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PD Block 2 > Peripheral vascular exam > Flashcards

Peripheral vascular exam Flashcards

1
Q

JVD

A

Jugular venous distention. External jugular vein. The pressure built up in the jugular vein due to RT atrial problem

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2
Q

JVP

A

Jugular venous pressure. Internal jugular vein. Estimates Right atrial pressure

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3
Q

How do you test for JVP

A

lie pt at 30 degree. turn head to left, look for venous fluttering. measure from the sternal angle to top of venous fluttering

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4
Q

Measurement interpretation of JVP

A

Rt atrium is ~5cm deep to sternum. A total of 9+cms (5cm +external measurement) is indicative of increased CVP.

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5
Q

Hepatojugular reflux

A

exaggerated when RT heart failure present

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6
Q

How do you do hepatojugular reflux

A
  1. Use hand to apply pressure to and (mid epigastric region)
  2. Pt breathes normally
  3. Check neck for increase in JVP with pressure and decrease without pressure
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7
Q

If no change in JVP during hepatojugular reflux, what is indicated

A

pressure is either higher or lower

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8
Q

Artery structure

A

Thick, muscular, high pressure

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9
Q

Vein structure

A

Thin walls, accommodates a lot of blood, stretches, low pressure

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10
Q

What things would indicate poor blood flow in extremities

A
  1. Loss of hair at certain level on legs
  2. Brown, red, pale skin
  3. Ulcers, gangrene
  4. Edema
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11
Q

Brown staining around ankles indicates

A

Venous return problem

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12
Q

What is rubor mostly associated with

A

Arterial problems

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13
Q

Ulcers on the toes

A

arterial problem

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14
Q

Ulcers on the ankles

A

Venous problem

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15
Q

Edema is indicative of

A

venous return problems, and RT sided heart failure. This causes a traffic jam of venous return, which induces swelling

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16
Q

If both legs have edema

A

systemic problem

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17
Q

If one leg has edema

A

local problem

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18
Q

Pitting edema

A

collection of fluid in lower limbs (dependent) measured 1-4

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19
Q

Non-pitting edema

A

aka brawny edema. Pt has had edema for so long that the fluid becomes scarred and hard. Does not push out of the way

20
Q

Orthostatic edema

A

usually occurs from sitting too long, pitting, always both legs

21
Q

Lymphedema

A

Lymphatic obstruction, common in breast CA (no pitting)

22
Q

Lipedema

A

Fat deposits. No edema in foot and no pitting

23
Q

Chronic venous insufficiency

A

Chronic venous stasis, leg injury, phlebitis. Pitting and ulcerations seen

24
Q

Variables affecting amplitude of arterial pulse

A
  1. SV
  2. Aorta stretchibility
  3. Obstruction/peripheral resistance
  4. Viscosity of blood
25
Q

Which arteries to you auscultate for bruits

A

Aorta, carotids, renal, iliac, femoral

26
Q

Pulsus alternans

A

Alternating strong and weak beats. Lt ventricular systolic problem

27
Q

Pulsus bigeminus

A

Two heartbeats close together followed by a longer pause. 2nd pulse weaker. Hypertrophic obstructive disease

28
Q

Pulsus bisferiens

A

Double peaked pulse (striking twice) aortic insufficiency

29
Q

Pulse deficit

A

Difference between apical pulse and palpable (radial pulse) seen in atrial fibrillation

30
Q

Venous insufficiency

A

Flow of blood through veins is impaired often times because of insufficient valve closure (chronic)

31
Q

Causes of venous insufficiency

A

Varicose veins or poor function of the venous valves. Get chronic venous stasis

32
Q

Signs of venous insufficiency

A

brown color on ankle ulcerations, brawny ankle

33
Q

Venous obstruction

A

poor venous return due to clot or DVT

34
Q

Signs of venous obstruction

A

swelling, pain in one leg, PE,

35
Q

Arterial insufficiency

A

Poor blood flow to the extremities

36
Q

Causes of arterial insufficiency

A

obstruction, plaque, trauma

37
Q

Signs of chronic arterial insufficiency

A

Claudication, pain, diminished pulses, pallor, rubor, ulcers on toes, gangrene

38
Q

Arterial obstruction

A

Lack of blood flow due to clot or stenosis

39
Q

Signs of arterial obstruction

A

Pain, numbness, tingling, pale, mottled, pulses absent

40
Q

Varicosities

A

Dilated, tortuous veins (saphenous)

41
Q

Signs of varicosities

A

dull, aching pain, heaviness. Exacerbated by pregnancy and obesity

42
Q

Claudication

A

Intermittent pain and cramping in leg due to arterial obstruction

43
Q

Test for possible DVT in calf

A

Homans sign

44
Q

Allen test

A

Checks collateral arterial circulation in hand

45
Q

How do you test for chronic arterial insufficiency

A

Raise both legs 60 degrees, if pale on elevation, positive test. THEN have pt dangle feet, it it takes longer than 10 seconds

PD Block 2 (6 decks)

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