Combo with Peripheral Vascular & Lymphatic and 1 other

-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

-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)

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

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.

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

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

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

-spleen -tonsils -thymus

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

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.

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.

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

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

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

-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

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.

to hold more blood when blood volume increase

spleen, tonsils, thymus

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

Increased

epitrochlear node

measure the widest point with a tape measure

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

very deep pitting, indentation lasts a long time

10 seconds or less

dilated, tortuous superficial bluish vessels

thin, shiny skin with loss of hair

muscular pain brought on by exercise

obesity

nonpitting

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

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

variation from the hearts normal rhythem

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, <50 beats per minute in the adult

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

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

the hearts filling phase

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

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

swelling of exterminty due to obstructed lymph channel, nonpitting

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

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

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

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

beats have weaker amplitue with respiratory inspiration, stronger with expirtion

the hearts pumping phase

rapid heart rate, >90 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