Peripheral Vascular Chapter 17
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| Arteries | blood vessels that carry oxygenated nutrient rich blood from the heart 2 capalliries
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| blood is propelled under preassure from the ____ ventricle of the heart | left ventricle
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| Arterial walls must be _____ ___ ______ because of the preassure that blood is propelled through them. | thick & strong
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| The pulse is? | Each heartbeat forces blood through the arterial vessels creating a surge, this surge of blood is the arterial pulse.
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| The pulse can be felt only by ? | Pressing a superficial artery against an underlying bone.
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| what are the major arteries of the arm? | Brachial, radial and ulnar,
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| Describe where the major arm arteries are located starting @ the Brachial. | Brachial artery divides near the elbow to become the radial artery (extending the thumb side of the arm) and the ulnar artery (extending down the little finger side of the arm)
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| Brachial pulse can be palpated ? | medial to the biceps tendon in and above the bend of the elbow
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| Radial pulse can be palpated? | radial pulse can be palpated on the lateral aspect of the wrist
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| Ulnar pulse can be palpated? | the ulnar pulse can be palpated on the medial aspect of the wrist
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| Name the major arteries of the leg. | femoral artery, popliteal artery, anterior and posterior branches ,dorsalis pedis artery ,posterior tibial artery
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| _______ is the major supplier of blood to the leg | femoral artery
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| femoral artery can be palpated where? | Under the inguinal ligament
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| Describe the path of the major arteries of the leg starting with the femoral artery | femoral artery = down front of thigh than crosses to back of the thigh where it is termed the popliteal artery, the popliteal artery divides below the knee into the anterior and posterior branches (anterior posterior popliteal/ tibial ? artery) Anterior
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| The popliteal pulse can be palpated ? | behind the knee
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| dorsalis pedis pulse palpated ? | The great toe side of the top of the foot
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| posterior tibial pulse can be palpated ? | behind the medial malleolus of the ankle
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| femoral artery = front of thigh to back thigh where = popliteal artery, popliteal artery divides below the knee into the | knee into the anterior and posterior branches (anterior posterior popliteal/ tibial ? artery) Anterior =down top foot= dorsalis pedis artery (Posterior branch = posterior tibial artery
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| veins? | blood vessels that carry deoxygenated nutrient depleated, waste laden, blood from the tissues back to the heart.
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| ______ carriws blood to the superior vena cava. | veins of the arms, upper trunk, head and neck carry blood ?
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| Veins of the arms upper trunk, head and neck carry blood to the superior vena cava where it passes into ??? | Right atrium
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| Blood from the lower trunk and legs drains upward into the | inferior vena cava
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| Why are vein walls much thinner than artery walls? | blood in veins is carried under much lower preassure
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| which have a larger diamiter veins or arteries? Why | Veins larger in diamiter /can expand if blood volume increases=reduction of heart workload
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| How many types of veins are theit? | 3 deep, superficial, and pereferator
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| what 2 deep veins are found in the legs | femoral= upper thigh & popliteal vein behind the knee
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| veins differ from arteries in that ???? | no force propelles foward blood flow, venous system = low preassure,
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| Why is the low preassure system of the veins of special concern in the legs? | Flow upward w/ no help from pumping heart,
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| what meckinisims of venous function help propeal blood back to the heart ? | structure, muscular contracation, preassur gradiaent
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| trisk factors 4 venous stasis ? | long periods of standing still, sitting or lying down, lack of muscle activity, vericose3 veins, and damage to veins
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| lymphatic system | Integral (A complete unit; a whole.) and complementary (Supplying mutual needs or offsetting mutual lacks.)component of the circulatory system
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| lymphatic system primary function = | drain excess fluid and plasma proteins from bodily tissues & return to the venous system
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| lymphatic system 2nd & 3rd function | 2nd = major part of immune system defending body against microrganisma 3rd =absorb fats (lipids) from the small intestine into the blood stream
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| shape of lymph nodes= | circular or oval
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| size of lymph nodes= | very small unpalapable to 1-2 cm in diamiater
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| lymph nodes are ---- and ----------- | deep & superficial
