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NURS 203 > Unit 3 - Peripheral Vascular and Lymphatic System > Flashcards

Unit 3 - Peripheral Vascular and Lymphatic System Flashcards

1
Q

In what area of the body does the blood turn from oxygenated to deoxygenated?

A

In the capillaries

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2
Q

What is the order of blood flow?

A

Heart –> Aorta –> Arteries –> Arterioles
Capillaries
Venules –> Veins –> Vena Cava –> Heart

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3
Q

What are two factors that affect blood flow?

A
  1. Pressure
    - BP Hight to low pressure
    - Venous return
  2. Vascular Resistance
    - Friction, between blood and vessel walls
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4
Q

What has a high muscular-elastic layer that has high compliance to stretch and contract with systole and diastole to generate pulse?

A

Arteries

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5
Q

True or False

Arteries typically run deeper than veins.

A

True

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6
Q

True or False

Atrial blood loss is not as detrimental as a venous blood loss.

A

False.

Atrial blood loss with pulse is much more detrimental to ones health.

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7
Q

What are the main pulse sites that are located on the upper portion of the body? (Waist up)

A 
Temporal
Carotid 
Brachial
Ulnar
Radial
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8
Q

What are the pulse sites that are found from the waist down?

A

Femoral
Popliteal
Posterior tibial
Dorsalis pedis

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9
Q

How much blood can the capillaries filter a day?

A

Up to 20L/ day

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10
Q

True or false

Capillaries are large blood vessels

A

False

Capillaries are the smallest blood vessels

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11
Q

Explain how the capillaries are exchange vessels?

3 ways

A

Simple diffusion - High to low concentration
Transcytosis - vesicle around substance like insulin
Bulk flow 85% of blood (excess 15% filtered to lymphatic system)

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12
Q

What area of blood flow exchange nutrients, remove waste and excess fluids?

A

Capillaries

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13
Q

True or false

There are more arteries then veins

A

False

Veins are far more numerous than arteries

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14
Q

There are two types of veins, what are they called?

A

Deep and Superficial

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15
Q

What is a superficial vein?

A

Superficial vein is a vein that is close to the surface of the body.

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16
Q

What veins are paired with arteries?

a) superficial
b) deep

A

B

Superficial veins are not paired with an artery, unlike the deep veins, which typically have an artery with the same name close by.

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17
Q

What are the major deep veins located in the head and arms?

A

Brachiocephalic
Internal Jugular
Brachial
Radial + Ulnar

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18
Q

What are the major deep veins located in the legs?

A

Iliac
Femoral
Popliteal
Tibial veins

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19
Q

Is the great/small saphenous veins considered deep or superficial?

A

Superficial

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20
Q

What vein is used for long term IV use and for grafts?

A

Great/Small Saphenous vein

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21
Q

What is known for a back up to the venous system?

A

Lymph System

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22
Q

What does the lymph produce and carry thorough the body?

A

It produced and carries white blood cells throughout the body (15% of the fluid)

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23
Q

What are the two lymphatic ducts?

A

Thoracic duct

Right Lymphatic duct

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24
Q

About 80% of the lymph system is returned into which duct?

A

Thoracic duct

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25
Q

What duct receive lymph from the right arm and right side of the head?

A

Right lymphatic duct

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26
Q

Where can you palpate nodes in the body?

A

Cervical
Axillary
Epitrochlear
Inguinal

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27
Q

What organs are essential to our immunity?

A

Spleen
Tonsils
Thymus Gland (Until puberty)

*Note - Not an organ, but bone marrow also contributes

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28
Q

What are 3 main functions of the lymphatics system?

A
  1. To drain excess interstitial fluid
    - Assist in venous system
  2. Act in immune response
    - Lymph nodes filter micro-organisms
    - Lymphocytes (WBC)
  3. Absorb fat from the gut
    - Dietary lipids and fat-soluble vitamins
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29
Q

What is Claudication?

A

A condition in which cramping pain in the leg is induced by exercise, typically caused by obstruction of the arteries.

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30
Q

If someone is experiencing “achey” lower leg and foot pain, are we expecting it to be venous or arterial?

A

Venous - hard time getting blood back up which will cause the achey feeling. What

31
Q

If someone is experiencing cold feet, is this an venous or arterial problem?

