Peripheral Vascular and Lymphatic System Learning Guide PDF

N247 University of Southern Indiana Learning Guide Peripheral Vascular and Lymphatic System Prep: Review Chapter 21; ATI Workbook Ch 29 Objectives: 1. Describe the structure and function of arteries, veins, and lymphatics. - Arteries: Thi...

N247 University of Southern Indiana Learning Guide Peripheral Vascular and Lymphatic System Prep: Review Chapter 21; ATI Workbook Ch 29 Objectives: 1. Describe the structure and function of arteries, veins, and lymphatics. - Arteries: Thick-walled vessels that carry oxygenated blood from the heart to tissues, except for the pulmonary artery, which carries deoxygenated blood to the lungs. They regulate blood flow and pressure through vasoconstriction and vasodilation. - Veins: Thin-walled vessels with valves that drain deoxygenated blood to the heart, except for the pulmonary veins, which carry oxygenated blood from the lungs. Veins rely on muscle contractions and valves to prevent backflow. - Lymphatics: Thin-walled vessels that drain excess interstitial fluid and return it to the bloodstream. Back-up for the immune system, absorbs lipids (fat) from the intestinal tract, conserve fluid plasma protein that leaks into capillaries refills 2. List pulses by name and location that are accessible to palpation. - Arms: Radial, Brachial, Ulnar - Lower Leg: Femoral, Dorsalis Pedis, popliteal, Posterior Tibial - Head: Temporal 3. Describe the mechanisms of the venous system. - Muscle constriction, sends blood up and valve prevent blood to fall back. 4. Explain the term “capacitance vessels.” - It’s a vein - Thinner that artery, contain values prevent back flow, passive blood flow dependent on muscles 5. Describe the process of venous flow in the lower extremities. - Great Saphenous vein (open heart surgery) = “a cabbage” 6. List risk factors for venous stasis. - Clots - Bed ridden - Patient not moving 7. Relate the structure and function of the lymph vessels. - Albumin: helps prevent cells for leaking out - Functions:  Fluid balance: Lymph vessels collect excess interstitial fluid from tissues, preventing swelling (edema), and return it to the bloodstream. Seibert 10/15/2024  N247 University of Southern Indiana Learning Guide  Immune response: Lymph vessels transport lymph to lymph nodes, where immune cells (lymphocytes) monitor and fight infections.  Fat absorption: Lymph vessels in the small intestine (lacteals) absorb dietary fats and transport them to the bloodstream - Structure:  Thin walls: Allow interstitial fluid (lymph) to enter.  Valves: Prevent backflow, ensuring lymph flows toward the heart.  Lymph capillaries: Collect lymph from tissues.  Larger lymph vessels: Transport lymph to lymph nodes for filtration.  Lymph nodes: Filter pathogens and debris.  Thoracic and right lymphatic ducts: Return filtered lymph to the bloodstream. 8. Describe the function of the lymph nodes. - Filters pathogens  Phagocytosis helps with immune response 9. Recognize the location of superficial groups of lymph nodes. - Cervical (lymph node) - Axillary (armpits) - Inguinal (groin) 10. Name the related organs and functions of the lymphatic system. 1. Spleen: Destroys old RBCs. Stores RBCs. Produces antibodies. Filters microorganisms. 2. Peyer’s patches: Keeps intestinal flora normalized. (balancing) 3. Tonsils: Respond to local inflammation 4. Thymus: Develops T-lymphocytes in children. 11. Identify subjective (normal and abnormal findings) information associated with assessment of the peripheral vascular system. - (Slide 15) 12. List and describe inspection, palpation, and auscultation techniques involved with PV assessment. - (slide 17,18,19,21) - 13. Describe how to document edema. - Pitting edema lower right extremities (2+) (being specific on extremity) 14. Describe how to document pulses. - Location, doc. Reading of pulse RRP (absent, bounding, rhythm),location, force 15. Describe how to document abnormal lymph nodes. Seibert 10/15/2024  N247 University of Southern Indiana Learning Guide - Inflamed, location, which