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Physical Assessment 2 > PV System > Flashcards

PV System Flashcards

1
Q

Celiac trunk?

A

Foregut: Esophagus, stomach, liver, gallbladder, spleen

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2
Q

Superior Mesenteric Artery?

A

Midgut: Small intestine, jejunum, ileum, cecum, large intestine (ascending/transverse colon)

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3
Q

Inferior Mesenteric Artery?

A

Hindgut: Large intestine (descending, sigmoid colon), proximal rectum

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4
Q

What is the only pulsation palpable in the abdomen?

A

Aorta pulsation

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5
Q

Femoral artery?

A

Right below inguinal ligament.

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6
Q

Popliteal artery?

A

Passes medially behind femur and behind knee.

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7
Q

Dorsalis Pedis Artery?

A

Dorsum of foot just lateral to extensor tendon of big toe.

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8
Q

Posterior Tibial Artery?

A

Lies behind medial malleolus.

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9
Q

Veins?

A

Thin walled, highly distensible.
Veins from arms, upper trunk, head, and neck drain to SVC–> R. atrium.
Veins from abdominal varices, lower trunk, and legs drain to IVC.
Exception is liver as circulation is through portal vein.

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10
Q

What are veins susceptible to due to weaker walls?

A

Irregular dilation, compression, and ulceration.

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11
Q

Great saphenous vein?

A

Up medial aspect of leg.

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12
Q

Small saphenous vein?

A

Passes upward along posterior calf to popliteal fossa.

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13
Q

What carries 90% of the venous return from lower extremities?

A

Deep veins of the legs.

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14
Q

What is the lymphatic system?

A

Extensive vascular network that drains lymph from body tissues and returns it to venous circulation. Moves lymph from tissues to the blood stream.

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15
Q

What is a lymph?

A

Clear/white fluid that carries WBC’s (lymphocytes).

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16
Q

What are lymph nodes?

A

Round, oval, or bean-shaped structures.

Vary in size according to location.

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17
Q

What is the important role of lymphatic system in body’s immune system?

A

Cells in lymph nodes engulf cellular debris/bacteria and produce antibodies.

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18
Q

Lymph nodes that are matted, firm, rubbery, progressively getting bigger?

A

Malignancy.

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19
Q

What are shotty lymph nodes?

A

Small nontender nodes that feel like BBs or buckshot under the skin.

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20
Q

What are fluctuant lymph nodes?

A

Wavelike motion that is felt when the node is palpated.

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21
Q

What are matted lymph nodes?

A

Group of nodes that feel connected and seem to move as a unit.

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22
Q

Pt w/ cold, numbness, pallor in the legs, hair loss at anterior tibial surfaces?

A

PAD

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23
Q

Pt w/ swelling in calves, legs and feet?

A

CHF/DVT

24
Q

Pt w/ color change in fingertips/toes in cold weather?

A

Raynold’s

25
Q

Pt w/ swelling w/ redness/tenderness?

A

cellulitis

26
Q

Pt w/ intermittent claudication?

A

PAD

27
Q

What is intermittent claudication?

A

Any pain or cramping in the leg during exertion that is relieved by rest within 10 minutes. (Only 10% of patients have classic presentation. 30-50% have atypical leg pain, and up to 60% may be asymptomatic.)

28
Q

What is atherosclerotic PAD?

A

Symptomatic limb ischemia with exertion.

29
Q

What is neurogenic claudication?

A

Pain with walking/prolonged standing radiating from the spinal area into buttocks and down leg to feet.

30
Q

If pain with walking/prolonged standing radiating from the spinal area into buttocks and down leg to feet is relieved by sitting or bending forward?

A

Spinal stenosis

31
Q

Red flags of PAD?

A

Fatigue, aching, numbness or pain that limits walking or leg exertion. Ask about erectile dysfunction.
Poorly healing/non-healing wound lower extremities.
First degree relative with AAA.

