question

Describe the structure and function of arteries and veins

answer

-Arteries contain elastic fibres which allow the walls to stretch with systole and recoil with diastole. Muscle fibres control the amount of blood delivered to the tissues. Carry oxygenated blood from the heart to the peripheries. Arterial walls stretch during systole and recoil during diastole resulting in a palpable pulse. -Veins drain deoxygenated blood and its waste products from tissues and return it to the heart. Low pressure

question

List the pulse sites accessible to examination

answer

-Temporal (in front of ear) -Carotid (neck) -Brachial (elbow) -Ulnar (wrist) -Radial (wrist) -Femoral (thigh) -Popliteal (behind knee) -Dorsalis pedis (top of foot) -posterior tibial (ankle)

question

Describe 3 mechanism that help return venous blood to the heart

answer

1. Contracting skeletal muscles that milk the blood proximally, back towards the heart 2. Pressure gradient caused by breathing 3. one-way (intraluminal valves) ensure unidirectional flow

question

Describe the term capacitance vessels and explain its significance

answer

the distensibility of blood vessels located within the body; it is inversely related to elasticity. Reduce stress on the heart. They can expand and hold more blood when blood volume increases.

question

List the risk factors for venous stasis

answer

Elderly Diabetes Obesity Peripheral vascular disease Pregnancy Prolonged standing Inactive lifestyle Smoking Varicose veins Tight clothing

question

Describe the function of the lymphatic system

answer

1) conserve fluid and plasma proteins that leak out of the capillaries 2) form a major part of the immune system that defends the body against disease 3) absorb lipids from the intestinal tract Without lymphatic drainage, fluid would build up in the interstitial spaces and produce oedema

question

Describe the function of the lymph nodes

answer

Filter fluid before it is returned to the bloodstream and filter out pathogens

question

Name the related organs in the lymphatic system

answer

-spleen -tonsils -thymus

question

LIST THE SYMPTOM AREAS YOU WOULD ADDRESS DURING HISTORY TAKING OF THE PERIPHERAL VASCULAR SYSTEM

answer

AREAS-- ARMS, LEGS,EPITROCHLEAR NODE CHECK-- TEMP,SWELLING, SIZE OF EXTRIMITIES, LESIONS CHECK PULSES-- RADIAL, BRACHIAL, POPLITEAL,FEMORAL, POST TIBIAL, DORSALIS PEDIA CHECK INGUINAL AND EPITROCHLEAR NODES

question

Grading system for arterial pulse:

answer

0 indicating no palpable pulse 1 + indicating a faint, but detectable pulse; 2 + suggesting a slightly more diminished pulse than normal; 3 + is a normal pulse; and 4 + indicating a bounding pulse.

question

Describe the procedure for doing the modified Allen's Test.

answer

To perform this test, the clinician instructs the patient to make a tight fist. Then compress both the radial and ulnar arteries. Now instruct the patient to open and relax his fist, revealing a blanched palm and fingers. Then release the pressure over the ulnar artery while observing the patient's palm for changes in color. If collateral flow is adequate, the patient's hand will "pink up" within 10 to 15 seconds; this constitutes a positive Allen's test. A positive result documents that collateral blood flow is adequate and that the radial artery is an acceptable puncture site. If the test is negative (the palm does not pink up rapidly), the radial artery is not an acceptable site for puncture. In such cases, the other wrist is evaluated or the brachial artery is used for the puncture site.

question

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

answer

-A difference in the temperature of the feet -Marked pallor

question

COMPARE THE CHARACTERISTICS OF LEG ULCERS ASSOCIATED WITH ARTERIAL INSUFFUCIENCY TO ULCERS WITH VENOUS INSUFFICIENCY.

answer

ARTERIAL INSUFFICIENCY-- COLD NUMBNESS TINGLING INTERMITTENT CLAUDICATION CRAMPS VENOUS INSUFFICIENCY-- ACHING, TIREDNESS, FEELING OF FULLNESS

question

Grading scale for pitting odema:

answer

Grading edema 1+: slight pitting/2 mm, disappears rapidly, 2+: somwehat deeper pit/4 mm, disappears in 10-15 sec 3+: deep pit/6 mm, may last > 1 minute; dep extremity swollen 4+: very deep pit/8 mm, lasts 2-5 min, dep extremity grossly distorted

question

Describe the technique for using the Doppler ultrasound to detect peripheral pulses

answer

-Position person supine, with legs externally rotated so you can reach the medial ankles easily -Place a drop of coupling gel on the end of the handheld transducer -Place the transducer over a pulse site, swivelled at a 45o angle. -Apply very light pressure, locate the pulse site by the swishing, whooshing sound

question

Raynaud's phenomenon has associated progressive tricolor changes of the skin from ____ to ___ then to ___. State the mechanism for each of these color changes.

