Health Screening Guidelines Quiz

Peripheral Vascular & Lymphatic Assessment

• Peripheral vascular and lymphatic assessment is a crucial part of patient evaluation
• Assessment involves both the vascular and lymphatic systems
• Assessment encompasses both subjective and objective data collection

Vascular System and Lymphatics

• High hydrostatic pressure pushes fluid out of capillaries into interstitial space

• High oncotic pressure draws fluid back into capillaries from plasma proteins

• Lymph vessels collect excess interstitial fluid and return it to the circulatory system

Structure and Function of Arteries

• Arteries pump freshly oxygenated blood throughout the body
• They have high pressure due to pumping heart
• Artery walls strong, tough, and tense to withstand pressure demands
• Contain elastic fibers for stretching during systole and recoiling in diastole
• Contain vascular smooth muscle (VSM) which controls blood delivery to tissues by altering artery diameter
• VSM alters artery diameter to control blood flow rate

Arteries in the Arm

• Pulse sites located along various arteries like radial, ulnar, brachial
• Deep and superficial palmar arches located in hand

Vessels in the Leg

• Major arteries and veins include aorta, common iliac, external iliac, femoral, popliteal, anterior tibial, posterior tibial, dorsalis pedis
• Pulse sites located in different leg areas
• Venous system including great saphenous and small saphenous veins

Venous Flow

• Venous flow aided by inspiration, skeletal muscle contraction and intraluminal valves that prevent backflow
• Inspiration creates pressure difference, helping venous return
• Skeletal muscle contraction compresses veins, promoting venous flow
• Intraluminal valves prevent backward movement of blood

Lymphatic Ducts and Drainage Patterns

• Lymphatic ducts and nodes are part of the immune system
• Nodes filter lymph fluid
• Lymph originates in interstitial space
• Lymphatic drainage patterns differ regionally based on location
• Right lymphatic duct and thoracic duct drain lymph into venous circulation
• Lymph nodes involved in filtering lymph fluid

Immune-Related Organs

• Tonsils, thymus, spleen, Peyer's patches and bone marrow part of the immune system
• These organs help fight infection and disease
• Lymph nodes scattered throughout the body filter lymph

Aging Adult

• Arteriosclerosis and atherosclerosis are common issues
• Systolic blood pressure often increases
• Intra muscular calf veins enlarge
• Deep vein thrombosis (DVT) and subsequent pulmonary embolism are risks

Subjective Data

• Subjective data includes patient reported symptoms
• Symptoms may be pain, cramps, skin changes, swelling, lymph node enlargement, smoking history, medications and history of breast changes

Objective Data

• Objective data involves physical examination
• Inspect and palpate arms, noting color, temperature, texture, lesions, edema, and clubbing of nails
• Measure normal nail bed angle (160 degrees)
• Assess capillary refill time (less than 2 seconds)
• Check skin temperature, symmetry and condition

Allen Test

• Allen test assesses for proper blood supply to the hand (radial and ulnar arteries)
• Clinician compresses radial and ulnar arteries, observes blood return through the other artery
• A normal test indicates good circulation

Objective Data (Legs)

• Uncover legs, observe for changes like skin discoloration, ulcers, or gangrene
• Note size and location of abnormalities
• Assess leg temperature; compare symmetric spots
• Compression of gastrocnemius muscle for tenderness
• Palpate for femoral, popliteal, posterior tibial, and dorsalis pedis pulses for proper blood flow

Deep Vein Thrombosis (DVT) Assessment

• Evaluation method used to determine probability of DVT
• Score determined by specific symptoms like active cancer, bedridden recentl, surgery or calf swelling, etc.

Pulse Grading Scale

• Pulse grading scale ranges from 0 to 3+
• 0 is absent pulse, 1+ is weak, 2+ is normal, 3+ is full bounding

Objective Data (cont.)

• Check for pretibial edema and grade it
• Mild pitting, slight indentation
• Moderate pitting, rapid subsidence of indentation
• Deep pitting, lasting indentation and swelling of the leg
• Very deep pitting, prolonged indentation and severe leg swelling

Manual Compression Test

• Manual compression assessing venous competence

Trendelenburg Test

• Trendelenburg Test assesses venous valves, evaluating competence.