lymph node, both side or one side, 16. Describe peripheral artery disease by pathophysiology and signs and symptoms. - (slide 39) - Emergent situation 17. Describe venous insufficiency by pathophysiology and signs and symptoms. - Lack of blood flow - Build up - Back flow - (Slide 41 question) - Fluid overload (tissue over worked) 18. Compare assessment findings in peripheral artery disease versus venous insufficiency/stasis. - PAD: lack of blood flow / zero blood (cold to touch, pallor, cyanosis, thin, frail, shinning, hair symmetry, low Pulse = Doppler, dry ulcer, distinct whole) - Venous: too much blood/fluid (Edema, pitting, hot/warm to palpate, Hemosiderin stain, pulse will be present, ulcers wet draining) 19. Describe interventions for venous insufficiency. - Elevate legs or SPD’s - Compression socks 20. Describe signs, symptoms, and risk factors for a DVT. - (slide 34 and 35) - Uni-lateral 21. Identify preventative treatments for DVT. - SPD’s - Compression socks - Mobility of lower extremities 22. Describe findings with Raynaud’s Phenomenon. - Muliti color hands - Arterial problem due lack of blood flow - Cause by trigger:  Cold  Vibration (object shacking) 23. Recite normal ranges for a INR and platelet counts. - (slide 45) 24. Recite normal ranges for A1C and blood glucose. Seibert 10/15/2024  N247 University of Southern Indiana Learning Guide - 25. Describe labs that relate to PVD. 26. Define the following terms. Allen’s Test: Evaluates the patency of the radial and ulnar arteries by temporarily occluding them. Patho: Used to check collateral circulation in the hand, ensuring both arteries can supply blood independently. Ankle-Brachial Index (ABI): Measures the ratio of ankle to brachial systolic blood pressure, indicating peripheral artery disease (PAD). Patho: PAD is caused by atherosclerosis, leading to reduced blood flow to the lower limbs, causing pain and delayed wound healing. Arteriosclerosis: Plaque buildup, eventually clotting. The hardening and thickening of arterial walls due to aging or disease. Patho: Decreases vessel elasticity, increasing blood pressure and reducing blood flow to organs and tissues. Aneurysm: A localized dilation of an artery due to weakened vessel walls. Patho: Caused by factors like atherosclerosis or hypertension, which weaken arterial walls and increase the risk of rupture, potentially causing life-threatening hemorrhage. (AAA) Bruit: An abnormal sound caused by turbulent blood flow in an artery (vessels). (not hearing anything when listening to vessels) Patho: Indicative of arterial narrowing (stenosis), often due to atherosclerosis, which increases the risk of ischemic events and JVD. Calf Circumference: Measurement used to assess edema or muscle atrophy = DVT Patho: Increased circumference may indicate deep vein thrombosis (DVT) or lymphedema, while decreased size may signal muscle wasting or disuse. Capacitance Vessel: Refers to veins, which act as reservoirs for blood due to their ability to stretch and store large volumes. Patho: Veins can hold 60-70% of the body’s blood, and their dysfunction (valve failure) can lead to venous stasis and varicose veins. Capillary Refill: A test of peripheral perfusion by observing the time it takes for color to return to the nail bed after pressure is applied. Seibert 10/15/2024  N247 University of Southern Indiana Learning Guide Patho: Delayed refill (>2 seconds) suggests poor peripheral circulation, often due to dehydration, shock, or peripheral vascular disease. Claudication: is ischemia, Pain or cramping in the legs during exertion due to inadequate blood supply. Patho: Common in PAD, where atherosclerosis limits blood flow to the muscles, causing ischemic pain with activity. Cyanosis: Bluish discoloration of the skin due to insufficient oxygen in the blood. Patho: Caused by hypoxia, which can occur from respiratory, cardiac, or circulatory conditions like chronic obstructive pulmonary disease (COPD) or heart failure. Deep Vein Thrombophlebitis: Inflammation of a deep vein, often accompanied by