Chap 15 Blood Vessels

Front 1

What constitiutes Cadiac output?

Back 1

Storke volume multiplied by hearts rate per minute (R)

Front 2

Are tougher more tensile, and less distensible; subjected to much more pressure than are the veins?

Back 2

arteries

Front 3

If blood volulme increases significantly what will happen to veins?

Back 3

expand and act as a respository for extra blood, helps dimish stress on the heart

Front 4

How long does it take for a pulse to be felt dorsails artery artery?

Back 4

.2 seconds

Front 5

The force exerted by the blood against the wall of an artery as the ventricles of the heart contract and relax?

Back 5

Arterial blood pressure

Front 6

How should the pulse be felts?

Back 6

forceful wave that is smooth and more rapid on the ascending part of the wave

Front 7

Force exerted against the wall of the artery when the ventricles contract?

Back 7

Systolic pressure

Front 8

Systolic pressure is largely the result of what things?

Back 8

cardiac output
blood volume
compliance of the arterial tree

Front 9

Force exerted against the wall of the artery when the heart is in the filling or relaxed state?

Back 9

Diastolic pressure

Front 10

Primarliy function of diastolic pressure is the reults of what?

Back 10

peripheral vascular resistance

Front 11

What is Pulse Pressure?

Back 11

difference between systolic and diastolic pressure?

Front 12

Following variables contribute to the characteristics of the pulses?

Back 12

Volume of blood ejected (SV)
distensiblity of the aorta and large arteries
Viscosity of the blood
Peripheral arteriorlar resistance

Front 13

What reflects the activity of the right side of theheart and offer clues to its competency?

Back 13

Jugular veins, empty direectly into the SVC

Front 14

Level at which the jugular venous pulse is visilbe gives an indication to what?

Back 14

RT Artrial pressure

Front 15

What vein is more superficial and are more visible bilaterally above the clavicle, close to the insertion of the sternocleidomastiod muslces?

Back 15

Ext. Jugular veins

Front 16

This wave is a result of brief backflow of blood to the vena cava during RT atrial contraction (1st)?

Back 16

A wave

Front 17

What is the C wave?

Back 17

transmitted impulse from the vigorous backward push produced by closure of the tricupsid valve during ventriclar systole

Front 18

What wave caused by increased volume and concomitant increasing pressure in the RT atrium?

Back 18

V wave; occurs a split moment after the c wave, ventricular systole

Front 19

X slope is what action?

Back 19

passive atrail filling

Front 20

Y slope results from what action of the heart?

Back 20

open tricuspid valve and rapid filling of the ventricle

Front 21

Calification/changes noted histologically in the walls of the arteries, af first proximmaly causes what in OLDER adults?

Back 21

dilation and tortusotiy of the aorta; aortic branches; carotid arteries

Front 22

What contributes to the dimishing resistance and ability to comply with changing body needs in Older adults?

Back 22

arterial wall lose elasticity
vasomotor tone

Front 23

What usually elevates the BP for older adults?

Back 23

Increased peripheal vascular resistance

Front 24

What are some family risk factors that should be documented?

Back 24

diabetes
heart disease
hyperlipidemia
Hypertension
FMHX or morbidity mortality, related cardiovascular systems hypertenstions, peripheral vascular diseae

Front 25

Risk factors for Varicose veins?

Back 25

Gender:
genetic perdispostion
Sedentary lifesytle
Age
Race

Front 26

Characteristics of genetic predispostion to get Varocise veins?

Back 26

Irish and German descent
daughters of women with varicosisties
genetically predisposed women taking birh control

Front 27

Examination of the vasulcar system includes what?

Back 27

observing and palapting pulses, comapring bilateral with upper to lower
inspecting the veins, particulary the jugular veins
measuring blood pressure in both upper extermities with patienting sitting, standing and supine

Front 28

What is a bounding wave of blood, with varying vigor that diminshes with increasing distance from the heart?

Back 28

Arterial pulsation

Front 29

Of all the arterial pulse, which one is most easily accessible and closest to the cardiac source, most useful in evaluating heart activity?

Back 29

carotids

Front 30

How do you examine arterial pulses ?

Back 30

digital pads of the second and thrid fingers.

Front 31

Can the thumb be used to palpate arterial pulses?

Back 31

yes

Front 32

How is the thumb useful in examing the arterial pulse?

Back 32

"fixing" the brachial and event the femoral pulses.

Front 33

Palpate the arterial pulsese (most often the radial) to assess what?

Back 33

HR/rhythm
pulse contour(waveform)
amplitude(force)
symmetry

Front 34

Regular rate; amplitude varies from beat to beat with weak and strong beats?

Back 34

Alternating pulse (pulsus alteranans)

Front 35

Two strong sytolic peaks separted by midsystolic dip?

Back 35

Pulsus bisferiens

Front 36

What is bigeminal pulse?

