Chapter 21- PVS and Lymphatic System Flashcards Preview

Health Assessment for Nurses > Chapter 21- PVS and Lymphatic System > Flashcards

Flashcards in Chapter 21- PVS and Lymphatic System Deck (73)
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1
Q

The major artery supplying the arm is the __, which runs in the biceps-triceps furrow of the upper arm and surfaces at the antecubital fossa in the elbow medial to the biceps tendon.

A

brachial artery

2
Q

The brachial artery bifurcated into the __ and __ .

A

ulnar and radial

3
Q

Peripheral artery disease affects ___ vessels and refers to arteries supplying the limbs.

A

noncoronary

4
Q

The major artery to the leg is the ___, which passes under the inguin ligament.

A

femoral artery

5
Q

At the lower thigh, the femoral artery courses posteriorly which then it is called the ___.

A

popliteal artery

6
Q

The anterior tibial artery travels down the front of the leg on the dorian of the foot, where it becomes the ____.

A

dorsalis pedis.

7
Q

The the back of the leg, the ___ artery travels down behind the medial malleolus and forms the plantar arteries in the foot.

A

Posterior tibial

8
Q

The function of the arteries is to ___.

A

supply oxygen and essential nutrients to the cells.

9
Q

a deficient supply of oxygenated arterial blood to a tissue caused by obstruction of a blood vessels.

A

Ischemia

10
Q

The course of veins is ___ to the course of arteries.

A

Parallel

11
Q

Body has more ___, and they lay ___ to the skin.

A

veins

closer

12
Q

Function: to drain deoxygenated blood and it’s waste products from tissue and return it to the heart.

A

veins

13
Q

veins are called capacitance vessels because ___

A

of their ability to stretch.

14
Q

Deep veins in the leg:

A

the femoral and popliteal veins

15
Q

Superficial veins in the leg:

A

the great and small saphenous

16
Q

Perforator veins:

A

connecting veins that join the deep and superficial veins.

17
Q

The veins do not have a pump to generate their blood flow so they need a _____

A

mechanism to keep blood moving

18
Q

The mechanism is accomplished by:

A

contracting skeletal muscles, pressure gradient caused by breathing, and intraluminal valves.

19
Q

In the legs, the mechanism for venous flow is called ____

A

calf pump or peripheral heart.

20
Q

Dilated and tortuous (varicose) veins create ____ valves leading to increased venous pressure, which further dilated the vein.

A

incompetent

21
Q

Lymphatic system retrieves what and from/to where?

A

excess fluid and plasma proteins from the interstitial spaces and returns them to the bloodstream.

22
Q

Caused by the pumping action of the heart and pushed somewhat more fluid out of the capillaries than the venules can absorb.

A

Hydrostatic pressure

23
Q

pulls interstitial fluid back into the venules

A

colloid osmotic pressure

24
Q

The right lymphatic duct empties into the ____.

A

subclavian vein. It drains the Right side of the head, neck, right arm, right side of the thorax, right lung, and pleura, right sid rod the heart, and right upper section of the liver.

25
Q

The thoracic duct drains the ____ and empties it into the ___.

A

Rest of the body, and empties into the left subclavian vein.

26
Q

Lymphatic system functions:

A

Conserve fluid and plasma proteins that leak out of capillaries

Form a major part of immune system that defends body against disease

absorbs lipids from intestinal tract

27
Q

small oval clumps of lymphatic tissue located at intervals along vessels

A

lymph nodes

28
Q

the ___ groups of nodes are accessible to inspection and palpation and give clues to the status of the lymphatic system.

A

superficial

29
Q

located in the left upper quadrant of the abdomen

A

spleen

30
Q

spleen’s four functions:

A

destroy old red blood cells
produce antibodies
store red blood cells
filter microorganisms from the blood

31
Q

located at the entrance to the respiratory and gastrointestinal tracts and respond to local inflammation

A

tonsils

32
Q

the flat, pink-gray gland located in the superior mediastinum behind the sternum and in front of the aorta

A

thymus

33
Q

lymph nodes are relatively ___ in children and the superficial ones are palpable even when the child is healthy.

A

large

34
Q

Hormonal changes in pregnant women cause ___ and the resulting drop in ___.

A

vasodilation

blood pressure

35
Q

the growing uterus obstructs drainage of the ___ and the ___.

A

iliac veins

inferior vena cava

36
Q

the pregnant women has a ___ chest cage and ___ estrogen.

A

wider

increased

37
Q

Peripheral blood vessels grow more rigid with age, termed ____.

A

arteriosclerosis

38
Q

The deposition of fatty plaques on the intima of arteries

A

Atherosclerosis

39
Q

What is intermittent claudication (IC) ?

A

cramping in arms or legs

40
Q

Aging produces a progressive ___ of the intramuscular calf veins.