a clot (thrombus). Patho: DVT can occur from stasis, vessel wall injury, or hypercoagulability, leading to swelling, pain, and potential embolism if the clot travels to the lungs. Doppler: An ultrasound device that detects blood flow through vessels. Patho: Used to diagnose vascular abnormalities like DVT, arterial occlusion, or fetal blood flow issues. Hemosiderin Staining (gator stain): Brownish discoloration of the skin caused by iron deposits from red blood cell breakdown. Patho: Occurs in chronic venous insufficiency when red blood cells leak into tissues, break down, and release iron, leading to skin pigmentation changes. Edema: The accumulation of fluid in tissues, causing swelling. Patho: Results from increased capillary pressure, decreased oncotic pressure, or lymphatic obstruction, commonly seen in heart failure, kidney disease, or venous insufficiency. Inguinal: Pertains to the groin area, including inguinal lymph nodes. Patho: Inguinal nodes filter lymph from the lower extremities, and enlargement can signal infections, cancers, or immune reactions. Ischemia: Inadequate blood supply to a tissue, leading to oxygen deprivation and possible cell death. Patho: Can occur due to arterial blockages (e.g., from atherosclerosis or embolism), reducing oxygen delivery to tissues, causing pain and tissue damage. Lymph Node: Small, bean-shaped structures that filter lymph fluid and house immune cells. Seibert 10/15/2024  N247 University of Southern Indiana Learning Guide Patho: Swollen lymph nodes often indicate an immune response to infection, malignancy, or inflammation. Lymphedema: Swelling due to lymphatic fluid accumulation when lymph drainage is impaired. Patho: Can result from lymph node removal, radiation, or congenital malformations, leading to chronic swelling, usually in the limbs. Necrosis: Death of tissue due to lack of blood supply (ischemia), infection, or injury. Patho: Without oxygen and nutrients, tissues die, leading to complications like gangrene or sepsis. Peripheral Artery Disease (PAD): Narrowing of peripheral arteries, usually due to atherosclerosis. Patho: Reduced blood flow leads to ischemia, causing symptoms like claudication, non-healing wounds, and, in severe cases, tissue necrosis. Pitting Edema: Swelling that leaves an indentation when pressed. Patho: Occurs from fluid buildup in tissues, often due to heart failure, kidney disease, or chronic venous insufficiency. Dependent Rubor: sign of PAD, sitting off table and feet dangling. A red discoloration of the skin when the affected limb is in a dependent (downward) position, often seen in arterial insufficiency. Patho: Indicates poor arterial blood flow; gravity-dependent blood pooling causes the reddish appearance. Spleen: An organ that filters blood, removes old red blood cells, and supports the immune system. Patho: Enlarged in conditions like infection or hemolytic anemia, but it can rupture in trauma. Thymus: A gland where T-cells mature, crucial for the adaptive immune system. Patho: Shrinks with age, but congenital or acquired issues affecting the thymus can lead to immune deficiencies. Tonsils: Lymphoid tissues in the throat that help trap pathogens. Patho: Repeated infections can cause tonsillitis, often leading to surgical removal (tonsillectomy). Varicose Veins: Enlarged, twisted veins due to valve dysfunction, leading to blood pooling. Seibert 10/15/2024  N247 University of Southern Indiana Learning Guide Patho: Venous valves become incompetent, allowing blood to backflow and veins to enlarge, causing pain, swelling, and skin changes. Venous Insufficiency: Chronic inability of veins to return blood efficiently to the heart, causing pooling in the lower extremities. Patho: Valve failure or vein wall damage results in venous stasis, leading to swelling, pain, and ulcers. Venous Stasis: Slowed or stagnant blood flow in the veins, often contributing to clot formation. Patho: Typically occurs in the lower limbs due to prolonged immobility, leading to an increased risk of DVT and ulcers. Seibert 10/15/2024