PV System

Question 1

what is the MAIN FUNCTIONS OF THE VASCULAR SYSTEM?

Answer 1

• important for transportation of FLUID (such as BLOOD & LYMPH)
• important for the OXYGEN & NUTRIENT DELIVERY / ELIMINATION OF WASTE PRODUCTS from cellular metabolism

Question 2

describe the ANATOMY of ARTERIES

Answer 2

• have very STRONG WALLS - have to withstand high pressure demands
• have ELASTIC FIBERS to STRETCH during SYSTOLE & RECOIL during DIASTOLE
• have MUSCLE FIBERS - allows to control the amount of blood delivered to the tissues

Question 3

artery function

Answer 3

• pumps OXYGENATED BLOOD through the arteries to all the body tissues
• since it is pumping towards the body; it needs a HIGH PRESSURE SYSTEM to do so

Question 4

ischemia

Answer 4

the deficient supply of oxygenated arterial blood to tissue caused by OBSTRUCTION of a BLOOD VESSEL

Question 5

what happens if we have ISCHEMIA and tissue?

Answer 5

can have various blockages;

COMPLETE BLOCKAGE;
leads to DEATH of DISTAL TISSUE

PARTIAL BLOCKAGE;
leads to an INSUFFICIENT SUPPLY; can be more apparent only during EXERCISE when oxygen needs increase

Question 6

what are the MAJOR ARM ARTERIES?

Answer 6

• BRACHIAL ARTERY
• RADIAL PULSE
• ULNAR ARTERY

Question 6

what are the major LEG ARTERIES?

Answer 6

• FEMORAL ARTERY
  **under inguinal ligament
• POPLITEAL ARTERY
  **splits into ant. tibial artery
• POSTERIOR TIBIAL ARTERY
  *travels down the medial malleolus – forms into plantar arteries

Question 7

structure of VEINS

Answer 7

• have a LARGER DIAMETER & are more DISTENSIBLE
• can EXPAND & HOLD MORE BLOOD allows to reduce strain on heart
• more often in the SUBQ tissue

Question 8

vein function

Answer 8

• drains DEOXYGENATED BLOOD & WASTE PRODUCTS and returns it to the heart
• more of a LOW PRESSURE SYSTEM

Question 9

describe VENOUS LEG CRAMPS

Answer 9

gets BETTER with EXERCISE, WORSE with dangling
**this makes sense because the veins work going UP against GRAVITY to get blood back into the heart
- has pain of pressure & fatigue
- often caused by VENOUS INSUFFICIENCY
- worsens with IMMOBILITY & DIABETES
- can lead to ULCERS, GANGRENE, AMPUTATIONS

Question 10

describe ARTERIAL LEG CRAMPS

Answer 10

gets WORSE with EXERCISE, BETTER WITH REST
**this makes sense as with more exercise, allows a greater necessity of oxygen being delivered towards body – greater work needed
- have PAIN OF ISCHEMIA–INTERMITTENT CLAUDICATION
- can be caused ARTERIOSCLEROSIS
- can lead to INFARCTS, DRY GANGRENE, AMPUTATIONS

Question 11

bilateral edema

Answer 11

can be an indication of CHRONIC VENOUS INSUFFICIENCY or a systemic problem

• ex. heart failure, liver failure, hypoalbuminemia

Question 12

unilateral edema

Answer 12

indication of LOCAL DAMAGE to or REMOVAL OF LYMPHATICS (post-mastectomy)
- OBSTRUCTION (lymphoma)
- INFECTION (cellulitis)

Question 13

what are HPI SYMPTOMS?

Answer 13

• skin changes
• leg pain/aching pain
• buldging veins
• leg wounds/sores
• swelling
• sexual activity changes

Question 14

what do we look for during ARTERIAL PULSE PALPATION?

