Peripheral Vascular System and Lymphatics

Question 1

What are the 2 main factors of blood flow?

Answer 1

1. Pressure differences- BP, venous return
2. vascular resistance- friction between blood and vessel walls

Question 2

What are arterioles?

Answer 2

They regulate resistance.

Question 3

What are arteries?

Answer 3

Deliver oxygenated blood. They run deeper than veins. They stretch and contract with systole/diastole to generate our pulse. High P system and their walls are strong/fibrous.

Question 4

What are the artery sites?

Answer 4

Carotid (neck), temporal, brachial, ulnar, radial, femoral, popliteal (behind knee), posterior tibial (by ankle), and dorsalis pedis (on top of foot).

Question 5

What are capillaries?

Answer 5

Exchange work of cardiovascular system. They filter blood and bring oxygen/ntrients to cells in exchange for CO2 and waste. Smallest blood vessel. Exchange vessels by diffusion, transcystosis, and bulk flow.

Question 6

What are veins?

Answer 6

Return deoxygenated blood and act as reservoir. Blood can pool in these and veins stretch and cause edema. Have valves and don’t have high blood pressure. Have thinner walls.

Question 7

What are the 3 types of veins?

Answer 7

Deep- conduct most venous return
Superficial- great and small saphenous veins
Perforator- have 1 way valves, connecting veins that join two sets of

Question 8

What are the major veins?

Answer 8

Major deep veins: Brachiocephalic, brachial, radial/ulnar, internal jugular (external is superficial), iliac, femoral, popliteal, great/small saphenous (superficial).

Question 9

How do veins keep blood moving?

Answer 9

By intraluminal valves to ensure unidirectional flow, contracting skeletal muscles move blood proximally back to heart, calf muscles help return blood to heart (milks it back). Respiratory pressure changes help move blood back up into heart (increased abdominal pressure and decreased thoracic pressure).

Question 10

What is blood flow through vessels?

Answer 10

Arteries to arterioles to capillaries to venule to veins.

Question 11

What are lymph vessels?

Answer 11

Have valves to support unidirectional flow, single ended capillaries/trunks/nodes/vessels. All drain into right lymphatic duct or thoracic duct. Lymph help return 15% of excess (interstitial) fluid to bloodstream and help us fight infection and absorb fat from our gut.

Question 12

What are lymph nodes?

Answer 12

Lymphatic tissue at intervals along vessels that filter fluid before it returns to blood. Cervical (drain head or neck), axillary (drain breast and upper arm), epitrochlear (drain head and lower arm), and inguinal (drain lower extremity).

Question 13

Where does the thoracic duct and right lymphatic duct empty into?

Answer 13

RLD- empties into R subclavian vein and drain right side of body from waist up
TD- drains rest of body/lower extremities

Question 14

What do the spleen, tonsils, and thymus gland do?

Answer 14

Spleen- destroys old RBC, produce antibodies, store RBC, filter micro-organisms from blood

Tonsils- respond to local inflammation, have immune response to some ingested/inhaled stuff

Thymus gland- large in fetus/kids until after puberty, develops T lymphocytes

Question 15

What is arteriosclerosis and atherosclerosis?

Answer 15

Arteriosclerosis- blood vessels grow rigid/hard, happens with age and cause increased BP

Atherosclerosis- deposition of fatty plaques and hardening of blood vessels

Question 16

Subjective data for lymph/PVS?

Answer 16

Leg pain/cramps, skin changes on arms/legs, swelling in arms/legs, lymph node enlargement, or medications.

Question 17

What is normal capillary refill time?

Answer 17

Between 1-2 seconds.

Question 18

What is normal for calf measurement?

Answer 18

Width less than 1. Anything greater than that is abnormal.

Question 19

What is the scale for pre tibial edema?

Answer 19

1+ mild (slight indent), 2+ moderate (indentation subsides), 3+ deep (indent remains for short time, leg swollen), 4+ very deep (ident lasts long time, swelling).

Question 20

What is raynaud’s disease?

Answer 20

Arteries to hands spasm and cut off blood supply. Tri colour change is expected (red, pallor, cyanosis). If it’s long term then we become worried.

Question 21

What is an ischemic and venous stasis ulcer?

Answer 21

IU- is an arterial ulcer that has lack of blood flow, round/clean borders, not leaky/bleeding

VSU- because of venous problems, lower leg swollen, rough/uneven edges, bleeding

Question 22

What are varicose veins?

Answer 22

Swollen veins that lie under skin usually in legs. Caused by incompetent valves and blood will pool in veins.

Question 23

What is PAD and DVT?

Answer 23

PAD- Weakening in vessel wall and blood vessel is prone to rupture (aneurysm), cause caludication pain, occlusions

DVT- red, swollen, warm, pain, tender are symptoms

Question 24

What is caludication?

Answer 24

Muscle pain due to lack of oxygen. Triggered by activity (walking) and relieved by rest.

Question 25

What is virchows triad?

Answer 25

3 factors that contribute to venous thrombus formation. Loose integrity of vessel wall, alterations in blood flow, and alteration in blood constituents.

Question 26

What is orthostatic hypotension?

Answer 26

Drop in BP, dizzy/light headed/nausea/faint when patient changes from sitting to standing.

Question 27

How to prevent venous stasis?

Answer 27

Make sure pt. is moving to keep blood moving, assess circulation at toes.
ICP- air pumped to sleeves on legs. allow room for 2 fingers. will compress and decompress legs to encourage blood flow.
Elastic stockings- measure in am before getting out of bed, turn sock inside out to apply, no folds/creases, 2 fingers below knee and 2 fingers above toes

Question 28

Is the lymphatic system more active in kids?

Answer 28

Yes, Should be able to feel palpable lymph nodes.

Question 29

Purpose of TED stockings?

Answer 29

To apply pressure and improve circulation. Also keep skin warm and dry.