A

enlargement

41
Q

Loss of ___ leads to fewer numbers of lymph nodes in older people and to a decrease in the size of remaining nodes.

A

Loss of lymphatic tissue

42
Q

Environmental risk factors for PAD patients:

A

smoking, diabetes, and hypertension.

also elevated levels of cholestrol and obesity.

43
Q

__ have twice the burden of PAD than do Caucasians.

A

African Americans

44
Q

the ___ is the first-line noninvasive test (screening tool) for PAD.

A

ankle-brachial index (ABI)

45
Q

___ are most at risk for PAD.

A

Non-hispanic blacks

46
Q

Increased DVT and subsequent pulmonary embolism is a result of :

A

prolonged bed rest, immobilization, and heart failure.

47
Q

AHA considers PAD a CAD risk equivalent, thus ___ are essential.

A

screening and treatment

48
Q

For Peripheral Vascular System: take vitals and examine ___ in the beginning while person is still sitting.

A

arms

49
Q

Inspecting and palpating the arms: lift the person’s both hands in your hands. Then:

A

inspect, then turn the persons hands over, noting color of skin and nail beds; temperature, texture, and turgor of skin; and the presence of any lesions, edema, or clubbing.

50
Q

how do you detect early clubbing?

A

profile sign (viewing finger from side to side)

51
Q

Radial pulses numbers and what they mean:

A

3+ increased, full bounding
2+ normal
1+ weak
0 absent

52
Q

What test can provide information about adequacy of collateral circulation?

A

Modified Allen Test

53
Q

Insepecting and Palpating the legs:

A

palpate for temperature along legs down to feet using bilateral comparison.

palpate lied extremity pulses using bilateral comparison

use of monofilament to assess neurovascular status.

54
Q

How to locate femoral artery:

A

Locate them just below inguinal ligament halfway between pubis and anterior superior iliac spines

55
Q

How to locate popliteal pulse:

A

With leg extended but relaxed. anchor your thumbs on knee, and curl your fingers around into popliteal fossa

56
Q

How to locate posterior tibial pulse:

A

curve your fingers around medial malleolus and feel the tapping right behind it in groove between malleolus and Achilles tendon

57
Q

How to locate Dorsalis pedis:

A

normally it is just lateral to and parallel with extensor tendon of big toe

58
Q

How do you check for a pretibial edema?

A

firmly depress skin over tibia or medial malleolus for five seconds and release

59
Q

Scale for grading a pitting edema:

A

1+ : mild pitting/ slight indentation, no perceptible swelling

2+ : moderate pitting, indentation subsides rapidly

3+ : Deep pitting, indentation remains, leg looks swollen

4+ : Very deep pitting, indentation lasts long time, leg grossly swollen and distorted

60
Q

If you suspect an arterial deficit, raise the legs ___ off the table and ask the person to wag the feet for about __ to drain off venous blood. The skin color now reflects only the contribution of arterial blood.

A

30 cm

30 seconds

61
Q

Use this device to detect a weak peripheral pulse, to measure low blood pressure or blood pressure in lower extremity.

A

Doppler Ultrasonic Probe

62
Q

Wells Score for Deep Vein Thrombosis facts:

A

Higher the score, greater the risk. 0-3.
0 low probabaility
1-2 moderate probability
3+ high probability

Combination of assessment findings categorized into low, moderate, or high probability of DVT.

63
Q

Vaccinations can produce local ____,

A

lymphadenopathy

64
Q

In pregnant women, expect ___ pitting edema in the lower extremities especially at the end of the day.

A

Bilateral

65
Q

Pregnant women: third trimester common findings

A

peripheral pitting edema

varicose veins

66
Q

Finding in older adults:

__ and ___ pulses may become more difficult to find.

A

DP and PT

67
Q

Strophic changes associated with arterial insufficiency may be seen:
(occur normally)

A

think, shiny skin
thick, ridged nails
loss of hair on lower legs

68
Q

Water-Hammer (Corrigan) Pulse 3+ :

A

Greater than normal force, then collapsed suddenly.

69
Q

Difference between:

  1. Pulses Bugeminus
  2. Pulses Alternans
  3. Pulses Paradoxes
  4. Pulses Bisferiens
A
  1. rhythm coupled, every other best comes early or normal beat is followed by a premature beat
  2. Rhythm regular, but force varies
  3. beats have weaker amplitude with inspiration, stronger with expiration
  4. each pulse has two strong systolic peaks with a dip in between
70
Q

Caused by the chronic gradual buildup of (in order) fatty streaks, fibroid plaque, calcification of the vessel wall, and thrombus formation.

A

Occlusion

71
Q

a sac formed by dilation in the artery wall

A

Aneurysms

72
Q

Arterial disease causes symptoms of ___.

A

Oxygen Deficit

73
Q

Venous disease causes symptoms of ____.

A

metabolic waste build up