Answer 14

looking at the characteristics BILATERALLY (for symmetry)
- RATE
- RHYTHM
- CONTOUR
- AMPLITUDE

**important to also look at JUGULAR VENOUS PULSATIONS & DISTENSION

Question 15

describe the PITTING EDEMA SCALE

Answer 15

0+ NO PITTING EDEMA

1+ MILD PITTING EDEMA; 2 mm depression; disappears rapidly

2+ MODERATE PITTING EDEMA; 4 mm depression; disappears in 10-15 sec

3+ MODERATELY SEVERE PITTING EDEMA; 6 mm depression; 1 min+

4+ SEVERE PITTING EDEMA; 8 mm depression; 2 min+

Question 16

what to INSPECT & PALPATE FOR?

Answer 16

• looking at any changes;
  color, hair distribution, lesions/ulcers
• varicosities **best assessed while standing? how is the pt’s symmetry?

Question 17

what ARTERIES DO WE PALPATE?

Answer 17

• CAROTID
• BRACHIAL
• RADIAL
• FEMORAL
• POPLITEAL
• DORSALIS PEDIS
• POSTERIOR TIBIAL

Question 18

what is the AMPLITUDE SCALE?

Answer 18

0 absent; not palpable
1; diminished; barely palpable
2; expected
3; full, increased
4; bounding, aneurysmal

Question 19

which arteries do we PALPATE FOR BRUITS?

Answer 19

• CAROTID
• SUBCLAVIAN
• ABDOMINAL AORTA
• RENAL
• ILIAC
• FEMORAL

Question 20

definition of PERIPHERAL ARTERY DISEASE

Answer 20

a chronic condition that occurs when the arteries that supply blood to the legs or arms narrow or become blocked due to the STENOSIS OF THE BLOOD SUPPLY
- having tiny clots within the system

Question 21

what aspects do PAD affect?

Answer 21

• SITE
• DEGREE OF NARROWING
• the RAPIDITY of which the problem develops

Question 22

venous insufficiency

Answer 22

the IMPROPER FUNCTIONING of the ONE-WAY VALVES in the VEINS

Question 23

arterial insufficiency

Answer 23

having POOR BLOOD CIRCULATION to the lower EXTREMITIES due to ATHEROSCLEROSIS

Question 24

symptoms of ARTERIAL INSUFFICIENCY

Answer 24

- cool to the touch - often having DRY, SVALY SKIN - DANGLING LEGS = RUBOR - ELEVATING LEGS = PALE **DR. EP - has SHARP STABBING PAIN that worsens with activity - often having absent or diminished pulse - INFREQUENT EDEMA

Question 25

symptoms of VENOUS INSUFFICIENCY

Answer 25

- warm to the touch - having THICKENED/MOTTLED/PIGMENTED SKIN - aching and cramping pain that BENEFITS FROM ACTIVITY - present pulse - FREQUENT EDEMA

Question 26

varicose veins

Answer 26

- dilated and engorged - has a DIMINISHED RATE OF BLOOD FLOW & increased INTRAVENOUS PRESSURE - often due to an incompetence of a VESSEL WALL OR VALVES - can be also caused by OBSTRUCTION in a more proximal vein

Question 27

what is the pain associated with PAD

Answer 27

known as CLAUDICATION PAIN - having MUSCLE ISCHEMIA with DECREASED BLOOD FLOW - having dull aching and muscle fatigue - gets better with rest; often worsens with activity

Question 28

who is at risk for PAD? (7)

Answer 28

- patients with ATHEROSCLEROTIC CORONARY, CAROTID, or RENAL ARTERY Dx - smoking/smoking Hx - diabetic pt - obesity - HTN - HIGH CHOLESTEROL - Family Hx of PAD, STROKE, Heart disease

Question 29

arterial embolic disease

Answer 29

emboli that are dispersed throughout the arterial system

Question 30

venous thrombosis

Answer 30

sudden or gradual depending on symptoms; can be the result of TRAUMA or PROLONGED IMMBOLIZATION - blood clots within the veins

Question 31

DVT

Answer 31

- when a BLOOD CLOT (thrombus) forms within the DEEP VEIN - often occurs within the LOWER EXTREMITIES

Question 32

s/s of DVT

Answer 32

- leg pain - swelling - warmth

Question 33

who is at RISK FOR DVT? what is the TREATMENT?

Answer 33

RISK; - pt's who are immobile - blood clotting disorder - oral contraceptives - obesity - smoking TREATMENT; - anticoagulants - compression stockings