N202 Peripheral Vascular

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N202 Peripheral Vascular
2010-10-10 03:10:22
N202 Peripheral Vascular

N202 Peripheral Vascular
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  1. Partial Arterial Occlusion
    leads to decreased O2 delivery to distal tissure adn tissue ischemia
  2. Venous return depends upon these 4 things:
    skeletal muscle contraction, functional valves to prevent backflow, a patent lumen, and respirations
  3. What are the deep veins of the legs?
    Femoral and popliteal
  4. What is the site for CABG-- (it is also a superficial vein of the leg)
    Great Saphenous Vein
  5. What are perforators
    Smaller veins that connect the major Veins (specifically for the legs)
  6. Arterial Insufficiency: Intermittent Claudication
    Muscle Ischemia (often affects gastrocnemius muscle)
  7. Arterial Insufficiency: Smoking
    Causes Vasoconstriction
  8. Venous Insufficiency: Swelling
    • Unilateral (venous occlusion) vs. bilateral (heart failure)
    • Precipitating factors: prolonged sitting/standing/travel
    • Associated factors: SOB, nocturia, may be HF
    • Nutritional Status: hypoalbuminemia may lead to edema
  9. What can venous insufficiencies cause?
    Swelling, Varicose Veins, Blood Clots, Horomonal Controceptives (gives inc. risk of thrombus)
  10. Head and Neck pulses
    temporal, carotid
  11. Arm pulses
    brachial, radial, ulnar
  12. Leg pulses
    femoral, popliteal, posterior tibial, dorsalis pedis
  13. What is the normal grade pulse?
  14. What is a "bounding" pulse
  15. Where do you ascultate for bruits
    temporal, carotid aortic, renal, iliac, femoral
  16. What is the normal CRT? (capillary refill time)
    less than 2 seconds
  17. If it takes too long to for capillary refill?
    it could mean arterial occlusion, hypothermia, hypovolemic shock
  18. Typical changes of arterial insufficiency:
    decreased or absent pulses, pallor of extremity, cool skin, thin-shiny-atropic skin, thick-ridged nails, loss of hair, ulcers & gangrene
  19. Does and occluded artery cause swelling?
  20. What are the special tests of arterial patency?
    Leg Elevation, Ankle Brachial Index, Allen test
  21. Leg Elevation
    • • With patient supine, raise the leg until it blanches
    • • Then have patient sit and dangle legs (note the time of color return)
    • • Arterial occlusion = delay in color return of many seconds or minutes
    • • Severe disease = delay in color return of ≥ 2 minutes
  22. Ankle-Brachial Index
    the ratio of B/P in lower legs compared to arms. A lower B/P in the leg is a sign of arterial occlusion
  23. Allen Test
    assess patency of the radial and ulnar arteries
  24. Edema
    Accumulation of fluid in extracellular [interstitial] spaces)
  25. What does pedal mean?
  26. What is "Anasarca" mean?
    entire body
  27. Superficial Thrombophlebitis
    Redness, thickening, tenderness along a superficial vein
  28. Deep Vein Thrombosis
    • May be life threatening, predisposes to a pulmonary embolis.
    • Pain, warmth, tenderness and swelling over a vein.
    • Asymmetric calf size
    • Homan's sign-- unreliable.
  29. 5 risks for DVT
    Bed Rest or immobility, Trauma, Hypercoagulable state, Varicosities, hormonal contraceptives (especially after age 35)
  30. Varicose Veins
    dilated and swollen vessels d/t incompetent venous valves or proximal vein obstruction
  31. With chronic venous insufficiency, are the pulses affected?
  32. What is teh color of chronis arterial insufficiency?
    Pale if elevated, bluish if dependent
  33. Where do you find ulcers of Arterial Insufficiency?
    Lateral Malleolus
  34. Where do you find ulcers of venous insufficiency?
    Medial Malleolus
  35. What is the skin like with arterial insufficiency?
    Smooth, thin, shing, decreased hair, thick toenails