Vascular and Lymph System

Question 1

Allen’s test

Answer 1

• -Occlude both radial and ulnar arteries
• -Clench and unclench patient’s fist
• -Release ulnar artery
• -Repeat, but release radial artery
• -Watch for reperfusion of the palm (normal within 3-5 seconds)
• -If the ulnar artery is insufficient, don’t puncture the radial artery

Question 2

Normal capillary refill

Answer 2

Less than 2 seconds

Question 3

Jugular venous pressure assessment

Answer 3

Three waveforms:
a - rebound from atrial systole
c - expansion of underlying carotid artery
v - filling of right atrium as tricuspid valve closes

Question 4

Prominent a wave in JVP assessment

Answer 4

Increased resistance to right atrial contraction

Question 5

Absent a wave in JVP assessment

Answer 5

Atrial fibrillation

Question 6

Large v waves in JVP assessment

Answer 6

Tricuspid regurgitation and constrictive pericarditis

Question 7

Crackles when auscultating lungs

Answer 7

Fluid leaking out the circulation

Question 8

Consolidation in lung auscultation

Answer 8

Lymphatic overload

Question 9

Purpose of Trendelenburg test

Answer 9

Assess for venous incompetence and can be used to locate incompetent valves in the saphenous vein and communicating veins

Question 10

Grading pitting edema

Answer 10

1 - slight, disappears quickly
2 - deeper pit, disappears in 10-15 seconds
3 - noticeable deep pit, more than a minute
4 - very deep pit, 2-5 minutes

Question 11

Aneurysm

Answer 11

“Swelling of the wall of an artery, vein, or heart

Generally result of congenital defect or degenerative disease”

Question 12

Ascites

Answer 12

Abnormal intraperitoneal accumulation of serous fluid

Question 13

Atherosclerosis

Answer 13

Most common form of arteriosclerosis, deposits in the walls of arteries

Question 14

Brudzinski sign

Answer 14

Flexion of the hips when the neck is flexed from a supine position
Occurs in patients with meningeal inflammation

Question 15

Bruit

Answer 15

Unexplainable audible swishing sound or murmur over an artery or vascular organ

Question 16

Cellulitis

Answer 16

Inflammation of soft tissue or CT that causes a watery exudate to spread through the tissue spaces

Question 17

Claudication

Answer 17

Condition resulting from muscle ischemia due to decreased arterial blood flow to an area, characterized by intermittent pain and limping

Question 18

Edema

Answer 18

Excessive accumulation of fluid in the cells, tissues, or serous cavities of the body

Question 19

Fluctuant

Answer 19

Wavelike motion felt when palpating a nodule

Question 20

Kernig’s sign

Answer 20

Sign of meningeal irritation evidenced by reflex contraction and pain in the hamstring muscles when attempting to extend the leg after flexing the hips

Question 21

Lymphadenopathy

Answer 21

Enlargement of the lymph nodes, typically greater than 1.5 cm
Increased size is caused by activation and proliferation of lymphocytes and phagocytic WBCs within the node or by invasion of the node by tumor

Question 22

Lymphangitis

Answer 22

Inflammation of the lymphatics that drain an area of infection which is often associated with tender erythematous streaks extending proximally from the infected area

Question 23

Lymphangioma

Answer 23

Congenital malformation of dilated lymphatics

Question 24

Lymphedema

Answer 24

Swelling, particularly of subQ tissue, caused by obstruction of the lymphatic system and accumulation of interstitial fluid

Question 25

Matted

Answer 25

Group of nodes that feel connected and appear to move as a single unit

Question 26

Meningitis

Answer 26

Inflammation of the membranes of the spinal cord or brain, usually but not always caused by an infectious illness

Question 27

Nuchal rigidity

Answer 27

Resistance to flexion of the neck, seen in individuals with meningitis

Question 28

Pitting

Answer 28

Form of edema which appears and an indentation or depression that will not rapidly return to its original appearance

Question 29

Shotty nodes

Answer 29

Small, nontender nodes that feel like a BB or bucket shot under the skin

Question 30

Thrombophlebitis

Answer 30

Inflammation of the wall of a vein associated with thrombus formation

Question 31

Thrombosis

Answer 31

Formation or presence of a blood clot within a blood vessel or within one of the cavities of the heart

Question 32

Varicose vein

Answer 32

Enlarged, dilated, superficial vein

Can occur in almost any part of the body, but most common in lower extremeties

Question 33

Homans sign

Answer 33

Pain on passive dorsiflexion of the foot which may be indicative of thrombosis in the lower extremity

Question 34

Hum

Answer 34

Nonpathologic venous phenomenon commonly found in children

Question 35

HTN

Answer 35

Exceeds 140/90

Question 36

Hypotension

Answer 36

Falls below 90 (systolic)

Question 37

Orthopnea

Answer 37

Discomfort with breathing brought on by laying flat

Question 38

Peripheral artery disease

Answer 38

Stenosis of blood supply to extremities by atherosclerotic plaques

Question 39

Phlebitis

Answer 39

Inflammation of a vein

Question 40

Preeclampsia

Answer 40

HTN in pregnancy that occurs after the 20th week, in the presence of proteinuria

Question 41

Raynaud phenomenon

Answer 41

Vascular disorder resulting in exaggerated spasms of the arterioles in response to cold

Question 42

Regurgitation

Answer 42

Backflow of blood due to incompetent valves

Question 43

Syncope

Answer 43

Loss of consciousness and postural tone caused by diminished cerebral blood flow

Question 44

Temporal arteritis

Answer 44

Inflammatory disease of the aortic arch

Question 45

Thrombus

Answer 45

Clot in the cardiovascular system; may be occlusive or attached without obstructing (mural thrombus)

Question 46

Venous thrombosis

Answer 46

Clot that forms in a vein