The extremities

Question 1

how can the endocrine system refer to the extremities

Answer 1

• thyroid and reproductive indirectly into extremities

Question 2

pulmonary system refer to extremities

Answer 2

• Pancoast tumor

- indirectly into the UE

Question 3

integumentary system refer to extremities

Answer 3

• burns
• rashes
• wounds

Question 4

immunologic system refer to extremities

Answer 4

• directly can refer to extremities

Question 5

cardiovascular system refer to extremities

Answer 5

• can refer directly into extremities

Question 6

hepatic system refer to extremities

Answer 6

• liver : into shoulder

- indirectly into extremities

Question 7

urogenital system into LE

Answer 7

• into gluteal region

- indirectly into legs

Question 8

gastrointestinal system refer into extrmeities

Answer 8

• into gluteal region and hip

- indirectly into leg

Question 9

metabolic syndrome

Answer 9

• name for a group of risk factors that raises your risk for heart disease and other health problems, such as diabetes and stroke
• the term “metabolic” refers to the biochemical processes involved in the body’s normal functioning

Question 10

risk factors for metabolic syndrome

Answer 10

• heart disease
• lipid problems
• hypertension
• type 2 diabetes
• dementia
• cancer
• polysystic ovarian syndrome
• non-alcoholic fatty liver disease

Question 11

Peripheral vascular disease

Answer 11

• PVD refers to any disease of the circulatory system outside of the brain and heart. occlusive disease of the arteries of the LE
• often used as a synonym for peripheral artery disease (PAD). PAD is a form of PVD

Question 12

Pathophysiology of PVD

Answer 12

• arterial narrowing –> decreased blood flow = Pain
• pain results from an imbalance between supply and demand of blood flow that fails to satisfy ongoing metabolic requirements

Question 13

risk factors of PVD

Answer 13

• diabetes
• male
• smoking
• family hx
• > 50 yr
• obesity
• sedentary
• HTN or high cholesterol

** Combination of diabetes and smoking almost always results in more severe disease

Question 14

atherosclerosis

Answer 14

• most common cause of PVD
• occurs when fatty material builds up inside the arteries and mixes with calcium, scar tissue and other substances
• mixture hardens slightly , forming plaques

Question 15

symptoms of PVD

Answer 15

• dull and cramping pain
• heaviness
• night pain
• buttock pain
• numbness, tingling or weakness in the legs
• burning or aching pain in the feet or toes while resting
• a sore on a leg or a foot that will not heal
• one or both legs or feet tingling cold or changing color
• loss of hair on the legs
• impotence

Question 16

allen test

Answer 16

• ask the patient to make a tight fist with one hand then compress both radial and ulnar arteries firmly between your thumbs and fingers
• ask the patient to open the hand into a relaxed position, the hand should be pale
• release your pressure over the ulnar artery
• if the ulnar artery is patent, the palm will flush in within 3-5 seconds
• patency of the radial artery can be tested by releasing the radial artery while the ulnar artery is still compressed

Question 17

capillary refill

Answer 17

• capillary refill time

- normal = <2 seconds

Question 18

Wells CPR for DVT

Answer 18

• active cancer
• paralysis, paresis or recent plaster immobilization of the LE
• recently bedridden for 3 days or more, or major surgery within the previous 12 weeks requiring anesthesia
• localized tenderness along the distribution of the deep venous system
• entire leg swelling
• calf swelling at least 3cm larger than asymptomatic leg (measure 10 cm below tibial tub)
• piting edema
• collateral superficial veins
• previous DVT
• subtract 2 if there is an alternative diagnosis at least as likely as a DVT

Question 19

Wells scoring for DVT

Answer 19

• high probability if score > 3
• moderate if score is 1-2
• low if score is 0

Question 20

Hodgkin’s disease/ lymphoma

Answer 20

• type of cancer of the lymphatic system.
• it can start almost anywhere in the body.
• it is believed to be caused by HIV, Epstein-barr syndrome, age and family history

Question 21

non- Hodgkin’s lymphoma

Answer 21

• usually malignant cancer

- it is caused by the body producing too many abnormal white blood cells. it is not the same as Hodgkin’s disease

Question 22

lymphadenitis

Answer 22

• infection of the lymph nodes usually caused by a virus, bacteria or fungi.
• symptoms include redness or swelling around the lymph node

Question 23

lymphangitis

Answer 23

• inflammation of the lymph vessels.

- symptoms usually include swelling, redness, warmth, pain or red streaking around the affected area

Question 24

lymphocytosis

Answer 24

• a high lymphocyte count
• it can be caused by an infection, blood cancer, lymphoma, or autoimmune disorders that are accompanied by chronic swelling

Question 25

Lymphedema

Answer 25

• swelling that generally occurs in one of your arms or legs… sometimes both arms or both legs swell
• most commonly caused by the removal of or damage to your lymph nodes as a part of cancer treatment
• —blockage prevents lymph fluid from draining well, and the fluid buildup leads to swelling
• can also be caused by surgery or trauma

Question 26

lymphedema symptoms

Answer 26

• swelling of part or all of your arm or leg, including fingers or toes
• a feeling of heaviness or tightness
• restricted range of motion
• aching or discomfort
• recurring infections
• hardening and thickening of skin