32
Q

Peripheral Venous Disease (chronic venous insufficiency)?

A

AKA Venous Thromboembolism.
Painful.
Mechanism: Venous HTN.
Pulses: Nml but hard too eel thru edema.
Color: Nml or cyanotic on dependency. Petechiae and then brown pigmentation appear w/ chronicity.
Temp: Nml.
Edema: Present, often marked.
Skin changes: Often brown pigmentation around ankle, stasis dermatitis, and possible thickening of the skin and narrowing of the leg as scarring develops.
Ulceration: At sides of ankles medially.
No gangrene.

33
Q

UE DVT MC from?

A

Catheter associated thrombosis (Central venous catheter).

34
Q

PAD (chronic arterial insufficiency)?

A

Pain: Int claudication, progressing to pain at rest.
Mechanism: Tissue Ischemia
Pulses: Decreased or absent.
Color: Pale, especially on elevation, dusky red on dependency.
Temp: Cool
Edema: Absent or mild; may develop as pt tries to relieve rest pain by lowering leg.
Skin changes: Thin, shiny, atrophic skin. Loss of hair over foot and toes; nails thickened and rigid.
Ulceration: Involves toes or points of trauma on feet.
Gangrene: Maybe.

35
Q

3+ bounding of arterial pulses?

A

Aortic regurgitation.

36
Q

2+ brisk, expected arterial pulses?

A

NML

37
Q

Enlarged epitrochlear node?

A

Local/distant infx. Assx w/ lymphadenopathy from lymphoma or HIV.

38
Q

What does spasm of distal arteries cause?

A

Episodes of sharply demarcated pallor of the fingers (cold air).

39
Q

1+ pitting edema?

A

Slight pitting, no visible distortion, disappears rapidly

40
Q

2+ pitting edema?

A

Deeper than 1+ and disappears in 10-15 sec.

41
Q

3+ pitting edema?

A

Noticeably deep and may last >1 min, with dependent extremity full and swollen.

42
Q

4+ pitting edema?

A

Very deep and lasts 2-5 min, with grossly distorted dependent extremity.

43
Q

When is Allen Test done?

A

Prior to arterial blood gas (ABG).

44
Q

Pt w/ asymmetric blood pressures?

A

Coarctation of the aorta and dissecting aortic aneurysm.

45
Q

Pt w/ local swelling, redness, warmth, and a subcutaneous cord?

A

superficial thrombophlebitis, (or DVT deeper)

46
Q

Pt w/ marked pallor on elevation?

A

Arterial insufficiency.

47
Q

Pt w/ pitting edema?

A

Prolonged standing (inc. hydrostatic pressure in veins), cardiac issues (CHF).

48
Q

Test to assess retrograde filling and evaluate competency of venous valves?

A

Trendelenburg test

49
Q

Swelling to back of leg?

A

Baker’s Cyst

50
Q

Baker’s Cyst eval?

A

Assx w/ osteoarthritis. US and usually incidental finding. Fluid filled, benign, but can rupture and cause damage. If painful removed.

51
Q

DVT?

A 
Blood clot (thrombus) that forms in deep vein. If a piece breaks off and travels: embolism
PE findings: redness, swelling, warmth, palpable cord.
52
Q

Homan’s Sign?

A

Calf pain on dorsiflexion of the foot (not a great test: “discredited by Homan himself”?).

53
Q

Reliable way to confirm DVT?

A

Measuring calf circumference.

54
Q

Lymphedema?

A

Edema initially soft then hard. Skin thickened. Usually bilaterally in feet/toes.
Can occur after axillary node dissection and/or radiation.
?? No BP on arm same side mastectomy/axillary node dissection and/or radiation.

55
Q

Lymphangitis?

A 
Acute infection (usually staph/strep), spreading from distal portal of entry up lymphatic channels. 
Also referred to as “ streaking”.

Physical Assessment 2 (4 decks)

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