Vascular and Lymphatic System Fundamentals

Vascular System Structure and Function

• Peripheral vascular and lymphatic assessments evaluate the vascular system.
• The heart pumps oxygenated blood through arteries to all body tissues.
• Arteries are a high-pressure system due to the heart's pumping action.
• Arterial walls are strong, tough, and elastic to withstand pressure.
• Vascular smooth muscle (VSM) controls blood delivery by changing arterial diameter.
• Veins return deoxygenated blood to the heart.
• Efficient venous return is essential for cardiovascular health.

Lymphatic System

• The lymphatic system drains lymph fluid from tissues and facilitates immune responses.
• Components include lymph nodes, lymphatic ducts, and immune-related organs.

Developmental Competence in Aging Adults

• Arteriosclerosis and atherosclerosis are common changes associated with aging.
• Increased systolic blood pressure is often observed.
• Enlarged intramuscular calf veins may be present.
• Deep vein thrombosis and pulmonary embolism risk increases.

Assessment Overview: Subjective Data

• Key questions for patients include leg pain/cramps.
• Skin changes on arms or legs (color, temperature, texture, turgor).
• Swelling in arms or legs.
• Lymph node enlargement (suggests immune system involvement).
• Medications and smoking (important risk factors).

Assessment Overview: Objective Data—Arms

• Inspect color, temperature, texture, and nail beds.
• Assess for lesions, edema, or clubbing.
• Use the profile sign and capillary refill test (normal is <2 seconds).

Assessment Overview: Objective Data—Legs

• Maintain patient modesty.
• Check for skin discoloration, ulcers, or gangrene.
• Palpate for temperature differences.
• Locate and assess pulses (femoral, popliteal, posterior tibial, dorsalis pedal).

Special Tests

• Allen test: Evaluates blood flow to hands and wrists.
• Doppler ultrasound: Measures blood flow and detects arterial insufficiency.
• Grading pulses: 0 (absent) to 3+ (full/bounding) assesses arterial strength.

Common Conditions and Indicators: Arterial Insufficiency

• Symptoms include deep muscle pain, claudication, and rest pain.
• Indicators include diminished pulses, pale skin, and cold limbs.
• Severe cases may present with ulcers or gangrene.

Common Conditions and Indicators: Venous Insufficiency

• Symptoms include aching pain that worsens with standing/sitting.
• Other indicators include edema, brawny skin, dermatitis, and pruritus.

Health Promotion

• Male patients should be encouraged to perform testicular self-exams and have prostate and colorectal cancer screenings.
• Female patients should perform breast self-exams and receive HPV vaccination and cervical cancer screenings.