composed of?
- arteries
- veins
- capillaries
- lympathics
define arteries
carry oxygen rich blood and nutrients
define veins
deliver deoxygenated blood from the periphery back to the heart
-The femoral and popliteal vein carry 90% of venous return
define capillaries
exchange nutrients and oxygen between the arterial and venous system
define lymphatics
help transport escaped fluid back into the vascular system
- Major role in immunity and defense ( spleen, thymus, Tonsils).
what is arterial flow?
blood flow to extremity
what is venous flow?
blood flow back to heart
what are the common concerns?
- pain (arterial or venous)
- edema
- skin changes
- temperature changes
- numbness and tingling
define atherosclerosis
thickening or hardening of the arteries caused by a buildup of plaque in the inner lining of an artery
define raynauds
problem that causes decreased blood flow to the fingers
define varicose veins
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
define thrombus
blood clot that forms in a vein
what is the amplitude measurement and what does each number mean?
- measurement of the pulses (0-4)
- 4 bounding, 3 is increased, 2=normal, 1= weak, 0 absent
How do you check for edema in lower extremities?
Press on shin bone for 5 seconds
Skin usually puffy and pitted indent stays
how do you grade edema?
1+ = 2mm
2+ =4mm
3+ = 6mm
4+ = 8mm
what does bilateral edema indicate? One side?
- Bilateral = ride sided heart failure: backflow peripheral
- One sided only could be relate to individual limb
What is chronic venous insufficiency?
- 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
What are risk factors of varicose veins?
- genetics
- gender
- obesity
what is DVT?
- deep vein thrombosis
- occlusion of deep vein by a blood clot
what is the concern of DVT? What should you do?
- may cause pulmonary embolism (PE)
- do not massage, limit activity until patient is on anticoagulant
What is thrombophlebitis?
o Peripheral or local inflammation and clot due to trauma of a vein
What are the characteristics of arterial insufficiency?
- diminished or absent pulses
- Shiny hairless skin
- Palor on elevation
- Recolor when dependent
- Deep muscle pain in calf aggravated by activity and elevation.
How do you relieve arterial insufficiency?
Relieved with rest and dependence.
Where do you find arterial ulcers? Characteristics?
usually on toes, lateral malleolus.
- Ulcer is pale, well defined edges, and no bleeding may be necrotic.
Characteristics of venous insufficiency?
- 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.
How do you relieve venous insufficiency?
• It is relieved by rest and elevation but only after several hours.
Where do you find venous ulcers? Characteristics?
- medial malleolus (top of the foot- ankle)
- uneven edges and bleeding minimal pain around the ulcer. Skin surrounding the ulcer is inflamed.
What are risk factors for DVT?
- Prolonged bed rest
- History of varicose veins
- Trauma
- Infection
- Cancer
- Use of oral contraceptives
What can helps prevent DVT? and how?
thromboembolic stockings help maintain external pressure on muscles of lower extremities, so it helps promote venous return
Reasons why you would not use elastic stockings, Why?
if any local condition affects the leg (skin lesion) but application of the stockings may compromise circulation
How does a sequential compression device help thrombosis prevention?
- used to prevent blood clots in lower extremities
- decreases venous stasis by increasing venous return through the deep veins of the legs
when should the sequential compression device be used?
as soon as possible and maintained until patient becomes fully ambulatory
Why is proper positioning important to prevent thrombus?
to prevent pressure on the posterior knee and deep veins and prevent venous pooling
what kind of positioning do you have to avoid to prevent thrombus?
Avoid crossing legs, sitting for too long, wearing clothes that constrict the legs or waist, putting pillows under knees, and massaging legs
Why should you avoid massaging legs for patients at risk for DVT?
if thrombus is prevent, massaging could dislodge it and occlude blood flow elsewhere in the body
How does ROM exercises help prevent thrombophlebitis?
- 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
when would you hear a softer sound when using a Doppler ultrasound?
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
What kind of sound would an artery make compared to a vein when using a doppler?
An artery: produces a higher pitch
A vein: produces a lower pitch