Objective Data (Peripheral Artery Disease)

• Assess for color changes and time for superficial veins to fill
• Unreliable assessment if venous disease coexists
• Test lower legs for strength and sensation

Using a Doppler to Measure Blood Flow

• Doppler ultrasound used to measure blood flow through arteries and veins

Arterial Insufficiency

• Symptoms include deep muscle pain, claudication, rest pain, dependent rubor, decreased pulses, skin changes, pain, pallor, pulselessness, paresthesia, and poikilothermia leading to paralysis
• Causes include atherosclerosis and arteriosclerosis

Arterial Risk Factors

• Age, smoking, diabetes, hypertension, elevated lipid levels, male gender, obesity, high fat diet, heavy alcohol use, coagulation abnormalities, and physical inactivity

Venous Insufficiency

• Symptoms include ache, worsens with prolonged standing/sitting, brawny edema, coarse thickened skin, dermatitis, and pruritis

Venous Risk Factors

• Pregnancy, prolonged sitting/standing, limited physical activity, age, obesity, and use of constricting clothing

Arterial vs Venous Lesions

• Arterial ulcers appear on toes, top of feet, or lateral ankle, and have minimal drainage, little granulation tissue, and deep "punched-out" appearance with distinct margins
• Venous ulcers appear on medial lower legs or medial ankle and are usually swollen with drainage, present granulation tissue and have shallow, irregular edges

Abnormal Findings (Arterial Pulses)

• Weak or "thready" pulses, full or bounding pulses, and pulsus paradoxus

Sample Charting (Subjective)

• Patient reports no leg pain, skin changes, or swelling, no history of heart/vascular problems, diabetes, or obesity, and no smoking or medications.

Sample Charting (Objective)

• Patient extremities display pink-tan coloring, without redness, cyanosis, or lesions. Extremities are symmetrical without edema or atrophy. Palpation indicates warm bilateral temperature. All pulses palpated bilaterally are 2+ in strength. No lymph node enlargement is present.

Male and Female Genitourinary Systems

• Focuses on health promotion for these systems

Subjective Data(Genitourinary)

• Includes detailed questions about usual bowel routine and changes, blood in stool, use of medications and rectal conditions
• In addition, patient's family history and recent medical examinations form part of the data.

Health Promotion (Males)

• Teaching on prostate cancer, colorectal cancer (CRC) and HPV
• Early screening tests (PSA, FIT, fecal immunochemical test, and colonoscopy) and HPV vaccination

Culture and Genetics (Prostate Cancer)

• Prostate cancer is frequently diagnosed in men.
• Risk factors including increasing age, African ancestry, family and genetic history, and mutation of BRCA1 and BRCA2 genes.
• Ethnic and geographic variations seen in terms of occurrence.

Self-Care (Testicular Self-Examination)

• Timing (once monthly), showering for warming the scrotal area, examination, noting any changes and reporting needed

Subjective Data (Female)

• Detailed information on menstrual and obstetric history (gravida, para, abortions, and menopause).
• Questions about screening for cervical cancer, acute pelvic pain, urinary symptoms, vaginal discharge, and sexual health.

Subjective Data Questions (Patient-Centered Care)

• Questions on self-breast examination (SBE), review of screening guidelines based on age, and patient's medical history.
• Referral to organizations like American Cancer Society for mammography recommendations.

Regional Lymphatics

• Drainage patterns for lymphatic system are regional, with different parts of the body having different lymphatic flow patterns.

Teaching Breast Self-Examination (BSE)

• Instructions on how to perform BSE, including lying down, and sitting up positions, and directional patterns to examine breast tissue

Health Promotion (Females)

• Discusses HPV vaccination, preparation for sexual activity, prevention of STIs and unintended pregnancies, and information on sexual identity, use of alcohol and drugs, physical safety in family and sexual relationships, along with awareness/prevention of cyberbullying.

Test your knowledge on health screening guidelines, including mammography, cervical cancer, and colorectal cancer screenings. This quiz also covers aspects of patient-centered care and critical health assessments. Perfect for healthcare students and professionals.