Health Assessment Lecture 8: Vascular System
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Questions and Answers

What type of system consists of the vessels of the body?

  • Digestive System
  • Respiratory System
  • Nervous System
  • Vascular System (correct)

    • Veins transport blood from the heart to the rest of the body.

    False (B)

    What is the function of the lymphatic vessels?

    Lymphatic vessels retrieve excess fluid from the tissues and return it to the bloodstream.

    Which of the following is NOT a subjective finding related to the peripheral vascular system?

    <p>Presence of scars on hands or arms (A)</p> Signup and view all the answers

    What are the two primary methods used to assess the peripheral vascular system?

    <p>Inspection and Palpation (A)</p> Signup and view all the answers

    The normal nail bed angle is ______ degrees.

    <p>160</p> Signup and view all the answers

    Capillary refill should be less than 1 or 2 seconds.

    <p>True (A)</p> Signup and view all the answers

    What is a potential abnormal finding when palpating the arms?

    <p>Edema of the upper extremities</p> Signup and view all the answers

    Which pulse is usually not necessary to palpate?

    <p>Ulnar Pulse (C)</p> Signup and view all the answers

    What is the purpose of the Modified Allen Test?

    <p>To evaluate collateral circulation.</p> Signup and view all the answers

    During the Modified Allen Test, pressure should be released on the radial artery first.

    <p>False (B)</p> Signup and view all the answers

    What is a sign of arterial insufficiency when checking skin color and temperature?

    <p>Pallor and coolness</p> Signup and view all the answers

    Which of the following is NOT a factor assessed when inspecting the legs?

    <p>Muscle strength (B)</p> Signup and view all the answers

    A brown discoloration of the skin on the legs suggests chronic venous insufficiency.

    <p>True (A)</p> Signup and view all the answers

    What is an abnormal finding if the lower legs appear asymmetric?

    <p>Measure the calf circumference with a tape measure (C)</p> Signup and view all the answers

    Diffuse bilateral edema is usually associated with systemic illnesses.

    <p>True (A)</p> Signup and view all the answers

    What is an abnormal finding in the legs when examining for acute swelling?

    <p>Unilateral swelling of the calf (A)</p> Signup and view all the answers

    What is the name of the test that involves flexing the person's knee and compressing the calf muscle?

    <p>Homan's Sign</p> Signup and view all the answers

    It is essential to palpate the popliteal pulse with the patient lying supine.

    <p>True (A)</p> Signup and view all the answers

    Which pulse is located lateral to the medial tendon of the knee?

    <p>Popliteal Pulse (A)</p> Signup and view all the answers

    What is the purpose of checking for pretibial edema?

    <p>To assess fluid retention and potential circulatory issues.</p> Signup and view all the answers

    Which type of edema is a common finding in heart failure?

    <p>Bilateral edema (B)</p> Signup and view all the answers

    What is the grading scale used to assess pitting edema?

    <p>1+ to 4+ (C)</p> Signup and view all the answers

    A 4+ pitting edema indicates a very deep indentation that lasts a long time and the leg is very swollen.

    <p>True (A)</p> Signup and view all the answers

    What is the purpose of observing the venous pattern in the legs?

    <p>To detect visible, dilated, and tortuous veins, which may indicate venous insufficiency.</p> Signup and view all the answers

    To test for arterial insufficiency, what is the initial position of the patient?

    <p>Lying supine (B)</p> Signup and view all the answers

    During the arterial insufficiency test, the patient should wag their feet for 30 seconds to drain off venous blood.

    <p>True (A)</p> Signup and view all the answers

    What is the normal finding in skin color during the arterial insufficiency test?

    <p>The feet will look a little pale but should still be pink.</p> Signup and view all the answers

    What is an abnormal finding that indicates arterial insufficiency during the skin color test?

    <p>Elevational pallor (C)</p> Signup and view all the answers

    When assessing for color changes in the legs, in what position should the patient be?

    <p>Sitting with legs dangling (C)</p> Signup and view all the answers

    Delayed venous filling is a sign of arterial insufficiency.

    <p>True (A)</p> Signup and view all the answers

    What is the purpose of using a Doppler Ultrasonic Stethoscope?

