Peripheral Vascular Flashcards
Epitrochlear lymph nodes
Medial arm
3cm above elbow
Drain into axillary nodes
Name two groups of superficial inguinal lymph nodes
Horizontal and vertical
Horizontal inguinal lymph nodes
In upper anterior thigh
Under inguinal ligament
Drains lower abdomen and pelvic area
Vertical inguinal node
Near upper part of sephenous vein
Drains local leg
Intermittent claudication
Pained during exertion
Relieved within 10 min of resting
Atherosclerosis
Differentiate from spinal stenosis
Ischemia of aortolliac artery
Hip/butt pain
Ischemia of pudendal artery
Erectile dysfunction
Femoral/aortolliac ischemia
Thigh pain
Ischemia of popliteal artery
Low calf pain
Ischemia of tibial/paroneal artery
Foot pain
General symptoms of peripheral ischemia
Fatigue, aching, numbness, non healing wounds, pain that that changes with position
Food fear and weight loss suggest:
Intestinal ischemia of celiac or superior or inferior arteries
Screening for abdominal aortic aneurysm suggestion:
Men 65-75 who have ever been smokers
Causes of asymmetric arm BP
Coarctation of the aorta
Dissecting aortic aneurysm
Causes of arm lymph edema
Axillary node dissection
Radiation
Four grades of pulse are
3+ Bounding
2+ brisk
1+ diminished
0 Absent
Causes of asymmetric DIMINISHED pulse
Arterial occlusion from
Arthersclorosis
Embolism
Femoral/popliteal aneurysm description
Big wide pulse
Usually caused by atherosclerosis
Femoral/popliteal aneurysm demographics
Uncommon.
Men
Over 50
Decreased pedal pulse when others are normal
Occlusion of lower popliteal artery
Or diabetes mellitus
Symptoms of deep iliofemoral thrombosis
Painful swollen leg
Tenderness over femoral vein
What are the two groups of veins in the leg?
The deep (well supported) and superficial (sephenous)
Symptoms of DVT of calfs
Possible nonspecific calf pain
Only half of patients experience pain
Signs of superficial thrombosis
Local swelling
Redness
Warmth
Subcutaneous cord
Signs of chronic venous insufficiency
Brown above malleolous
Ulcers above the malleolous
Causes of brawny thickened skin
Lymphedema
Chronic venous insufficiency
Causes of absent or diminished wrist pulse
Acute emboli occlusion
Burgers disease
Thromboangitis obliterans
(Use Allen’s test)
Reynauds disease
Episodic spasm of small arteries and arterioles
No occlusion
Sudden onset
Brief
Chronic arteriole insufficiency
Intermittent pain, even at rest Tissue ischemia Decreased or absent pulse Thick nails and toe ulcers Cool
Chronic venous insufficiency
Consistent pain Venous hypertension Cyanotic or petechia Brown patches Ankle ulcers
Chronic venous insufficiency ulcers
Malleoli
Small granulations
Irregular borders
Arterial insufficiency ulcers
Feet/toes
Neuropathic ulcers
Pressure points
Diabetes and neuro diseases
Hansen disease
No pain