A

Arterial - oxygenated blood is not reaching the feet.

32
Q

What are we looking for when we are inspecting the arms during the PVS system?

A

Skin colour, temperature, clubbing, cap refill, edema

33
Q

What is a suggested way to palpate when assessing a patients epitrochlear lymph nodes?

A

Hand shake

34
Q

Why are we measuring BOTH calfs in our patients?

A

If unsymmetrical, we suspect a DVT.

35
Q

What is a DVT?

A

Deep Vein Thrombosis

36
Q

How long should you press when assessing for pitting edema?

A

5 seconds

37
Q

What disease causes the hands to spasm and discolour due to a cut off of blood supply?

A

Raynaud’s disease/ Phenomenon

38
Q

Will you see pitting edema with lymphedema?

A

No.. Damage to lymph nodes that obstruct flow so will have a buildup of fluid. (both lymph and intercellular fluid)

39
Q

Describe 3 mechanism that help return venous blood to the heart.

A
  1. The contracting skeletal muscles that milk the blood proximally, back toward the heart
  2. The pressure gradient caused by breathing, in which inspiration makes the thoracic pressure decrease and the abdominal pressure increase
  3. The intraluminal valves, which ensure unidirectional flow
40
Q

Define the term capacitance vessels and explain its significance.

A

Veins have a larger diameter and are more distensible; they can expand and hold more blood when blood volume increases. This is a compensatory mechanism to reduce stress on the heart; this ability to stretch, veins are called capacitance vessels.

41
Q

What are risk factors for venous stasis.

A

Elderly, diabetes, obesity, peripheral vascular disease, pregnancy, smoking, varicose veins, inactivity

42
Q

Describe the function of the lymph nodes.

A

Nodes filter the fluid before it is returned to the bloodstream and filter out the micro-organisms that could be harmful to the body.

43
Q

What are the functions of the spleen?

A
  1. To destroy old red blood cells
  2. To produce antibodies
  3. To store red blood cells
  4. To filter micro-organisms from the blood
44
Q

What are symptom areas to address during history-taking relating to the peripheral vascular system.

A
  • Leg pain or cramps
  • Skin changes on arms or legs
  • Swelling in the arms or legs
  • Lymph node enlargement
  • Medication
45
Q

List the skin characteristics expected with arterial insufficiency to the lower legs.

A

Malnutrition, pallor and coolness occur with arterial insufficiency. Malnutrition: thin, shiny atrophic skin, thick-ridged nails, loss of hair, ulcers, gangrene

46
Q

What is a defect or say formed by dilation in artery wall due to atherosclerosis, trauma, or congenital defect?

A

Aneurysm

47
Q

What is a thickening and loss of elasticity of the arterial walls?

A

Arteriosclerosis

48
Q

What is Atherosclerosis?

A

Plaques of fatty deposits formed in the inner layer (intimate) of the arteries.

49
Q

What is a deficiency of arterial blood to a body part, due to constriction or obstruction of a blood vessel?

A

Ischemia

50
Q

What is thrombophlebitis?

A

Inflammation of a vein associated with thrombus formation.

51
Q

What is a dilated tortuous vein with incompetent valves?

A

Varicose veins.

52
Q

What best describes +2 edema?

A

2+: somewhat deeper pit/4 mm, disappears in 10-15 sec

53
Q

What grade of edema is, slight pitting/2 mm, disappears rapidly?

A

1+

54
Q

What grade of edema is, very deep pit/8 mm, lasts 2-5 min, dep extremity grossly distorted?

A

4+

55
Q

What best describes 3+ edema?

A

3+: deep pit/6 mm, may last > 1 minute; dep extremity swollen

56
Q

A function of the venous system is:

a) to hold more blood when blood volume increases
b) to conserve fluid and plasma proteins that leak out pot the capillaries
c) to form a major part of the immune system
d) to absorb lipids from the interstitial fluid

A

a) to hold more blood when blood volume increases

57
Q

The organs that aid the lymphatic system are:

a) liver, lymph nodes, and stomach
b) pancreas, small intestine, and thymus
c) spleen, tonsils, and thymus
d) to absorb lipids from the intestinal tract

A

c) spleen, tonsils, and thymus

58
Q

Mr. T. has come for a prenatal visit. She complains of dependent deem, varicosities in the legs, and hemorrhoids. The best response is:

a) “if these symptoms persist. we will perform an amniocentesis.”
b) “If these symptoms persist, we will discuss having you hospitalized.”
c) “The symptoms are caused by the pressure of the growing uterus on the veins. They are usual conditions of pregnancy.”
d) “At this time, the symptoms are a minor inconvenience. You should learn to accept them.”

