Peripheral Vascular System & Lymphatics

Front 1

Temporal Artery is palpated

Back 1

In front of the Ear

Front 2

The Carotid Artery is palpated

Back 2

Groove between the sternomastoid muscle & trachea (neck)

Front 3

Brachial artery is palpated

Back 3

Runs in the biceps-triceps furrow of the upper arm & surfaces at the antecubital fossa in the elbow (where you listen for B/P)

Front 4

Radial artery is palpated

Back 4

just medial to the radius at the wrist

Front 5

Ulnar artery is palpated

Back 5

just medial to the ulna at the wrist, but deep and difficult to locate

Front 6

Femoral artery is palpated at

Back 6

palpated just past the inguinal ligament (inner thigh/pelvic area--groin)

Front 7

Popliteal artery is palpated at

Back 7

Lower thigh, behind the knee

Front 8

Dorsalis Pedis artery is palpated at

Back 8

The dorsal arch (top of foot)

Front 9

Posterior Tibial artery is palpated at

Back 9

behind the medial malleolus (inner ankle area)

Front 10

The 9 accessible arteries are

Back 10

Temporal, Femoral, Carotid, Popliteal,
Brachial, Dorsalis Pedis, Radial, Posterior Tibial, Ulnar

Front 11

Capacitance Vessels are:

Back 11

Veins. Called capacitance vessels because of their ability to stretch and reduce stress on the heart

Front 12

Jugular Veins

Back 12

Two veins present on each side of the neck. (Internal & External). Internal lies deep & external lies superficial

Front 13

Superficial & Deep veins of the arm

Back 13

The superficial veins are in the subcutaneous tissue and are responsible for most of the venous return

Front 14

Femoral & Popliteal Veins of the leg

Back 14

Deep veins running alongside the arteries and conduct most of the venous return from the legs.

Front 15

Great & Saphenous veins of the leg

Back 15

Superficial veins found to the sides of the leg. Great vein noted in front of the medial malleolus. Small saphenous noted on the lateral side of the dorsum

Front 16

Subjective Information to be gained in the peripheral vascular assessment

Back 16

Pain, Cramps, Skin Changes, Lymph node enlargement, past medical history, Temperature changes, TED hose use, numbness or tingling, oral contraceptive (OCP) use, smoking, Hormone Replacement (HRT)

Front 17

Objective Information to be gained in the peripheral vascular/ lymphatic assessment

Back 17

Skin/hair changes, Capillary Refill, temperature, measure calf size (bilateral), grade pulses, auscultation of bruits

Front 18

Homan's Sign

Back 18

Calf pain that occurs when the foot is sharply dorsiflexed (pushed up); may indicate Deep Vein Thrombosis (DVT), phlebitis, Achilles Tendinitis, or muscle injury

Front 19

Edema

Back 19

Swelling or collection of fluid, graded as follows:
1+ Mild pitting, slight indentation
2+ Moderate pitting, Indentation fades quickly
3+ Deep pitting, Indentation remains for a short time, looks swollen
4+ Very Deep Pitting, Indentation lasts long time, very swollen

Front 20

Coolness vs. Heat in assessing veins & arteries

Back 20

Unilaterally, coolness may indicate an arterial deficit (poor circulation). Heat may be an indicator of inflammation.

Front 21

Modified Allen Test

Back 21

Used to evaluate the adequacy of collateral circulation prior to cannulating the ulnar radial artery. Occlude both the ulnar and radial arteries while patient makes a fist several time. Patient then opens hand. Return to normal color in 2-5 seconds is normal

Front 22

Manual Compression Test

Back 22

Testing competency of vericose vein. Place one hand on lower vericose vein, then compress with other hand about 15cm higher. If no wave is felt, valves are competent

Front 23

Ankle-Brachial Index (ABI)

Back 23

Use a B/P cuff above the ankle and a doppler to listen for systolic B/P on tibial or dorsalis artery. Divide that # by systolic # from brachial (arm) b/p. Normal ABI is 1.0 to 1.2. Indicates extent of peripheral vascular disease.

Front 24

Aneurysm

Back 24

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

Front 25

Arrhythmia

Back 25

Variation from the heart's normal rhythm.

Front 26

Arteriosclerosis

Back 26

Thickening and loss of elasticity of the arterial walls

Front 27

Athlerosclerosis

Back 27

Plaques of fatty deposits formed in the inner layer (intima) of the arteries

Front 28

Bruit

Back 28

Blow, swooshing sound heard througha stethescope when an artery is partially occluded

Front 29

Profile Sign

Back 29

Viewing the finger from side to side to detect early clubbing

Front 30

Pulsus alternans

Back 30

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

Front 31

Pulsus Bigeminus

Back 31

Irregular rhythm, every other beat is premature, premature beats have weakened amplitude

Front 32

Pulsus Paradoxus

Back 32

Beats have weaker amplitude with respiratory inspiration, stronger with expiration

Front 33

Thrombophlebitis

Back 33

Inflammation of the vein associated with thrombus formation

Front 34

Varicose vein

Back 34

dilated toruous veins with incompetent valves.

Front 35

A function of the venous system is

Back 35

To hold more blood when volume increases

Front 36

The organs that aid the lymphatic system are

Back 36

Spleen, tonsils, thymus

Front 37

Ms. T has come for a prenatal visit. She complains of dependent edema, varicosities in the legs and hemorrhoids. The best response is:

Back 37

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

Front 38

A pulse with an amplitude of 3+ would be considered.

Back 38

Increased

Front 39

Inspection of a person's right hand reveals a red, swollen area. To further assess for infection, you would palpate the:

Back 39

Epitrochlear Node

Front 40

In order to screen for deep vein thrombosis (DVT), you would:

Back 40

Measure the widest point with a tape measure

Front 41

During the examination of the lower extremities, you are unable to palpate the popliteal pulse. You should:

Back 41

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

Front 42

While reviewing a medical record, a notation of 4+ edema of the right leg is noted. The best description of this type of edema is:

Back 42

Very Deep Pitting, indentation lasts a long time.

Front 43

The examiner wishes to assess for arterial deficit in the lower extremities. After raising the legs 12 inches off the table & then having the patient sit up & dangle the leg, the color should return in :

Back 43

10 seconds or less

Front 44

A 54 year old woman with five children has varicose veins of the lower extremities. Her most characteristic sign is:

Back 44

Dilated, tortuous superficial bluish vessels.

Front 45

Atrophic skin changes that occur with peripheral arterial insufficiency include:

Back 45

Thin, shiny skin with loss of hair

Front 46

Intermittent claudication is:

Back 46

Muscular pain brought on by exercise

Front 47

A known risk factor for venous ulcer development is:

Back 47

Obesity

Front 48

Brawny edema is:

Back 48

Non pitting

Front 49

3 Mechanisms that help return venous blood to the heart:

Back 49

1.Contracting skeletal muscles that "Milk" the blood back to the heart.
2.The pressure gradient caused by breathing.
3. Intraluminal valves,unidirectional flow.

Front 50

Cervical Lymphatic nodes:

Back 50

Drain the head and neck.

Front 51

Axillary nodes

Back 51

Drain the breast and upper arm.

Front 52

Epitrochlear node

Back 52

Located in the antecubital fossa and drains the hand and lower arm.

Front 53

Inguinal nodes.

Back 53

Located in the groin. Drain most of the lymph of the lower extremity, the external genitalia, and the anterior abdominal wall.