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| which lymph nodes are accessable to examination? | superficial
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| superficial lymph nodes assessed in a PV assessment = | arms = axillary nodes and epitrochlear nodes epitrochlear and legs =superficial inguinal nodes
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| epitrochlear nodes are located ? | appx 3 cm above the elbow on the (inner) medial aspect of the arm
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| and superficial inguinal | 2 groups horizontal chain of nodes = anterior thigh, just under the inguinal ligament, VERTICAL CHAIN OF NODES =close to the great saphenous
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| Peripheral Vascular PV Exam | Identify S&S Arms Legs Veins
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| Lymphatic System | Function Structure Lymph nodes Nodes that can be examined Related organs
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| Subjective Information Risk Factors for PVD-Arterial | Smoking Age Family Hx Hypertension Gender Possible Risk Factors Health Promotion
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| Risk Factors PVD-Venous | Pregnancy Prolonged standing Limited physical activity Gender Age Genetics Obesity
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| Potential Objective Findings | General Cardiovascular Respiratory Abdominal Extremities
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| Venous Insufficiency | Ulcerations Edema Induration Skin dry & scaly Aching pain Pulses may be normal
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| Arterial Insufficiency | No edema Pulses may be absent This, shiny skin Feels cool painful
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| Pulses | Compare bilaterally Scale for grading pulse Which pulses to assess
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| Objective cont | Legs Color Varicosities Homan’s sign Tests
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| Health Promotion Women & Cardiovascular Disease | 1996-Primary Care MD’s reported no difference in S&S of heart disease with women Leading cause of death among American Women Angina common in men & women SOB and fatigue
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| Gallup Survey | 39% extensive medical training in Women 68% said no difference in diagnostic testing Hormone replacement Therapy 50% listed other health problems as greatest health risk
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| Misconceptions | Breast Cancer Unrecognized risk factors Diabetes & hypertension Obesity Lipid levels Recovering from MI’s Seeking Treatment
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| Time Is Muscle | Onset Location Duration Characteristics Accompanying symptoms Radiation Treatment
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| factors affecting pulse= | sympathetic response, increased BP, Position= sitting standing = pooling, results in transient drop in BP, rate compensates by increasing check for symmetry
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| sympathetic nervous system | The part of the autonomic nervous system originating in the thoracic and lumbar regions of the spinal cord that in general inhibits or opposes the physiological effects of the parasympathetic nervous system, as in tending to reduce digestive secretions, s
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| Pulses | carotids upper extermities = brachial, ulnar, radial, Lower extermities= femorial, popliteal, dorosalis pedis, posterior tibial
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| History intermittent claudication | pain on walking, diseapears with rest
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| History | intermittent claudication,leg cramps, leg ulcers, vericose veins, edema of feet or legs, b;lood clots, pallor of fingertips
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| smooth even margins of skin ulcers on the leg indicate ? | arterial insuffciency
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| which lymph nodes drain the lower arm and hand? | epitrochlear
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| Peripheral edema resluts from obstruction od ____? | venous blood flow
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| The S COLDSPA refers to which charastic of pain? | Severity
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| The Allen test evaluates the patency of which artery? | radial
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| Disorders of the PV system may develop ____? | gradually
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| Rationale 4 ? Have you noticed any color texture or temp changes in skin? | cold pale clamy skin on extermities = arterial insufficiency/ warm skin & brown pigmatitation around ankles = venous insufficiency
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| Rationale 4 ? Do you experience pain in legs? If so does it awaken u from sleep? | Intermittent claudiation occurs w/ activity relived w/ rest = arterial disease -vs-Heaveness and acking sensation worse = stand sit long time relieved by rest =venous disorder/ Leg pain that awakens a client from sllep =advanced cronic arterial occlusive
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| pain that awakens a client from sleep = | advanced cronic arterial occlusive disease
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| Rationale 4 ? Do you have any leg veins that rropelike , bulging,or contorted? | Vericose veins =heridity + increased venous preassure and pooling ie=pregencystanding in 1 place 4 long time + +'s risk
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| Rationale 4 ? Any sores or open wounds an legs? Where located? Are they Painful? | Arterial disease ulcers =painful, located = toes foot , lateral ankle /Vemous Ulcers= painless, located= lower leg medial ankle
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| Rationale 4 ? Any swelling (edema) in legs or feet? | Peripheral edema (swealling = ) from obstruction of lymph flow,or venous insufficiency ie= incompentent valve or - osomatic preassure in capalarries also deep vein thrombosis
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