Back 36

Pulsus bigeminus- two beats in rapid succession followed by longer interval

Front 37

increased pulse pressure; contour may have rapid rise, brief peak, rapid fall.

Back 37

bounding pulse

Front 38

What is labile pulse?

Back 38

pulse amplitude increased when patient sitting or standing when compared with amplitude while supine

Front 39

Three beats folllowed by a pause?

Back 39

Trigeminal pulse (pulsus trigeminus)

Front 40

Jerky pulse with full expansioin followed by sudden collapse.

Back 40

Water-hammer pulse (corrigan pulse)

Front 41

What is amplitude 4 of pulse?

Back 41

bounding

Front 42

amplitude 3 of a pulse?

Back 42

full, increased

Front 43

If there is a irregular heart rate rhythm, what should you do?

Back 43

determine whether there is a consistent pattern

Front 44

Heart rate that is irregular but that occurs in a repeated pattern may indicate what?

Back 44

sinus arrhythmia

Front 45

Patternless, unpredictable, irregular rate may indicate what in a patient?

Back 45

Heart diseas
Conduction system impairment

Front 46

Lack of symmtery (contour or amplitude) btw the left and right extermities suggests what?

Back 46

imparied circualation

Front 47

Ordinarily the femoral is as strong as or stronger than radial pulse, if this is reveres or femoral pulsation is absent, what should be considered?

Back 47

coarctation of the aorta must be suspected

Front 48

Sites to auscultate for a bruit are over what areas?

Back 48

temporal, carotid
subclavian, abdominal aorta, renal, iliac an femoral arteries

Front 49

Where is the carotid artery bruits best heard?

Back 49

anterior margin of sternocleidomastiod msucle

Front 50

Carotid artery bruits heard should include the following types?

Back 50

Transmitted murmurs resulting from valvular aortic stenosis,
-ruptured chordae tendinease of the mitral valve, sever aortic regurgitation
-vigorous left ventriucular ejection
-Obstructive dz in cariod arteries

Front 51

Characteristics of Venous Hum?

Back 51

medial end of clavicle/ant border of SCM muscle
-No clinical significance
-occurs with anemia, pregancy, thyrotoxicosis and Intracranial arteriovenous

Front 52

Characteristics Cartoid Artery Bruits?

Back 52

Medial end of clavicle/ant. margin SCM muscle.
Transmitted murmurs: vavular aortic stenosis, ruptured shordae tendinaea or mitral valve/sever aortic regrug
Can be hear with vigouous left venticular ejection
Occurs with Obstructive disaes

Front 53

Resultant dimunution in circulation to the tissues will lead to signs and symptoms are realted to the following?

Back 53

site
degree of occulstion
ability of collateral channesl to compensate
Rapidity with which problem develop

Front 54

Arterial occlusion first symptom is pain that results from what?

Back 54

muslce ischemia, referred as claudication

Front 55

Site pain is distal to the occulsion, after determining the distinguishing characteristics of the pain, following?

Back 55

Pulses (weak)
Possible systolic bruits over the arteries
Loss of expced body warmth in area
-Collapsed superfical veins, delay venous filling
-Thin, atrophied skin, muslce atroph. or loss of hair

Front 56

How often should a blood pressure should be measured for both arms?

Back 56

least once annually and during hospitalization

Front 57

How far above the antecubital crease should the cuff should be?

Back 57

2-3 cm

Front 58

Checking the palpable systoloic blood pressure first will help you avoid being misled by what?

Back 58

auscultatory gap

Front 59

Rapidly inflate the cuff with handbulb to what limit above the point at which you no longer feel the peripheal pulse?

Back 59

20-30mm Hg

Front 60

After you astoblish a palable systolic blood pressure, place the bell of the stethscope over the brachial artery and pausing for how long before inflating the cuff until its 20-30mm Hg above systolic blood pressure?

Back 60

30sec pause

Front 61

Which is more effective when it comes to the diaphragm or bell?

Back 61

bell

Front 62

What constitutes the beginning of phase 1 of the Korotkoff sounds?

Back 62

two consecutive beats indicate the systolic pressure

Front 63

What establishes the Phase 2 of blood pressure?

Back 63

Korotkoff sounds wil be heard, disappear and will appear 10-15 mmHg lower.

Front 64

Period of silence is what?

Back 64

Auscultatory gap

Front 65

The ausculatory gap widens when?

Back 65

instance of systolic hypertension in older persons or with drop in diastolic pressure (chronic server aortic regurg)

Front 66

Softer thud than phase 1 still crisp right before first diastolic?

Back 66

phase 3

Front 67

What is phase 4 of blood pressure?

Back 67

softer blowing sound that disappears

Front 68

sounds that disappeaer is the second diastolic sound?

Back 68

phase 5

Front 69

Repeating between the arms may vary by as much as how much?

Back 69

10mmHg

Front 70

What two values are recorded for blood pressure?

Back 70

systolic and second diastolic pressure

Front 71

the difference between the systolic an diastolic pressure is called?