answer

White --->Blue --> Red (1) white (pallor) in top figure from arteriospasm and resulting deficit in supply; (2) blue (cyanosis) in lower figure from slight relaxation of the spasm that allows a slow trickle of blood through the capillaries and increased oxygen extraction of hemoglobin; (3) finally, red (rubor) in heel of hand due to return of blood into the dilated capillary bed or reactive hyperemia. May have cold, numbness, or pain along with pallor or cyanosis stage; then burning, throbbing pain, swelling along with rubor. Lasts minutes to hours; occurs bilaterally. Several drugs predispose to the episodes, and smoking can increase the symptoms.

question

A function of the venous system is:

answer

to hold more blood when blood volume increase

question

The organs that aid the lymphatic system are:

answer

spleen, tonsils, thymus

question

Ms T has come for a prenatal visit. She complains of dependent edema, varicosities in the legs, and haemorrhoids. The best response is:

answer

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

question

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

answer

Increased

question

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

answer

epitrochlear node

question

In order to screen for deep vein thrombosis, you would

answer

measure the widest point with a tape measure

question

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

answer

proceed with the examination. It is often impossible to palpate this pulse

question

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

answer

very deep pitting, indentation lasts a long time

question

The examiner wishes to asses for arterial deficit in the lower extremities. After raising the legs 12 inches off the table and than having the person sit up and dangle the leg, the colour should return in:

answer

10 seconds or less

question

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

answer

dilated, tortuous superficial bluish vessels

question

Atrophic skin changes that occur with peripheral arterial insufficiency include:

answer

thin, shiny skin with loss of hair

question

Intermittent claudication is:

answer

muscular pain brought on by exercise

question

A known risk factor for venous ulcer development is:

answer

obesity

question

Brawny edema is:

answer

nonpitting

question

Allen Test

answer

determining the patency of the radial and ulnar arteries by compressing one artery site and observing return of skin color as evidence of patency of the other artery

question

Aneurysm

answer

defect or sac formed by dilation in artery wall due to atherosclerosis, trauma, or congenital defect

question

Arrhythmia

answer

variation from the hearts normal rhythem

question

Arteriosclerosis

answer

thickening and loss of elasticity of the arterial walls

question

Atherosclerosis

answer

plaques of fatty deposits formed in the inner layer (intima) of the arteries

question

Bradycardia

answer

slow heart rate, <50 beats per minute in the adult

question

Bruit

answer

blowing swooshing sound heard through a stethoscope when an arter is partially occluded

question

Cyanosis

answer

dusky blue mottling of the skin and mucous membranese due to excessive amount of reduced hemoglobin in the blood

question

Diastole

answer

the hearts filling phase

question

Homans Sign

answer

calf pain that occurs when the foot is sharply dorisflexed (pushed up toward the knee); may occur with deep vein thrombosis, phlebitis, Achilles tendinitis, or muscle injury

question

Ischemia

answer

deficiency of arterial blood to a body part due to constiction or obstruction of a blood vessel

question

Lymphedema

answer

swelling of exterminty due to obstructed lymph channel, nonpitting

question

Lymph Nodes

answer

small oval clumps of lymphatic tissue located at grouped intervals along lymphatic vessels

question

Pitting Edema

answer

indentation left after examiner depresses the skin over swollen edematous tissue

question

Profile Sign

answer

viewing the finger from the side to detect early clubbing

question

Pulse

answer

pressure wave created by each heartbeat, palpable at body sites where the artery lies close to the skin and over a bone

question

Pulsus Alernans

answer

regular rhythm, but force of pulse varies with alternating beats of large and small amplitude

question

Pulsus Bigeminus

answer

irregular rhythm, every other beat is premature; premature beats have weakened amplitude

question

Pulsus Paradoxus

answer

beats have weaker amplitue with respiratory inspiration, stronger with expirtion

question

Systole

answer

the hearts pumping phase

question

Tachycardia

answer

rapid heart rate, >90 beats per minute in the adult

question

Thrombophlebitis

answer

inflammation of the vein associated with thrombus formation

question

Ulcer

answer

Open skin lesion extending into dermis with sloughing of necrotic inflammatory tissue

question

Varicose Vein

answer

dilated tortuous veins with incompetent valves

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