Human Anatomy: Veins and Arteries Quiz

Body: Veins vs. Arteries

• The body has more veins than arteries.
• Veins lie closer to the skin surface.

Arterial Pulses

• Arterial pulses are graded on a scale of 0 to 3+.
• 0: absent
• 1+: weak, thready
• 2+: “normal”
• 3+: full, bounding
• Possible locations where pulses can be palpated include the temporal, carotid, brachial, radial, ulnar, femoral, popliteal, posterior tibial, and dorsalis pedis arteries.

Anatomy: Veins

• Veins direct blood flow to the heart.
• Veins contain valves to prevent backflow of blood.

Anatomy: Lymphatics

• The lymphatic system is a completely separate vessel system.
• The lymphatic system drains excess fluid and plasma proteins from the interstitial fluid and returns them to the bloodstream.
• Faulty lymphatic drainage can lead to buildup of fluid in interstitial spaces, known as edema.
• The lymphatic system drains into two main trunks that empty into the subclavian veins: the right lymphatic duct and the thoracic duct.

Superficial Lymph Nodes of the Arms & Legs

• Superficial lymph nodes of the arms and legs are easily accessible.

Peripheral Vascular: Subjective Data

• The peripheral vascular system can be assessed by examining the arms and legs.

Arms: Palpation

• Palpating Radial Pulse: Normal findings include strong and bilateral pulses (2+), abnormal findings include full, bounding pulses (3+), weak, thready pulses (1+), or absent pulses (0).
• Palpating Brachial Pulse: Normal findings include strong and bilateral pulses (2+), abnormal findings include full, bounding pulses (3+), weak, thready pulses (1+), or absent pulses (0).
• Allen Test: Used to evaluate collateral circulation of the radial artery. Normal findings include pink coloration returning to the palms within 7 seconds after releasing pressure on the ulnar artery. Abnormal findings include pallor that persists or sluggish return to color.

Legs: Inspection

• Skin Coloration & Size: Normal findings include even skin tone, symmetrical legs. Abnormal findings include pallor (vasoconstriction), erythema (vasodilation), pallor on elevation/rubor on dependence, asymmetry, DVT (Deep Vein Thrombosis), gangrene/necrosis, and ulcers.
• Hair Distribution on Legs: Normal findings include hair covering the legs. Abnormal findings include loss of hair on the legs.
• Older Adult Considerations: Hair loss on the lower extremities occurs with aging and is not an absolute sign of arterial insufficiency. Observe for lesions or ulcers.
  • Arterial Ulcers: Smooth, even margins, occur at pressure areas.
  • Venous Ulcers: Irregular edges, bleeding, possible bacterial infection, occur on the medial ankle.
• Edema: Normal findings include symmetrical size and shape with no edema or atrophy. Abnormal findings include diffuse bilateral edema, acute, unilateral edema, asymmetry, lymphedema, or asymmetric calf swelling.
• Varicosities: Normal findings include veins that are flat and barely visible. Abnormal findings include varicose veins (distended, nodular, bulging, and tortuous).
• Older Adult Considerations: Varicosities are common in older adults.
  • Thrombophlebitis: Superficial thrombophlebitis resulting from thrombus formation in the superficial veins.

Legs: Palpation

• Palpating Dorsalis Pedis Pulse: Normal findings include strong and bilateral pulses (2+), abnormal findings include full, bounding pulses (3+), weak, thready pulses (1+), or absent pulses (0).
• Palpating Posterior Tibial Pulse: Normal findings include strong and bilateral pulses (2+), abnormal findings include full, bounding pulses (3+), weak, thready pulses (1+), or absent pulses (0).

Peripheral Vascular Disease

• Peripheral vascular disease (PVD) is a circulatory condition where narrowed blood vessels reduce blood flow to the limbs.
• Symptoms of PVD include feeling cold and pain.
• The most common cause of PVD is atherosclerosis (buildup of fatty deposits in blood vessels).
• Other causes of PVD include diabetes, obstruction, infections, arteritis, blood vessel defects, and blood vessel spasms.

Chronic Venous Insufficiency

• Chronic venous insufficiency is caused by poor venous return to the heart.
• Location: Calf, lower leg.
• Character: Aching, tiredness, feeling of fullness.
• Onset & Duration: Chronic pain, increased at the end of the day.
• Aggravating Factors: Prolonged standing or sitting.
• Relieving Factors: Elevation, lying, walking.
• Associated Symptoms: Edema, varicosities, weeping ulcers at ankles, hemosiderin staining.
• Risk Factors: Job with prolonged standing/sitting, prolonged bed rest, history of heart failure, obesity, varicosities or thrombophlebitis, trauma to veins.

Chronic Arterial Insufficiency

• Chronic arterial insufficiency is caused by reduced arterial blood flow.
• Location: Deep muscle pain, usually in the calf, but may be lower leg or dorsum of foot.
• Character: Intermittent claudication.
• Onset & Duration: Chronic pain, onset after gradual exertion.
• Aggravating Factors: Activity (walking up stairs).
• Relieving Factors: Rest (usually within 2 minutes).
• Associated Symptoms: Low ankle-brachial index, cool, pale skin, diminished pulses, pallor on elevation.
• Risk Factors: Older adult, smoking, diabetes, hypertension, hypercholesterolemia, obesity, chronic kidney disease.

Acute Arterial Insufficiency

• Acute arterial insufficiency is a serious condition that requires immediate medical attention.
• Location: Varies, distal to occlusion (may involve entire extremity).
• Character: Throbbing.
• Onset & Duration: Sudden onset (within 1 hour).
• Associated Symptoms: Six P’s - pain, pallor, pulselessness, paresthesia, poikilothermia (coldness), paralysis.
• Risk Factors: History of vascular surgery, invasive arterial procedure, abdominal aneurysm, trauma to arteries, chronic atrial fibrillation.

Comparison of Arterial & Venous Insufficiency

Testing for Arterial Insufficiency

• The ankle-brachial index (ABI) is a common test to assess arterial insufficiency.
• The ABI is calculated by dividing the systolic blood pressure in the ankle by the systolic blood pressure in the arm.

Test your knowledge on the differences between veins and arteries, including their structure and function. Explore arterial pulses and the lymphatic system's role in fluid drainage. Understand the significance of these concepts in human anatomy.