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127 Cards in this Set

  • Front
  • Back
  • 3rd side (hint)
three major arteries of the arm
brachial, radial, and ulnar
major artery that supplies the arm
brachial artery
What artery extends down the thumb side of the arm
radial artery
What artery extends down the little finger side of the arm?
ulnar artery
What artery is the major supplier of blood to the legs ?
femoral artery
Where can the femoral artery be palpated?
under the inguinal ligament.
What artery does the femoral artery become once it crosses the back of the thigh?
popliteal artery
Where can the popliteal artery be palpated?
behind the knee
Where can the dorsalis pedis artery be palpated?
on the top to the foot, on the great toe side
Which system is a low pressure system?
venous system
What vessels can expand if the blood volume increases?
What vessel contains 70% of the body's blood volume?
the veins
What is the purpose of the perforator (communicator)?
connect the superficial veins with the deep veins
What are three mechanisms that propel blood back to the heart?
one way valves
skeletal muscle contractions
pressure gradient
What are four risk factors for venous status?
long periods of standing still, sitting or lying down.

lack of muscular activity

varicose veins

damage to the vein wall
What are the primary functions of the lymphatic system?
drains excess fluid and plasma proteins from bodily tissues and returns them to the venous system.

prevents edema
What is lymph fluid made of ?
fluids and proteins absorbed by the lymp. vessels
What do lymph nodes do?
trap and destroy microorganisms,foreign materials. dead blood cells, and abnormal cells
Lymph nodes are how big?
What shape?
And where are they located?
circular or oval, 1-2 cm. in diameter, and non-palpatable.

many are located near major joints
The lymphatic system is composed of ?
lymphatic capillaries, lymphatic vessels, and lymph nodes
What does the right lymphatic duct drain?
upper right side of the body.
What area of the body does the thoracic duct drain?
all of the body except the right upper side.
Because of the lymph nodes, the second function of the lymphatic system?
as a major part of the immune system.
The third function of the lymphatic system?
absorbs fats from the small intestine into the blood stream.
Normally, can the lymph nodes be palpated?
The superficial inguinal nodes drain?
the legs, external genitalia, and lower abdomen and buttocks.
What is the capillary bed is important in maintaining?
equilibrium of interstitial fluid and preventing edema.
Symptoms of the legs that are associated with arterial insufficiency are?
cold, pale, clammy skin and thin shiny skin with loss of hair, especially on the lower legs.
Warm and brown pigmented skin around the ankles is associated with?
venous insufficiency
What are symptoms of intermittent claudication?
pain, tension, and weakness that occurs with activity and is relieved with rest
Intermittent claudication may indicate?
arterial insufficiency
heaviness or aching sensation that is aggravated by standing or sitting for long periods of time and is relieved by rest is associated with ?
venous disease
Leg pain that awakens a client from sleep is associated with ?
chronic arterial occlusive disease
older clients with arterial disease may not have the classic symptom of intermittent claudication but may experience what other symptoms?
coldness, color change, numbness, and abnormal sensations.
What are ropelike, bulging, or contorted veins?
varicose veins
Varicose veins develop from ?
heredity or increased venous pressure and venous pooling
What can increase the risk for varicosities?
standing in one place for long times
Where are arterial ulcers often located ?
toes, foot, or lateral ankle
Where are venous ulcers usually located?
on the medial ankle or lower leg.
Which ulcers, venous or arterial, are painful?
arterial ulcers
An obstruction of the lymphatic flow, or from venous insufficiency or deep vein thrombosis can cause?
peripheral edema AKA swelling
Enlarged lymph nodes or swollen glands indicates?
local or systemic infection
What disorders cause damage to the blood vessels?
diabetes, hypertension, coronary heart disease, or elevated cholesterol or triglyceride levels
What can alter the appearance of the veins or skin?
heart or blood vessel surgeries or treatments such as coronary artery bypass grafting, repair of an aneurysm, or vein stripping
Smoking cigarettes increases the risk of?
chronic arterial insufficiency
What can help a person decrease his or her risk for peripheral vascular disease?
regular exercise
How does exercise decrease a person's risk for peripheral vascular disease?
It improves peripheral vascular circulation, and decreases stress, pulse and blood pressure
Female clients who take oral contraceptives are at an increased risk for developing?
Thrombophlebitis, Raynaud's disease, hypertension, and edema
How does stress contribute to vascular disease?
it increases the heart rate and blood pressure.
How do support stockings reduce varicose veins?
they reduce venous pooling and increase blood return to the heart.
prominent venous pattern can indicate ?
venous obstruction
Breast surgery can cause?
Is prominent venous pattern a normal or abnormal finding?
lymphedema causes what ?
induration and non-pitting edema
What is Raynaud's disease caused by ?
vasoconstriction or vasospasm of the fingers or toes.
What are symptoms of Raynaud's disease?
rapid changes in color
Would Raynaud's disease affect both sides of the body?
yes, it occurs bilaterally; symptoms last minutes to hours
What disorders can cause clubbing of the fingertips ?
heart diseases and lung diseases
Normal capillary refill time?
less than two seconds
Capillary refill time that exceeds 2 seconds could indicate?
vasoconstriction, decreased cardiac output, shock, arterial occlusion, or hypothermia.
What is a radial pulse that is 2+ considered ?
What does an increased radial pulse indicate?
hyperkinetic state
Diminished or absent pulses could indicate ?
partial or complete arterial occlusion.
An obliteration of the pulse may result from ???
compression by external sources
To palpate a difficult to palpate pulse the nurse should?
apply more pressure on the most distal palpating finger or use a Doppler ultrasound device
After palpating the radial pulse, if you suspect arterial insufficiency you would then palpate what artery?
ulnar pulse, then the brachial pulse
enlarged epitrochlear lymph nodes indicates?
an infection in the hand or forearm, generalized lymphadenopathy, or because of a lesion in the area
What does the nurse do if lymph nodes are enlarged on in one arm?
evaluate the size, tenderness, consistency, and repeat palpation on the opposite arm
How does a nurse palpate the epitrochlear lymph nodes.
take the clients right hand into your left hand, as if shaking hands. Flex the elbow at a 90 degree angle. use your left hand to palpate behind the elbow in the groove between the biceps and triceps muscle
Why is the Allen test preformed?
to evaluate the patency of the radial or ulnar arteries
Why is the Allen test done?
when the patency is questionable or before procedures as a radial artery puncture
Which artery does the Allen test begin with?
the ulnar artery
What is a normal Allen test result?
pink coloration returns to the palm within 3 to 5 seconds if the ulnar artery is patent.