Back 71

pulse pressure

Front 72

What should thepulse pressure range be?

Back 72

30-40mmhg

Front 73

What is more senstive than stethoscopes to the first Korotkoff sound?

Back 73

Doppler devices

Front 74

Systolic pressure is more labile and more readily responsive to a wide range of variances like?

Back 74

physical
emotional
pharmacologic (caffiene) stimuli

Front 75

what would you see if you needed to measure the blood pressure in the legs?

Back 75

Diastolic pressure arms above 90mmHg..coarctation of the aorta

Front 76

Leg pressures, which are usually higher than arm pressures will be lower with what conditions?

Back 76

Coarctation of aorta
aortic steniosis

Front 77

Blood pressure reading may be undermined by some condtions like these?

Back 77

Cardiac dysrhtmias
Aortic Regurgitation
Venous congestion
Valve replacment

Front 78

Determination of paradoxic pulse may be important diagnostic finding, the difference in systolic pressure btw expiration and inspiration should be what?

Back 78

5mmg

Front 79

If the split of exp versus insp is grearter th 10mmHg during blood pressure, we would find what?

Back 79

pardoxic pulse is exaggerated

Front 80

What is paradoxic pulse?

Back 80

is the exaggerated fall in systolic pressure during inspiraton

Front 81

Several condtions may make examinationof JVP more difficult under this condtions?
And may cause extreme elevation of JVP

Back 81

Severe right Heart failure
Tricupsid insufficiency,
constrictive pericarditis
Cardiac tampondage

Front 82

What maneuvers useful for confirming JVP measurement include what?

Back 82

Heaptojugular reflux
and evaluation of venous engorgment of thehands at varous leves of elevetaion above the heart

Front 83

Hepatojugular reflux is exaggerated when what is present and its measurement is uded to evaluate that condition?

Back 83

Right heart failure

Front 84

How do you asses the heaptojugular reflux maneuver?

Back 84

use your hand to apply firm and sustained pressure to the abdomen in the midepigastric region while the patient is instructed to breathe regularly

Front 85

Veins of the hand can be used how?

Back 85

"auxillary manometer of right heart pressure

Front 86

The Auxillary manometer of veins in the hand test for what?

Back 86

absence of thrombosis in the hand or sublcavain vein
abscence of A-V fistual in arm
Absence of superior vena cava syndrom

Front 87

Hand vein measurement is particulary helpful for identifying what?

Back 87

extrems of JVP
severe right heart failure where pressure may be 20-30 cmH2O.
Volume depletion

Front 88

Examing a Thrombosis, what should you look for?

Back 88

redness, thickening and tenderness along a superficial vein

Front 89

Findings of redness an thickening and tenderness along superial vein suggest?

Back 89

Trhombophlebitis of superficail vein

Front 90

What does the Homan's sign test for?

Back 90

if calf pain is present then there is venous thrombsis

Front 91

Edema accompanied by some thickening and ulceration of the skin is associated with what?

Back 91

deep venous obstruction
venous valvular incompetence

Front 92

Slitting pitting, no visible distortion, disapperas rapidly is class type of edema?

Back 92

1

Front 93

+3 edema is constitiutes what ?

Back 93

noticeable deep pit that may last more than a minute; dependent extermeity looks fuller ans swollen

Front 94

Very deep pit that last long as 2-5 minutes, dependent extremeity is grossly distorted?

Back 94

4+ edema

Front 95

What are varicose veins?

Back 95

dilated and swollen , with dimished rate of blood flow and in increased intraveous pressure.

Front 96

Cause or characteristics of VAricose veins?

Back 96

incomptenece of vessel wall or venous valves
Obstruction in a more proximal vein

Front 97

So if you lift a patients leg above the hear until the veins empty, then lower the leg quickly, incompentnt system does what?

Back 97

rapid filling of the veins

Front 98

Loss of elasticity of the vessels in the process of aging, what will hapeen in older adults?

Back 98

systolic blood pressure incearse

Front 99

Hypertesion in older adults is defined how?

Back 99

pressure greater than 140/90

Front 100

Individuals who are normotensive at what age will have 90% lifetime risk of developing hypertension?

Back 100

55 yrs of age

Front 101

Idiopathic, intermittent spasm of arterioles in the digits, vasospamms may last form minutes to hours. Ulcers may appear on tips of digits?

Back 101

Raynaud phenomenon dz

Front 102

Localized dilation of artery caused by weakness in the arterial wall. Pulsatlile swelling along course of an artery.

Back 102

Arterial aneurysm

Front 103

What might be evident over the aneurysm?

Back 103

thrill

Front 104

Aortic aneurysm is usuall result of what condition?

Back 104

Atherosclerosis

Front 105

Dilation of the left atrium b/c mitral regurgiation can lead to atrial fibrialtion and clot formation .CLot unstable?

Back 105

Arterial embolic disease