Peripheral vascular

Question 1

Ulcer on the distal area of foot

Answer 1

arterial problem

Question 2

ulcer on the ankle

Answer 2

Venous problem

Question 3

gangrene

Answer 3

a lack of oxygenated blood, arterial issue

Question 4

JVD

Answer 4

jugular venous distention
poor heart function,
right side is not working well enough to keep up

Question 5

Hepatojugular reflux

Answer 5

alternate test for JVD
pressure is put on the right upper quadrant for 10 sec
would cause increase in JVP of 4cm if messuring

Question 6

JVP

Answer 6

jugular venous pressure
pt. lies back 45-30% with head to the left
measure height of flutter with respect to angle of louis

Question 7

pulsus alternans

Answer 7

variation in pulse amplitude occurring with alternate beats due to changing systolic pressure.
Most common cause is left ventricular failure

Question 8

pulsus bigeminus

Answer 8

normal pulse followed by a premature beat

due to premature ventricular contraction

Question 9

pulsus bisferiens

Answer 9

characterized by two systolic peaks of the left ventricular ejection separated by a mid systolic dip, caused by a left rapid left ventricular ejection followed by a tidal wave,
thought to be a reflected wave from the periphery

Question 10

pulsus paradoxus

Answer 10

the exaggerated drop in systemic blood pressure of greater than 10 mmHg during inspiration
most common in patients with cardiac tamponade

Question 11

pulse deficit

Answer 11

difference between auscultated pulse at the apex of the heart and the palpated pulse on the periphery

Question 12

signs of venous insufficiency

Answer 12

thrombosis, varicose veins, edema

Question 13

signs of venous obstruction

Answer 13

pain and swelling of ankle
homan’s sign: calf pain with dorsiflexion
DVT can lead to pulmonary embolism
unilateral pitting edema

Question 14

signs of arterial obstruction

Answer 14

allen test, unilateral pulse

pain, numbness, giggling, weakness, poor capillary/arterial vein refill

Question 15

dependent edema

Answer 15

right sided heart failure leads to increase fluid volume,
increase hydrostatic pressure in the vascular space
= edema in dependent parts of the body

Question 16

pitting edema

Answer 16

unilateral, think occlusion of major vein

bilateral, think CHF

Question 17

claudication

Answer 17

first sign of peripheral arterial disease
muscle fatigue, pain a dull ache
sustained during exercise, usually goes away quickly after rest

Question 18

capillary refill

Answer 18

refill time should be less than 2 seconds if vascular system is intact

Question 19

pulse on the foot

Answer 19

dorsalis pedis

Question 20

pulse on the ankle

Answer 20

posterior tibialis

Question 21

pulse behind the knee

Answer 21

popliteal

Question 22

pulse scale

Answer 22

0-4+; 2+ normal