WEEK 8- PERIPHERAL VASCULAR Flashcards
anatomy and physiology of upper and lower peripheral vascular systems and regional lymphatics
developmental changes- infant
It is well developed at birth and grows
rapidly until age 10 or 11 years. By age 6 years, the lymphoid tissue
reaches adult size; it surpasses adult size by puberty, and then it
slowly atrophies
developmental changes- older adults
arteriosclerosis
atherosclerosis
deep vein thrombosis
relationship between peripheral vascular/lymphatic system and skin integrity
skin changes:
venous stasis
incompetent valves
prolonged standing, sitting, or BR
Blockage
Ischemia
subjective questions
leg pain or cramps
skin changes
swelling
medications
- oral contraceptives, hormone replacement, aspirin
equipment needed
Paper tape measure
Tourniquet or blood pressure cuff
Stethoscope
Doppler ultrasonic stethoscop
technique for inspection/palpation of peripheral pulses
- used to assess blood flow
- palpable pulses (0,3+)
techniques of/practice of the doppler ultrasonic device
- used in weak pulses
- magnifies pulsatile sound
- light pressure with coupling gel
- swishing/whooshing sound
abnormalities: difference between venous and arterial insufficency
venous insufficiency
- edema
- occurs with vein issues
- increased pressure in the lower extremities.
arterial insufficiency
- inadequate blood flow through the arteries
- color change in lower extremities due to lack of blood. (pallor)
- reduced blood flow to extremities
abnormalities: lymph node enlargement and causes
infection/inflammation
viral infections
autoimmune disorders
the lymph node becomes enlarged- lymph nodes are small bean like structures (armpits, neck, groin)
abnormalities: peripheral edema : how to measure and cause
swelling in extremities
“Peripheral edema” refers to swelling that occurs in the extremities, such as the arms, hands, legs, or feet, due to an accumulation of fluid in the tissues. It is a common condition that can result from various factors, including:
- venous insufficiency
- pregnancy
- meds
- lymph dysfunction
- kidney/heart disease/liver
abnormalities: lymphedema
accumulation of lymph fluid in tissues, leads to swelling (edema)
It occurs when the lymphatic system, which is responsible for draining excess fluid and waste products from the body tissues and transporting them back into the bloodstream, becomes impaired or damaged. As a result, lymph fluid cannot properly drain, leading to swelling and tissue changes.
abnormalities: Raynaud’s phenomenon
decreased blood flow to fingers
symptoms: arterial insuffiency
Symptoms of arterial insufficiency may include intermittent claudication (pain or cramping in the legs during physical activity), cold feet or legs, numbness or weakness in the legs, slow-healing wounds or ulcers (particularly on the feet or toes), and changes in skin color or texture (such as shiny, thin, or pale skin).
symptoms: venous insuffiency
Symptoms of venous insufficiency may include swelling (edema) in the legs and ankles, aching or heaviness in the legs, skin changes (such as discoloration or thickening), varicose veins, itching or tingling sensations, and leg ulcers (particularly around the ankles).
arteries are
vascular smooth muscle
heartbeat creates what wave?
pressure wave
Pulses
temporal, carotid, brachial, radial, ulnar, femoral, popliteal, dorsalis pedis, posterior tibial
Arteries
temporal, carotid, arteries in arms and legs
Veins
- return blood
- low pressure system
- jugular veins, deep and superficial veins in legs,
- capacitance vessels
- venous return
developmental changes- pregnancy
dependent edema and varicosities
objective data
room temperature (22)
inspection and palpation
bilaterally
inspect and palpate the hands
colour of skin and nail beds
temperature
texture and turgor
lesions/scars
size and edema
profile sign-clubbing
capillary refill
pulses (rate, rhythm, elatscity, force
radial and brachial
0-3+
0=absent
1+=weak
2+=normal
3+=bounding
inspect and palpate legs
subjective:
- skin color
- size/edema
- hair distribution
- venous pattern
- lesions/scars/ulcers
- temperature
- pain
femoral pulse
- below inguinal ligament
- halfway between pubis and anterior superior iliac spine
Popliteal pulse
- palpate popliteal pulses
- lateral to medial tendon
Posterior Tibial pulse
Curve fingers around medial malleolus
Dorsiflex foot
Dorsalis Pedal pulse
- lateral to extensor tendon of big toe
- palpate with light touch
assessing for arterial insufficiency
supine- raise legs 30cm
- ask client to wiggle toes
- observe colour change or pallor
reposition client with sitting up feet dangling off bed
- colour should come back within15s
inspecting leg veins
spider veins
varicose veins
deep vein thrombosis
dilated, torturous veins
how to take care of feet?
inspect feet
exercise
do not smoke
keep feet clean
and dry
temporal artery
The temporal artery is palpated in front of the ear
carotid artery
The carotid artery is palpated in the groove between the
sternomastoid muscle and the trachea
arm arteries
brachial, radial, ulnar
leg arteries
femoral, popliteal, posterior tibial artery, dorslis pedis
superficial veins
venous return
deep veins
The deep veins run alongside the deep arteries and conduct
most of the venous return from the legs. These are the
femoral and popliteal veins. As long as these veins
remain intact, the superficial veins can be excised without
harming the circulation
superfical veins
great and small saphenous
veins.
venous return
Veins drain the deoxygenated blood and its waste products from the
tissues and return it to the heart.
mechanisms for blood moving through veins
1) contracting skeletal muscles
2)pressure gradient caused by breathing
3) intraluminal valves, unidirectional flow
veins have the ability to
stretch, capacitance vessels also known as veins
lymphatic vessels drain into either 2 ducts
The right lymphatic duct empties into the right subclavian
vein. It drains the right side of the head and neck, right arm,
right side of thorax, right lung and pleura, right side of the
heart, and right upper section of the liver.
2. The thoracic duct drains the rest of the body. It empties
into the left subclavian vein.
functions of the lymphatic system
e (a) to conserve fluid
and plasma proteins that leak out of the capillaries, (b) to form a
major part of the immune system that defends the body against
disease, and (c) to absorb lipids from the intestinal tract.
lymph nodes
are small oval clumps of lymphatic tissue located
at intervals along the vessels. Most nodes are arranged in groups,
both deep and superficial, in the body. Nodes filter the fluid before
it is returned to the bloodstream and filter out micro-organisms that
could be harmful to the body
spleen
LUQ: (a) to destroy old red blood cells,
(b) to produce antibodies, (c) to store red blood cells, and (d) to
filter micro-organisms from the blood.