Pink coloration returns to the palm within 3 to 5 seconds if the radial artery is patent
What is an ABNORMAL Allen test result?
with both arterial or venous insufficiency pallor persists
What can cause a false positive Allen test result?
an exaggerated extension of the hand when opening after making a fist.
Pallor when elevated and rubor when dependent suggests?
arterial insufficiency
Legs that are cyanotic when dependent suggest?
venous insufficiency
Is hair loss on the lower extremities of the elderly client an absolute sign of arterial insufficiency ? loss could be a result of the aging process.
Ulcers with smooth even margins, that occur at pressure points (toes, foot, lateral side of the ankle) are the result of ?
Arterial insufficiency
Ulcers with irregular edges, bleeding, and possible bacterial infection, and occur on the medial ankle are the result of ?
venous insufficiency
Bilateral edema indicates ?
systemic problems such as chronic heart failure.

local problems such as lymphedema or prolonged standing or sitting
orthostatic edema is caused by ?
prolonged standing or sitting.
Muscular atrophy can be the result of?
disuse due to stroke or from a limb being in a cast for an extended period of time.
What are the characteristics of unilateral edema?
1 cm. difference in measurement at the ankles or a 2 cm. difference at the calf, and a swollen extremity.
What causes unilateral edema ?
usually it is caused venous stasis due to insufficiency or an obstruction
If the legs appear asymmetic where would you take measurements ?
circumference at mid-thigh.
largest circumference of the calf
smallest circumference of the ankle
and across the forefoot
Pitting that is 1+ is ?
slight pitting
Pitting that is 2+ is considered?
deeper than 1+
Pitting that is 3+ is ?
noticeably deep pit; extremity looks larger
4+ pitting is considered?
very deep pit; gross edema in the extremity
If edema is noted during inspection of the legs what should the nurse do first?
palpate the area to determine if it is pitting or non pitting
How should a nurse test for pitting?
press the edematous area with the tips of your fingers, hold for a few seconds, and then release. If skin remains indented on release, pitting edema is present.
What does generalized coolness in one leg or a change in temperature from warm to cool as you move down suggest?
arterial insufficiency
increased warmth in the leg may be caused by?
superficial thrombophlebitis from a secondary inflammation in the tissure around a vein
five common vascular disorders
aortic aneurysms
cerebrovascular disease
deep vein thrombosis
pulmonary embolism
peripheral arterial occlusive disease
What does PVD refer to ?
disorders of the veins and arteries of the lower limbs.
venous disease and venous insufficiency have a higher _________
and ___________ incidence than __________.
higher prevelence

