what type of structure do arteries consist of?
muscular-walled tubes forming part of the circulation
system by which blood (oxygenated) is
conveyed from the heart to all parts of the body
what is the function of veins & how do they differ from arteries?
tubes forming part of the blood circulation system of the body, carrying in most cases oxygen-depleted blood toward the
heart
* work on vascular system
* dependent on a # of factors in the body
what does palpation of the peripheral pulses evaluate for? what are the grades for peripheral pulses?
how well the arteries are working based on strength & equality of the pulses 0= absent 1+ = weak/thready 2+ = normal 3+ = full, bounding
what pulses are in the upper extremity and why are distal pulses in BUE important in hospital settings?
- Carotid
- Brachial
- Radial -> more superficial, where ABG is done
- Ulnar
what pulses are compared in the Allen Test & why is it important?
Ulnar & radial: Compares patency of blood flow in ulnar and radial arteries
*important to check prior to checking ABG
*if done wrong -> can compromise blood flow to hands
what pulses are evaluated in the lower extremities?
- Femoral
- Popliteal
- Dorsalis Pedis
- Posterior Tibialis
while the femoral pulse is deferred in adults, what type of patients is it evaluated in?
peds & infants
True or false:
the abdominal aortic pulse is palpable
True
which pulses in the abdomen are non-palpable?
• Celiac: esophagus, stomach, duodenum, liver, gallbladder, pancreas
• Superior Mesenteric: small intestine, ascending and transverse colon,
right splenic flexure
• Inferior Mesenteric: descending and sigmoid colon, proximal rectum
on inspection of the upper & lower extremities, what are you evaluating for?
- color: pallor, erythema, rubor, cyanosis
- appropriate skin tone for pt
- same color throughout - hair distribution
- skin changes
ex) excoriations, ulcerations, blistering, bullae
on palpation of BUE & BLE, what are you evaluating for?
• Temperature -must use back of the hand -look for symmetry • Edema • Pulses
what is pitting edema and when might you see this?
palpable swelling that can be easily moved around
- divet will appear when pushing into skin
- d/t accumulation of fluid in the interstitial space
- pt w/ sprained ankle
what can pitting edema in the bilateral lower extremities indicate? what should you also look for in these patients?
venous insufficiency
- texture of skin
- appearance of sock lines
- toenails
how do you do the Brueger test & what is it used to evaluate for?
elevation of pt’s legs x1 minute at 60°
- evaluate for color return/venous filling when pt is sitting up
- PAD
what is the normal time for color return and venous filling?
color return: 5-10 seconds
venous return: 10-20 seconds
on exam of BLE, there is delayed color return and diminished pulses. what do you suspect?
possible PAD
if a pt presents with leg pain/claudication that is worse w/ exertion & leg elevation, what should you suspect?
PAD
what is PAD associated with?
• Related to narrowing or decreased oxygenated blood to the
extremities
what are risk factors for PAD>
age > 65 age >50 with history of DM or smoking • History of coronary artery disease • Ethnicity: increased in African American • Family history of AAA
what symptoms occur with PAD?
leg pain w/ exertion non-healing or poorly healed wounds fatigue aching/pain with limited exertion abdominal pain hair loss
on inspection of the extremities for a pt with PAD, what are typical findings?
- Cold, numbness, pallor to extremities
- Swelling
- Color changes
if PAD affects the aorto-iliac artery, what might a pt present with?
pain in the buttocks, hip, thigh
if PAD affects the iliac-pudendal artery, what problem might a pt report?
erectile dysfunction
if PAD affects the common femoral artery, what might a pt present with?
thigh pain
