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NURS 319: Peripheral
Chapters 15 and 19 Peripheral Vascular System
| Question | Answer |
|---|---|
| Central circulation | blood that flows through the heart and lungs |
| Peripheral circulation | blood that flows outside of the heart and lungs (think the remainder of the body) |
| Lymphatic circulation | vessels that lie adjacent to an artery and vein |
| lymphatic circulation drains fluid from | the capillary space |
| lymphatic circulation is part of the | immune system |
| lymphatic circulation filters fluid at the | lymph nodes |
| Fluid empties back into the bloodstream through the | subclavian veins |
| 3 layers of the vessel | tunica externa: outmost layer tunica media: middle layer |
| tunica media role | regulates blood flow by constriction |
| constriction is regulated by | alpha-adrenergic fibers |
| dilation is regulated by | beta-adrenergic fibers |
| calcium causes the vessel walls to | constrict |
| if there is injury to the endothelium, we will see 2 main problems | arteriosclerosis and atherosclerosis |
| arteriosclerosis | hardening and narrowing of the arteries |
| atherosclerosis | build-up of plaque on the arterial wall |
| when vessels constrict it causes the blood pressure to | increase |
| when vessels dilate it causes the blood pressure to | decrease |
| factors that cause vasoconstriction | nitric oxide and carbon dioxide, as well as hormones such as histamine, acetylcholine, and prostaglandins. |
| factors that cause vasodilation | low oxygen levels, a decrease in available nutrients, and increases in temperature |
| laminar blood flow | smooth flow parallel to vessel |
| turbulent blood flow | rough flow perpendicular to vessel, causes whooshing sound bruit |
| term for the amount of blood that flows out of the left ventricle each minute | cardiac output |
| average cardiac output | 4900 mL/min |
| Peripheral vascular resistance (PVR) is regulated by the | baroreceptor reflex |
| baroreceptor reflex helps do what | maintain pressure and perfusion to the body |
| 3 factors that affect hemodynamic function | 1. volume 2. pressure 3. resistance |
| located in the walls of the aorta and carotid arteries and sense a stretch in the vessel | baroreceptors |
| if there is a change in the blood flow or BP, they send a signal to the | cardioregulatory center in the brain |
| if the BP is too high, the __________ _________ _________ will decrease the heart rate, contractility, and vasoconstriction | parasympathetic nervous system |
| if the BP is too low, the ________ ________ ________ will increase the heart rate, contractility, and vasoconstriction | sympathetic nervous system |
| what is the term used for a drop in BP when changing positions and what are symptoms a patient may experience? | orthostatic hypertension; dizziness, feel "woozy," may pass out |
| types of lipids in the blood and where they are stored | cholesterol: liver triglycerides: adipose fat lipoproteins: blood plasma |
| how does glucose have a negative effect on the endothelium? | sets off insulin influenced inflammatory response- formation of atherosclerotic plaque |
| how do free radicals have a negative effect on the endothelium? | damage cell membranes, inflammation of artery- plaque formation |
| how does nicotine have a negative effect on the endothelium? | vessel constriction, increase BP, activate SNS and release epinephrine |
| how does homocysteine have a negative effect on the endothelium? | thrombosis formation and cardiovascular disease |
| what are risk factors for hyperlipidemia, hypertension, and atherosclerosis? | family history, diabetes/ increase blood sugar, obesity/sedentary lifestyle, hypothyroidism |
| what do elevated levels of lipids lead to? | hyperlipidemia- plaque formation |
| if a person has hyperlipidemia, what other medical conditions may they also have? What symptoms could they have if they have had hyperlipidemia for years? | hypertension, angina, CAD, MI, DM, Xanthoma, xanthelasma, arcus senilis |
| silent killer | hypertension |
| hypertension can lead to large events such as | myocardial infarction ad angina |
| to be diagnosed with hypertension there must be: | 2 or more BP readings with a SBP of 130 mmHg or higher or DBP of 80 mmHg or higher |
| Primary hypertension | etiology unknown |
| secondary hypertension | due to underlying disease |
| complications of hypertension | headaches, chest pain, vision changes, dizziness, palpitations, or syncope |
| atherosclerosis is the result of | endothelial injury and inflammation |
| steps of development of atherosclerosis | chronic irritant, endothelial damage, WBCs/macrophages migrate, release lipids, plaque develops, atheroma, rupture or bleeding |
| complications of atherosclerosis | ischemic heart disease, stroke, MI, peripheral arterial disease |
| thrombus | blood clot |
| emboli | broken off blood clot |
| aneurysm | ruptured blood vessel |
| bruit | whooshing sound |
| peripheral arterial disease and symptoms | arteriosclerosis and atherosclerosis outside coronary arteries; lack of perfusion, diminished/ absent pulse, coolness/ pallor, rubor, muscle atrophy, hair loss |
| diagnostic choice for PAD and how do you do it? | Ankle brachial index: ratio of BP of lower leg and BP of arm (also can use ESR/CRP, arteriography, exercise stress test, arterial plethysmography, CT/MRI) |
| 7 p's of an acute arterial embolism? | pistol shot, pallor, polar, pulselessness, pain, paresthesia, paralysis |
| three types of aneurysms | saccular, fusiform, berry |
| saccular aneurysm | impacts one side |
| fusiform aneurysm | thoracic/ abdominal areas |
| berry aneurysm | circle of willis |
| what aneurysm is a medical emergency? | a ruptured aneurysm |
| symptoms of aneurysm | pallor, diaphoresis, nausea, vomiting, tachycardia, hypotension, confusion |
| reynaud's disease, causes, and symptoms | vasospasm in arterioles of hands and sometimes feet; exaggerated SNS receptors; pallor, cyanosis, rubor |
| Veins rely on what two factors to get blood back to the heart | skeletal muscle pump and valves |
| deep vein thrombosis | blood clot in leg |
| virchow's triad | venous stasis: sedentary behavior/ lifestyle venous injury: trauma or surgery hypercoagulability: cancer, estrogen, smoking |
| risk factors and symptoms of DVT | unilateral leg pain, redness, ropiness, tenderness, warmth over vein, calf may be swollen |
| main complication from DVT that becomes an embolism? what are the symptoms? | thrombus travels; dyspnea, chest pain, tachycardia, hypotension, hemoptysis, syncope, anxiety |
| what are diagnostics used for DVT and PE? | D-dimer, ultrasound, IPG, CT/MRI (DVT) MDCTA, V-Q scan (PE) |
| Venous insufficiency | result of damage to valves in deep leg vein |
| varicose veins | abnormally dilated superficial vein |
| venous stasis ulcer | trauma or pressure on lower limbs skin breakdown, tissue damage, necrosis no well-defined borders, uneven margins good pulses |
| arterial ulcer | shallow, below knee, irregular edges, discolored, swelling, painful |
Created by:
lcorlew1
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