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21 Cards in this Set
- Front
- Back
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Major Arteries? 4
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1. Aorta: takes blood AWAY from heart; takes oxygenated blood to rest of body
2. Carotid arteries: supply blood to brain 3. Subclavian arteries: supply blood to arm, chest wall, shoulders, back and CNS (spinal cord) 4. Iliac arteries: supply blood to pelvis and legs |
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Major Arteries in Body: name them (8)
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1. Common carotid
2. subclavian 3. axillary 4. thoracic aorta 5. renal 6. iliac 7. hepatic 8. abdominal aorta |
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Arteries in Arm Pathway from pitt to finger
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Subclavian artery --> axillary artery --> brachial artery (branches off to) supplies majority of blood to arm:
1. radial artery 2. ulnar artery |
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Arteries in Leg (Pathway from hip to toes)
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Femoral artery --> Popliteal artery --> branches off to:
1. anterior tibial art --> dorsalis pedis 2. post tibial art --> plantar arteries |
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Major Veins (3)
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Superior Vena Cava: receives blood from tissues and organs of head, neck, chest, shoulder, upper extremities
Inferior vena cava: receives blood from organs below diaphragm Jugular vein: carries blood from head and face |
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Veins in Arm (fingers to chest)
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From palmer venous arches to:
1. radial vein to brachial vein 2. ulnar vein to brachila vein brachial --> axillary --> subclavian vein --> superior vena cava |
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Deep Veins in leg (toes to chest)
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Plantar Veins branches to:
1. anterior tibial vein --> popliteal vein 2. post tib vein --> poplit. vein popliteal vein --> femoral vein --> iliac vein --> inferior vena cava |
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Superficial Leg Veins (2)
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1. Great Saphenous vein: cont. up medial aspect of leg to join femoral vein
2. Small Saphenous vein: goes up back of leg to join popliteal vein both carries blood from dorsal venous arch veins |
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PAD -- what, where?
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Atherosclerosis occurs in peripheral vasculature (arteries) --- arterial lumen of lower extremities become occluded w/ plaques --> ischemia in legs
Affects: 1. Femoral artery 2. Popliteal artery 3. Tibial artery 4. Aortoiliac |
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PAD - risk factors
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Same risk factors as CHD
- not a discriminating disease --> affects everyone. -Once a pt has it in their coronary arteries... likely to affect arteries all over body (brain etc) SMOKING biggest risk factor |
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PAD Clinical Man [IC vs. Pain at rest]
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- Can be asymptomatic early in disease
- Intermittent Claudication (IC): fatigue, discomfort, cramping, pain, tightness, numbness in butt, thigh or calf. Occurs during EXERTION, resolves by rest. -Pain at rest: often occurs later in disease. While at night, lying in bed. Felt in toes and heel of foot. |
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PAD signs/symptoms
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1. decr. or absent peripheral pulses
2. hair loss on toes feet lower legs 3. smooth shiny skin on feet/leg 4. cool skin temp 5. cyanosis/paleness of toes feet leg 6. thick hardened toenails 7. peripheral edema 8. ulcers or gangrene of toes, feet legs |
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PAD pt interview
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Ask about: leg pain, skin changes, edema.
Det if they have any risk factors for CHD |
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Questions for leg pain
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is pain burning, aching or cramping?
where does it occur? how long has it been? what causes pain? w/ exertion or not? what makes it better? |
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Questions about Skin changes
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Any skin changes?
changes in temp? leg sore or ulcers? |
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Q about Edema
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When did swelling start?
What brings it on? When during the day? throughout day? all day? what relieves swelling? one leg, both leg? history of HF or Kidney disease |
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Pulse Scale -- for all pulses felt for
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force of pulse graded - subjective!
4+ bounding 3+ increased 2+ normal 1+ weak/decr. 0 absent force tells of vascular problems |
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How to palpate for edema
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press down with first 2 finges over: tibia, top of foot, ankle -- for 5 seconds then release.
Normal: skin should bounce back w no indentation Edema: will leave pitting mark |
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Peripheral Edema Scale:
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Subjective!
1+ slight indentation, mild pitting, no visible swelling 2+ moderate pitting, indentation subsides quickly, no swelling 3+ deep pitting, indentation remains a bit, visible swelling 4+ very deep pitting, indent, sig swelling |
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ABI equation
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ABI = ankle systolic pressure / brachial systolic pressure
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How to measure ABI
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pt should be at rest in supine position for 10 min. measure SBP in both arms, use higher of the two.
Record both Posterior Tibial and Dorsalis Pedis systolic pressure in each leg. Take highest in each limb. Once calc ABI, take lowest ABI --> risk |
