Cu Etp Pa: L5B Pvs And Lymphatic System

Front 1

Define ischemia

Back 1

deficient supply of O2 to blood

Front 2

Define infarction

Back 2

complete block (may occur in any artery)

Front 3

Define partial blockage

Back 3

insufficient supply (sometimes only noticeable when pain occurs during exercise)

Front 4

What do arteries do?

Back 4

-bring oxygen to the body;

-they are a high pressure system from high pressure in the heart

-walls are strong and tense

Front 5

Name 9 arteries in which you can feel their palpations

Back 5

1. carotid
2. radial
3. brachial
4. ulnar
5. aorta (site in abdomen)
6. femoral (site in groin)
7. popliteal
8. posterior tibial pulse (medial ankle)
9. dorsalis pedis pulse (lateral to extensor tendon of big toe)

Front 6

Describe the veins.

Back 6

1. fxn: drain deoxygenated blood and waste
2. low pressure system
3. thinner, distensible walls

Front 7

Why do you need a lymph system?

Back 7

there is more fluid than the venous system can accomodate

Front 8

Do veins have a pump to generate their blood flow?

Back 8

no

Front 9

What are 3 mechanisms of venous flow

Back 9

1. contraction of skeletal muscles to milk the blood proximally, back to the heart
2. the intraluminal valves that ensure unidirectional flow
3. patent lumen

Front 10

Describe the opening and closure of intraluminal valves of veins.

Back 10

each valve...
-opens toward the heart
-closes tightly when filled to prevent back flow of blood

Front 11

What happens in incompetent intraluminal valves?

Back 11

blood goes the wrong way and shows up as varicosities

Front 12

What is venous stasis?

Back 12

when blood is not moving back to the heart

Front 13

What does venous stasis cause?

Back 13

-deep vein thrombosis
-dilated/tortuous varicosities

Front 14

Name 3 functions of the lymphatic system

Back 14

1. conserve fluid and proteins that leak out of the capillaries into the interstitial tissue
2. form a major part of the immune system
3. absorb lipids from the intestinal tract

Front 15

5 pieces of subjective data to acquire during the health history

Back 15

1. pain or cramps (ie when walking?)
2. skin changes on arms or legs
3. swelling
4. lymph node enlargement
5. medications

Front 16

What areas do you inspect and palpate on the arms? (6)

Back 16

1. skin
2. profile sign of nails (look for clubbing)
3. capillary refill
4. symmetry
5. pulses
6. epitrochlear lymph node

Front 17

Name 3 features you can assess on the skin

Back 17

1. temperature
2. texture
3. lesions

Front 18

Name 3 pulses you can feel in the arm

Back 18

1. brachial pulse
2. radial pulse
3. ulnar pulse

Front 19

What is the profile sign in early clubbing?

Back 19

straight angle

Front 20

What is the profile sign in late clubbing?

Back 20

whole tip of finger gets bulbous looking

Front 21

How soon should blood return to the tissue of the nail bed in capillary refill.

Back 21

2-3 sec

**possibly dept on room temperature

Front 22

What is the technique for epitrochlear lymph node palpation.

Back 22

take the patient's arm like you want to shake it and feel with the other hand

Front 23

When you palpate for aortic pulsation, what are you looking for?

Back 23

widening of the aorta (larger than 3 cm is pathologic)

Front 24

If you find an abdominal aorta that is wider than 3 cm, what do you need?

Back 24

an ultrasound

Front 25

Who is at risk for a widened aorta?

Back 25

1. hypertensive patients
2. smokers
3. people with high cholesterol

Front 26

7 features to check when inspecting and palpating the legs.

Back 26

1. skin for lesions and color
2. size and symmetry
3. temperature
4. hair distribution
5. inguinal lymph nodes
6. pulses
7. pretibial edema

Front 27

Name 4 palpable leg pulses

Back 27

1. femoral pulse
2. popliteal pulse
3. posterior tibial pulse
4. dorsalis pedis pulse

Front 28

Why might there not be much hair on the legs?

Back 28

poor arterial supply to legs

Front 29

Describe the inguinal lymph nodes

Back 29

1. horizontal and vertical chains
2. CAN feel in most people (~1cm, soft, mobile)

Front 30

How should you palpate inguinal lymph nodes?

Back 30

wear gloves or do assessment over sheet

Front 31

How should you palpate the popliteal pulse?

Back 31

Use both hands!

You might have a person lay on his stomach because it's hard to feel

Front 32

Define the location and technique of the posterior tibial pulse

Back 32

medial side of ankle

wrap fingers around the ankle bone

Front 33

Define the location of the dorsalis pedis pulse

Back 33

lateral side of the extensor tendon big toe

Front 34

How do you grade edema?

Back 34

1+-4+

Front 35

What is 4+?

Back 35

pitting for ~5 sec

Front 36

What are 6 causes of edema?

Back 36

1. DVT (deep vein thrombosis)
2. chronic venous insufficiency
3. lymphedema
4. orthostatic edema
5. CHF
6. incompetent venous valves

Front 37

What is DVT?

Back 37

blockage in veins from prolonged sitting or standing

Front 38

What is lymphedema caused by?

Back 38

blockages from congenital reasons, tumors, or fibrosis

Front 39

How is lymphedema unique?

Back 39

does NOT pit, but edema is evident

Front 40

Which test should you perform before placing an arterial line inside the radial artery?

Back 40

Allen test

Front 41

What is the purpose of the Allen test?

Back 41

to make sure that the ulnar arter is working (if it is not patent and the radial artery is punctured, the patient could lose his hand)

Front 42

How do you do the Allen test?

Back 42

1. depress the radial artery while patient opens and closes fist
2. normal if blood returns via the ulnar artery
3. if the ulnar artery is occuluded, there is no blood return (no pink up)

Front 43

What is the manual compression test?

Back 43

checks for the competency of leg venous valves

Front 44

How do you do a manual compression test?

Back 44

1. patient standing
2. compress popliteal vein while feeling for wave near ankle

3. no wave-->competent valves
wave-->incompetent valves

Front 45

What are the physical signs of ischemia?

Back 45

1. thickened toe nails
2. pain at exercise (at rest is more severe)
3. decreased hair on legs

Front 46

What is a sign of Intermittent claudication in smokers?

Back 46

when they have to stop every 15 minutes due to pain

Front 47

Why mich chronic arterial insufficiency ulcers appear black?

Back 47

they become necrotic from lack of oxygen

Front 48

Describe outward signs of venous insufficiency.

Back 48

1. incompetent-->widening/tortuous
2. edema
3. varicosity
4. brawny
5. ulcers

Front 49

Describe arterial insufficiency

Back 49

Rugor in the sitting position, disappearance of rugor in the raising position

Front 50

What is Homan's sign?

Back 50

a sign of DVT

Front 51

How do you elicit Homan's sign?

Back 51

1. support thigh
2. bend leg
3. dorsiflex ankle

-->+ if you feel deep pain in the calf

Front 52

How accurate is Homan's sign?

Back 52

only 35% of the time