    <p>To detect weak peripheral pulses that may be difficult to palpate manually.</p> Signup and view all the answers

    What is the name of the neuro-circulation check that is performed to assess circulation to a body part?

    <p>Circulation Check (A)</p> Signup and view all the answers

    The 4 Ps of circulation check include Pulses, Pallor, Pain, and Paresthesia.

    <p>True (A)</p> Signup and view all the answers

    Which of the following is a characteristic of arterial insufficiency pain?

    <p>Deep muscle pain in the calf or foot (B)</p> Signup and view all the answers

    Venous insufficiency pain is typically worse at the end of the day.

    <p>True (A)</p> Signup and view all the answers

    What is claudication?

    <p>Claudication is pain that occurs with walking and is relieved by rest, often a symptom of peripheral artery disease.</p> Signup and view all the answers

    Skin with a coarse, thick, and tough texture is a characteristic of arterial insufficiency.

    <p>False (B)</p> Signup and view all the answers

    What type of skin discoloration is associated with venous insufficiency?

    <p>Brown pigmentation (A)</p> Signup and view all the answers

    Pulses are usually absent or decreased in arterial insufficiency.

    <p>True (A)</p> Signup and view all the answers

    What type of edema is typically seen in venous insufficiency?

    <p>Firm brawny edema (B)</p> Signup and view all the answers

    Which of the following is a characteristic finding in arterial ulcers?

    <p>No bleeding (C)</p> Signup and view all the answers

    Ulcers associated with venous insufficiency are often located at the medial malleolus and anterior tibia.

    <p>True (A)</p> Signup and view all the answers

    What is the term for unilateral edema that occurs with occlusion of a deep vein?

    <p>Unilateral edema</p> Signup and view all the answers

    Unilateral or bilateral edema can occur with lymphatic obstruction.

    <p>True (A)</p> Signup and view all the answers

    Acute arterial insufficiency is a medical emergency and requires immediate intervention.

    <p>True (A)</p> Signup and view all the answers

    Venous insufficiency is a chronic condition where the veins are unable to transport blood efficiently back to the heart.

    <p>True (A)</p> Signup and view all the answers

    Study Notes

    Health Assessment Lecture 8: Peripheral Vascular & Lymphatic System Assessment

    • Vascular System: Consists of the body's vessels, which transport fluids like blood and lymph.
    • Arteries: Contain elastic fibers and smooth muscle, enabling them to contract and dilate for a high-pressure system.
    • Capillaries: Microscopic vessels.
    • Veins: Located closer to the skin, with thinner walls than arteries and a lower pressure system. They have a larger diameter.
    • Lymphatic Vessels: Collect excess fluid from tissues and return it to the bloodstream. The right lymphatic and thoracic ducts are key components.

    Subjective Data

    • Leg pain or cramps: A symptom to note.
    • Skin changes (arms or legs): Changes in appearance.
    • Swelling (arms or legs): Edema, which can be bilateral (generalized) or unilateral (local obstruction or inflammation).
    • Lymph node enlargement: Assess for swollen lymph nodes.
    • Medications: Include medications in the patient's history.
    • Smoking history: A risk factor to document.

    Objective Data/Preparation

    • Privacy: Ensure patient privacy.
    • Room temperature: Adjust to approximately 22°C.
    • Inspection and palpation: Visual and tactile examination.
    • Compare extremities: Examine both sides of the body.
    • Equipment: Needed for assessment: Tape measure, tourniquet/blood pressure cuff, Doppler ultrasound stethoscope.

    Inspection & Palpation of Arms

    • Color of skin and nailbeds: Important for identifying changes.
    • Temperature: Measure temperature and note any differences.
    • Texture: Note skin texture.
    • Turgor of skin: Assess skin elasticity.
    • Lesions, edema, clubbing: Look for abnormal findings.
    • Capillary refill: Time it takes for color return, less than 1–2 seconds is normal.
    • Arms size: Should be symmetric in size.
    • Abnormal findings: Edema of upper extremities, potentially due to obstructed lymphatic drainage (like after breast surgery).
    • Scars, Radial Pulses, Brachial Pulses Assess for any visible scars or abnormal pulses.