higher incidence

arterial disease
What race has a higher incidence of varicose veins?
Who has the highest incidence of Peripherial Arterial Occulsive Disease (PAOD)?
elderly Italians
Eight risk Factors for Arterial Disease.
Age- > older adults
diabetes mellitus
tobacco smoking
elevated blood lipid levels
coronary or cerebral vascular disease
family history
11 Risk factors for venous disease?
job w/ prolonged sitting or standing
limited physical activity
congenital or acquired vein wall or valve weakness
female sex
increasing age
genetics-non-African Americans
family history
lack of fiber
use of constrictive clothing
Lymphedema results from__________, may be caused by_________ and usually effects what side of the body?
blocked lymphatic ducts
breast surgery
one side of the body
Buerger's disease or scleroderma can cause a _________ in the radial pulse?
A popiteal pulse that is difficult or impossible to detect would be considered a ____________ finding.
normal. the popliteal pulse is not easily palpated further circulatory assessment would be needed.
What postition would the client be in if the nurse is to palpate the femoral pulse?
bend the knee and move it out and to the side
Where would the nurse feel the femoral pulse?
below and medial to the inguinal ligament
What should the nurse do if he/she suspect an arterial occlusion over the femoral artery?
position stethoscope over femoral artery and listen for bruits
Bruits over one or both femoral arteries indicated?
partial obstruction of the vessel and diminished blood flow to the lower extremities
If you cannot palpate a popliteal pulse what would you do next?
ask the client to lay in the prone position and the nurse would then try again
What percent of the population will have congenitally absent dorsalis pedis?
10-15 percent.
common sites for varicose veins.
anterior lower thigh and lower leg, the posterior lateral calf, or anus (hemorrhoids)
superficial vein thrombophlebitis is marked by?
redness, thickening, and tenderness along the vein.
Positive Homan's sign.
aching or cramping that occurs with walking or dorsiflexion of the foot.
To elicit a Homan's sign. A pain felt when doing this would be a positive Homan's sign.
client supine
flex knee about 5 degrees
nurse squeezes the calf muscle against the tibia
then passive dorsiflexion of the foot.
hydrostatic pressure
pushing....allows interstital fluid to enter tissue space
osmotic pressure
pulling....returns fluid to the capillaires
persistent rubor of toes and feet w. legs dependent
persistent pallor w. legs elevated
return of pink that takes >10-15 sec
arterial insufficiency
manual compression test assesses for
assesses the competence of the veins valves.
performing the manual compression test
compress the lower portion of varicose
place the other hand 6 -8 inches below
feel for pulsation in the upper hand
repeat in other leg if varicose is present.
ABNORMAL manual compression finding
if the valves are incompetent you will feel a pulsation with your upper fingers
Use of Doppler
apply lukewarm gel
at 45-60 degree angle
whoosing=artery rushing=vein
trendelenburg test
to determine the competency of the saphenous vein valves.
normal vein fills from below < 30 sec.
abnormal vein fills from above >30 sec
ABI= ankle-brachial index
is the ratio of the ankle systolic blood pressure to the arm (brachial) systolic pressure.
Normal ABI
ankle pressure the same or slightly higher than the brachial pressure

reading of 1 or no arterial insufficiency

an ABI of 0.5 to 0.95 indicates moderate arterial insufficiency

an ABI of 0.25 or lower indicates severe arterial insufficiency
What test should be done by the nurses if pulses in the legs are weak?
positions change test
If superficial thrombophlebitis is noted the nurse should ?
note redness or discoloration on the skin surface over the vein