Assessments Ch 20 Vascular & Lymphatic

test that determines 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 outer artery

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

variation from the hearts normal rhythm

thickening and loss of elasticity of the arterial walls

plaques of fatty deposits formed in the inner layer, intima, of the arteries

slow heart rate, less than 50 beats per minute in the adult

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

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

in hearts filling phase

deficiency of arterial blood to a body part due to constriction of obstruction of a blood vessel

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

swelling of extremity due to obstructed lymph channel, nonpitting

indentation left after examiner depresses the skin over swollen edematous tissue

viewing the finger from the side to detect early clubbing

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

irregular rhythm; every other beat is premature; premature beats have weakened amphlitude

beats have weaker amplitude with respiratory inspiration, stronger with expiration

the hearts pumping phase

rapid heart rate, more than 95 beats per minute in the adult

inflammation of the vein associated with thrombus formation

open skin lesion extending into dermis, with sloughing of necrotic inflammatory tissue

dilated tortuous veins with incompetent valves

The heart pumps freshly oxygenated blood through the arteries to all body tissues. Artery walls are strong, tough, and tense to withstand pressure demands; contain elastic fibers, which allow their walls to stretch with systole and recoil with diastole. Veins are often closer to the skin and contain valves to help keep blood flowing toward the heart, while arteries carry blood away from the heart. Most veins carry deoxygenated blood from the tissues back to the heart; exceptions are the pulmonary and umbilical veins that carry oxygenated blood to the heart. Arteries are more muscular than veins.

Temporal artery, carotid artery, brachial artery, femoral artery, popliteal artery, dorsalis pedis, posterior tibial.

1. The contracting skeletal muscles that milk the blood proximally, back toward the heart 2. The pressure gradient caused by breathing, in which inspiration makes the thoracic pressure decrease and the abdominal pressure increase 3. The intraluminal valves, which ensure unidirectional flow.

Veins have a larger diameter and are more distensible; they can expand and hold more blood when blood volume increases. This is a compensatory mechanism to reduce stress on the heart; this ability to stretch, veins are called capacitance vessels.

Elderly, diabetes, obesity, peripheral vascular disease, pregnancy, smoking, varicose veins, inactivity

Retrieves excess fluid from the tissue spaces and returns it to the bloodstream. During circulation of the blood, somewhat more fluid leaves the capillaries than the veins can absorb. Without lymphatic drainage, fluid would build up in the interstitial spaces and produce edema.

Nodes filter the fluid before it is returned to the bloodstream and filter out the micro-organisms that could be harmful to the body.

- Spleen; (1) to destroy old red blood cells (2) to produce antibodies (3) to store red blood cells (4) to filter micro-organisms from the blood - Tonsils; respond to local inflammation - Thymus; important in developing the T lymphocytes if the immune in children

- Leg pain or cramps - Skin changes on arms or legs - Swelling in the arms or legs - Lymph node enlargement - Medication

Fill in the grading scale for assessing the force of an arterial pulse: • 0 = absent • 1+ , weak • 2+, normal • 3+, increased, • 4+ full, bounding

Malnutrition, pallor and coolness; thin, shiny atrophic skin, thick-ridged nails, loss of hair, ulcers, gangrene

Arterial deficit ulcers occur on tips of toes, metatarsal heads, and lateral malleoli. Venus deficit is in the medial malleolus and lower leg; uneven edges superficial ulcer base, granulation tissue, beefy red to yellow, bleeding, may or may not be painful.

• 1+ Mild pitting, slight indentation, no perceptible swelling of the leg • 2+ Moderate pitting, indentation, subsides rapidly • 3+ Deep pitting, indentation remains for a short time, leg looks swollen • 4+ Very deep pitting, indentation lasts a long time, leg is very swollen

-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

(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.

abdominal aorta common iliac artery external iliac artery femoral pulse site popliteal artery popliteal pulse site anterior tibial artery posterior tibial artery dorsalis pedis artery dorsal arch dorsal pedis pulse site posterior tibial pulse site

A. Holding more blood when blood volume increases

organs that aid the lymphatic system

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

Is increased and full

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

Measure the wildest point with a tape measure

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

D. Very deep pitting, indentation lasts a long time.

After raising the legs 12 inches off the table and then having the person sit up and dangle the leg, the color should return in 10 seconds or less.

in lower extremities; dilated, tortuous superficial bluish vessels.

Atrophic skin changes; thin, shiny skin with loss of hair

Muscular pain brought on by exercise

obesity

Loss of elasticity of the walls of blood vessels

In hands and feet as a result of exposure to cold, vibration, and stress