    Inspection & Palpation of Arms Continued

    • Rate and rhythm of pulses: Palpate brachial and radial pulses for normal rate and rhythm.
    • Amplitude (scale 0-3+): Assess the strength of the pulse (normal = 2+, increased = 3+, weak = 1+, absent = 0).
    • Elasticity: Check the elasticity of the vessel.
    • Pulse assessment of Brachial and Radial: Assess the presence and strength (amplitude) of these pulses. Ulnar pulse is typically not necessary.
    • Epitrochlear lymph nodes: Usually not palpable.
    • Modified Allen Test: Checks collateral circulation. Steps and normal findings.

    Inspection & Palpation of Legs

    • Skin color and temperature: Check for pallor (paleness) and coolness, often seen in arterial insufficiency.
    • Hair distribution: Note any abnormalities.
    • Venous pattern: Assess for visible, dilated or tortuous veins in a standing position.
    • Skin discoloration/lesions/ulcers/gangrene: Note any discoloration, lesions, ulcers, or gangrene, especially associated with chronic venous stasis.
    • Symmetric size Assess for symmetry.
    • Calf circumference: Measure in case of asymmetry.

    Inspection & Palpation of Legs Continued

    • Diffuse bilateral edema: Occurs with systemic illness.
    • Acute unilateral painful swelling: Possible indications of DVT or lymphedema.
    • Homans' sign: A test for calf pain, tenderness, or pain when dorsiflexing the foot. Note any tenderness or calf pain during this test.
    • Inguinal lymph nodes: Palpate for size, tenderness, and mobility.
    • Peripheral pulses: Palpate femoral, popliteal, posterior tibial, and dorsalis pedis pulses.

    Checking for Pretibial Edema

    • Procedure: Firmly depress the skin over the tibia for 5 seconds and release. Note if there's an indentation.
    • Normal: No indentation.
    • Pitting edema: Grade the severity if present (e.g., 1+ to 4+).
    • Abnormal findings: Can indicate heart failure, diabetic neuropathy, hepatic cirrhosis, deep vein occlusion, or lymphatic obstruction.

    Pitting Edema Scale

    • 1+: Mild pitting, slight indentation; no noticeable swelling.
    • 2+: Moderate pitting, indentation quickly subsides.
    • 3+: Deep pitting, indentation remains for a short time; leg looks swollen.
    • 4+: Very deep pitting, indentation lasts a long time; leg significantly swollen.

    Testing for Arterial Insufficiency

    • Procedure: Have the patient lie supine, elevate the legs 30cm, and ask the patient to move their feet side-to-side.
    • Observe Color Return Time: Note the time it takes for color return to the feet after the movement (normal is ≤10 seconds).
    • Abnormal findings: Marked elevational pallor suggests suspected arterial insufficiency.

    The Doppler Ultrasonic Stethoscope

    • Used to detect weak peripheral pulses. Continuous-wave Doppler ultrasound detects blood flow.

    Other assessments

    • Neuro-circulation check (circulation check): Done any time there's a possibility of compromised blood circulation (post-surgery/surgery procedures, use of casts, etc.)
    • Assess for 4 Ps: Pain, Pallor, Pulselessness, Paresthesia.
    • Arterial & venous insufficiency: Differentiate symptoms and findings related to arterial and venous problems, include information like pain, skin changes, edema, pulses, and ulcers.

    Important Additional Points

    • Assessment details: Focus on specific details of each assessment technique.
    • Normal vs. abnormal findings: Clearly distinguish between normal and abnormal results/findings, with corresponding conditions/diagnosis if possible.
    • Patient information: Patient history regarding smoking, medications, and past medical conditions.
    • Documentation: Importance of accurate documentation in patient records.

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    Health Assessment Lecture 8: Peripheral Vascular System & Lymphatic System Assessment PDF

    Description

    This quiz focuses on Lecture 8 of Health Assessment, concentrating on the Peripheral Vascular and Lymphatic Systems. You'll learn about the anatomy of arteries, veins, and lymphatic vessels, as well as key subjective data to assess in patients. Test your knowledge on these essential components of health assessment.

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