A

c) “The symptoms are caused by the pressure of the growing uterus on the veins. They are usual conditions of pregnancy.”

59
Q

A pulse with an amplitude of 3+ would be considered:

a) bounding
b) decreased
c) normal
d) weak

A

a) bounding

60
Q

Inspection of a person’s right hand reveals a red, swollen area. To further assess for infection, you would palpate the:

a) cervical node
b) axillary node
c) epitrochlear node
d) inguinal node

A

c) epitrochlear node

61
Q

In order to screen for deep-vein thrombosis, you would:

a) measure the circumference of the ankle
b) check the temperature with the palm of the hand.
c) compress the dorsals pedis pulse, looking for blood return
d) measure the widest point with a tape measure

A

d) measure the widest point with a tape measure

62
Q

During the examination of the lower extremities, you are unable to palpate the popliteal pulse. You should:

a) proceed with the examination. It is often impossible to palate this pulse
b) refer the patient to a vascular surgeon for further evaluation.
c) schedule the patient for a venogram.
d) schedule the patient for an arteriogram

A

a) proceed with the examination. It is often impossible to palate this pulse

63
Q

While removing a medical record, a notation of 4+ edema of the right leg is noted. The best description of this type of edema is:

a) mild pitting, no perceptible swelling of the leg.
b) moderate pitting, indenation subsides rapidly
c) deep pitting, leg looks swollen
d) very deep pitting, indentation lasts a long time.

A

d) very deep pitting, indentation lasts a long time.

64
Q

The examiner whines to assess for arterial deficit in the lower extremities. After raising the legs 30 cm off the table and then having the person sit up and dangle the leg, the colour should return in:

a) 5 seconds or less
b) 10 seconds or less
c) 15 seconds
d) 30 seconds

A

b) 10 seconds or less

65
Q

A 54 year old woman with five children has varicose veins of the lower extremities. Her Mose characteristic sign is:

a) reduced arterial circulation
b) blanching, deathlike appearance of the extremities on elevation
c) loss of hair on feet and toes
d) dilated, tortuous, superficial bluish vessels.

A

d) dilated, tortuous, superficial bluish vessels.

66
Q

Atrophic skin changes that occur with peripheral arterial insufficiency include:

a) thin, shiny skin with loss of hair
b) brown discolouration
c) thick, leathery skin
d) slow-healing blisters on the skin

A

a) thin, shiny skin with loss of hair

67
Q

Intermitten claudication is:

a) muscular pain relieved by exercise
b) neurological pain relieved by exercise
c) muscular pain brought on by exercise
d) neurological pain brought on by exercise

A

c) muscular pain brought on by exercise

68
Q

A known risk factor for venous ulcer development is:

a) obesity
b) male gender
c) history of hypertension
d) daily aspirin therapy

A

a) obesity

69
Q

Brawny edema is:

a) acute in onset
b) soft
c) non pitting
d) associated with diminished pulses

A

c)non pitting

70
Q

What is a venous ulcer?

A

A venous skin ulcer (also known as a stasis leg ulcer) is a small wound that occurs when the veins in the legs do not properly return blood back toward the heart.

71
Q

Where do venous ulcers tend to develop on the body?

A

Venous ulcers often occur over bony prominences, particularly the gaiter area (over the medial malleolus)

72
Q

What are arterial ulcers?

A

Arterial ulcers, also referred to as ischemic ulcers, are caused by poor perfusion (delivery of nutrient-rich blood) to the lower extremities. The overlying skin and tissues are then deprived of oxygen, killing these tissues and causing the area to form an open wound.

73
Q

Where do arterial ulcers tend to develop?

A

Arterial ulcers are often found between or on the tips of the toes, on the outer ankle, or where there is pressure from walking or footwear. The wounds themselves are characteristically deep, often extending down to the underlying tendons, and will frequently display no signs of new tissue growth.

NURS 203 (8 decks)

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