PVD Flashcards
The peripheral vascular system is composed of what?
- arteries
- Veins
- Capillaries
- Lymphatics
What is the fxn of arteries?
receive O2-rich blood from the heart and carry it to the organs tissues of the body
What causes the arteries to expand and contract?
pulses which is created by ventricular systole
What are locations to assess to pulse?
- carotid
- brachial
- ulnar
- rad
- popliteal
- femoral
- posterior tibial
- dorsalis pedis
What is the fxn of the veins?
deliver de-O2 blood from the body periphery back to the heart
What are some difference between veins and arteries?
veins have valves, thinner walls, and a larger diameter than arteries
What occurs if there a problem with the lumen or valves of the leg veins?
stasis or pooling of blood in the veins of the lower extremities
What is the fxn of the capillaries?
gas and nutrient exchange between arterial and venous systems
List the lymphoid organs
- tonsils
- spleen
- thymus gland
- appendix
Where does the right lymphatic duct and thoracic duct collect lymph from?
the R lymphatic duct collects lymph from the R upper extremity and the thoracic duct collects lymph from the remaining part of the body
What are the 3 main fxns of the Peripheral vascular system?
- delivering oxygen and nutrients to tissues of the body
- transporting CO2 and other waste products from the tissues for excretion
- removing pathogens from the body fluid by filtering lymph
When should you take the BP of an infant less than 1?
if the infant is lethargic and tires easily during feeding or if the skin becomes cyanotic while crying
How should you take the bp of an infant less than 1 if you need to?
use the Doppler flowmeter
In younger children where should you place the BP cuff?
on the thigh to rule out a significant diff between upper and lower extremity pressures
How does aging affect the peripheral vascular system?
- arteriosclerosis or calcification of the walls of the blood vessels
- arterial walls lose elasticity and become more rigid
What is lymphedema?
unilateral swelling associated w/ an obstruction in lymph nodes
What is DVT?
occlusion of a deep vein by a thrombus
What is the biggest concern when a pt has DVT?
the thrombus becoming an embolus and traveling to the lungs resulting in a PE
What is arteriovenous fistula (AV fistula)?
an abnormal connection between an artery and vein
When is AV fistula surgically formed?
for a pt who has kidney dialysis to prevent the pt to being stuck every time they go to dialysis also allow easy access to the site
Derrick comes into the clinic with unilateral edema in L leg, low-grade fever, and tachycardia. He is c/o of increased pain with sharp dorsiflexion and pain in his calf. What do you know his Si/Sx are associated w/?
DVT
Hazel comes into the clinic with limited range of motion in her R arm, edema in her R arm, R arm skin is thick and hard. She is c/o of discomfort and sensation of heaviness or tightness in the R arm. When you inspect you notice her R arm is significantly swelled compared to the L arm. What do you think is going on?
lympedema
Raynaud’s Disease
a condition in which the arterioles in the fingers develop spasms, causing intermittent skin pallor or cyanosis and then rubor.
Heather calls c/o of aching, burning, heaviness, and tiredness in her L left. Her left leg is also very itchy. She says she is a cashier. You tell her to come into the clinic what do you expect to see? What are her Si/Sx associated w/?
I would expect to see the following in varicose veins
- distended, twisted veins near the sin surface
- edema in feet or ankles
- skin changes (discoloration, dryness, scaling)
- skin ulceration
- bleeding after minor trauma
Kelly has a BP of 124/80 while laying when she stands her BP is 90/50. She says this happens at home and she feels dizzy and her vision blurs. She feels weakness and this causes her to get headache and experience nausea. What do you recognize this to be?
orthostatic hypotension
You are assessing Jared who was stabbed and showing Si of cyanosis, his BP is 100/60, clubbed fingers, bulging vein, and when you auscultated his chest you heard a machinery murmur. He is c/o of fatigue, difficulty breathing, dizziness, and lightheadness. What do you recognize this to be?
AV fistula
What are the obj. and sub. findings in Raynaud’s Disease?
Obj: 1. skin pallor 2. cyanosis 3. swelling of affected digits or areas Subj: 1. Bilateral spasms lasting mins- hrs 2. Numbness or pain during pallor or cyanotic state 3. Burning or throbbing pain during the rubor
What are varicose veins?
veins that have become dilated and have diminished rate of blood flow and increased intravenous pressure
A bulging or dilation caused by a weakness in the wall of an artery?
Arterial aneurysms
Sometimes an arterial aneurysm cane be detected by a characteristic what over the artery?
bruit
Why wouldn’t you hear a bruit over an arterial aneurysm?
if they are located in the abdomen they can be difficult to discover
David has thickening and brown discoloration of skin around his ankles, his skin temp is normal with edema. He says that is is very uncomfortable but is okay when he rest, he feels as though his legs are full. What are these SI/SX associated w/?
venous insufficiency
Diana has diminished pedal pulses, cool, shiny skin, pallor on lower extremities when elevated and became rubor earlier that morning. During the shift report the nurse told you she has been c/o of pain like burning, and she sometimes can’t feel her legs or feet. Her sister brought her in after their hike at Temescal Canyon. What is this consistent w/?
arterial insufficiency
Inadequate circulation in the arterial system usually due to the buildup of fatty plaque or calcification of the arterial wall
arterial insufficiency
Inadequate circulation in the venous system usually due to incompetent valves in deep veins or a blood clot in the veins
Venous insufficiency
What may leg ulcers indicate?
chronic or arterial or venous problems
What is the result of nicotine in PVD?
vasoconstrictor and aggravates PVD
What role do oral contraceptives have on PVD?
Bloof clots
What is the physical assessment steps used for PVD?
- Inspection
- Palpation
- Auscultation
- Assessment of BP
What are 2 conditions you know that cause bruit?
- hyperthryroidism
2. anemia
What are some reasons a persons may have a capillary refill at 5 sec?
- decrease CO
- constriction of the peripheral vessels
- cigarette smoking
- anemia
- cold temp
What is the reason you would use the Doppler flowmeter?
if any pulses are difficult to palpate
What is the purpose of Allen’s test?
determine the patency of the radial and ulnar arteries
Lisa has an unequal size of the legs, you the Dr. what do you expect her to say is the medical Dx possibility?
blood clot in the deep vessels of the leg
What is the purpose of the manual compression test?
determine the length of the varicose vein and the competency of its valves
What is the purpose of the Homans’ sign?
to determine if the pt feels pain when pressure is exerted on the posterior tibial vein; test may be inconsistent
If a pt has a positive Homans’ sign what does this mean?
this indicate a blood clot in one of the deep veins in the leg, inflammation of one of the superficial leg veins or leg tendon
