Elsevier items and derived items © 2008, 2004, 2000, 1996, 1992 by Saunders, an imprint of Elsevier Inc. Peripheral Vascular System and Lymphatic System Chapter 20
Elsevier items and derived items © 2008, 2004, 2000, 1996, 1992 by Saunders, an imprint of Elsevier Inc. Chapter 20: Chapter 20: Peripheral Vascular System and Lymphatic System Slide 20-2 Structure and Function Subjective Data—Health History Questions Objective Data—The Physical Exam Abnormal Findings
Elsevier items and derived items © 2008, 2004, 2000, 1996, 1992 by Saunders, an imprint of Elsevier Inc. Chapter 20: Chapter 20: Peripheral Vascular System and Lymphatic System Slide 20-3 Structure and Function Arteries Temporal artery Carotid artery Arteries in the arm Brachial Ulnar Radial Arteries in the leg Femoral Popliteal Dorsalis pedis Posterior tibial
Elsevier items and derived items © 2008, 2004, 2000, 1996, 1992 by Saunders, an imprint of Elsevier Inc. Chapter 20: Chapter 20: Peripheral Vascular System and Lymphatic System Slide 20-4 Structure and Function (cont.) Veins Jugular veins (Chapter 19) Veins in the arm Veins in the leg Deep veins Femoral Femoral Popliteal Popliteal Superficial veins Great saphenous Great saphenous Small saphenous Small saphenous Perforators (connecting veins)
Elsevier items and derived items © 2008, 2004, 2000, 1996, 1992 by Saunders, an imprint of Elsevier Inc. Chapter 20: Chapter 20: Peripheral Vascular System and Lymphatic System Slide 20-5 Arteries in the Arm
Elsevier items and derived items © 2008, 2004, 2000, 1996, 1992 by Saunders, an imprint of Elsevier Inc. Chapter 20: Chapter 20: Peripheral Vascular System and Lymphatic System Slide 20-6 Vessels in the Leg
Elsevier items and derived items © 2008, 2004, 2000, 1996, 1992 by Saunders, an imprint of Elsevier Inc. Chapter 20: Chapter 20: Peripheral Vascular System and Lymphatic System Slide 20-7 Venous Flow
Elsevier items and derived items © 2008, 2004, 2000, 1996, 1992 by Saunders, an imprint of Elsevier Inc. Chapter 20: Chapter 20: Peripheral Vascular System and Lymphatic System Slide 20-8 Structure and Function (cont.) Lymphatics Right lymphatic duct Thoracic duct Functions of the lymphatic system Lymph nodes Related organs to lymphatic system
Elsevier items and derived items © 2008, 2004, 2000, 1996, 1992 by Saunders, an imprint of Elsevier Inc. Chapter 20: Chapter 20: Peripheral Vascular System and Lymphatic System Slide 20-9 Lymphatic Ducts and Drainage Patterns
Elsevier items and derived items © 2008, 2004, 2000, 1996, 1992 by Saunders, an imprint of Elsevier Inc. Chapter 20: Chapter 20: Peripheral Vascular System and Lymphatic System Slide Immune-Related Organs
Elsevier items and derived items © 2008, 2004, 2000, 1996, 1992 by Saunders, an imprint of Elsevier Inc. Chapter 20: Chapter 20: Peripheral Vascular System and Lymphatic System Slide Subjective Data— Health History Questions Leg pain or cramps Skin changes on arm or legs Swelling Lymph node enlargement Medications
Elsevier items and derived items © 2008, 2004, 2000, 1996, 1992 by Saunders, an imprint of Elsevier Inc. Chapter 20: Chapter 20: Peripheral Vascular System and Lymphatic System Slide Objective Data—The Physical Exam Preparation Equipment needed (occasionally) Paper tape measure Tourniquet or blood pressure cuff Stethoscope Doppler ultrasonic stethoscope
Elsevier items and derived items © 2008, 2004, 2000, 1996, 1992 by Saunders, an imprint of Elsevier Inc. Chapter 20: Chapter 20: Peripheral Vascular System and Lymphatic System Slide Objective Data—The Physical Exam (cont.) Arms—Inspect and palpate Skin Profile sign Capillary refill Symmetry Radial pulse Ulnar pulse Brachial pulse Epitrochlear lymph node Modified Allen test
Elsevier items and derived items © 2008, 2004, 2000, 1996, 1992 by Saunders, an imprint of Elsevier Inc. Chapter 20: Chapter 20: Peripheral Vascular System and Lymphatic System Slide Radial Pulse
Elsevier items and derived items © 2008, 2004, 2000, 1996, 1992 by Saunders, an imprint of Elsevier Inc. Chapter 20: Chapter 20: Peripheral Vascular System and Lymphatic System Slide Ulnar Pulse
Elsevier items and derived items © 2008, 2004, 2000, 1996, 1992 by Saunders, an imprint of Elsevier Inc. Chapter 20: Chapter 20: Peripheral Vascular System and Lymphatic System Slide Brachial Pulse
Elsevier items and derived items © 2008, 2004, 2000, 1996, 1992 by Saunders, an imprint of Elsevier Inc. Chapter 20: Chapter 20: Peripheral Vascular System and Lymphatic System Slide Objective Data—The Physical Exam (cont.) Legs—Inspect and palpate Skin and hair Symmetry Temperature Calf muscle Inguinal lymph nodes Femoral pulse Popliteal pulse Posterior tibial pulse Dorsalis pedis pulse Pretibial edema Leg veins Assess while patient stands Manual compression test
Elsevier items and derived items © 2008, 2004, 2000, 1996, 1992 by Saunders, an imprint of Elsevier Inc. Chapter 20: Chapter 20: Peripheral Vascular System and Lymphatic System Slide Femoral Pulse
Elsevier items and derived items © 2008, 2004, 2000, 1996, 1992 by Saunders, an imprint of Elsevier Inc. Chapter 20: Chapter 20: Peripheral Vascular System and Lymphatic System Slide Popliteal Pulse
Elsevier items and derived items © 2008, 2004, 2000, 1996, 1992 by Saunders, an imprint of Elsevier Inc. Chapter 20: Chapter 20: Peripheral Vascular System and Lymphatic System Slide Posterial Tibial Pulse
Elsevier items and derived items © 2008, 2004, 2000, 1996, 1992 by Saunders, an imprint of Elsevier Inc. Chapter 20: Chapter 20: Peripheral Vascular System and Lymphatic System Slide Dorsalis Pedis Pulse © Pat Thomas, 2006.
Elsevier items and derived items © 2008, 2004, 2000, 1996, 1992 by Saunders, an imprint of Elsevier Inc. Chapter 20: Chapter 20: Peripheral Vascular System and Lymphatic System Slide Manual Compression Test From Bloom A, Watkins PH, Ireland J: Color atlas of diabetes, ed 2, St. Louis, 1992, Mosby.
Elsevier items and derived items © 2008, 2004, 2000, 1996, 1992 by Saunders, an imprint of Elsevier Inc. Chapter 20: Chapter 20: Peripheral Vascular System and Lymphatic System Slide Pitting Edema © Pat Thomas, 2006.
Elsevier items and derived items © 2008, 2004, 2000, 1996, 1992 by Saunders, an imprint of Elsevier Inc. Chapter 20: Chapter 20: Peripheral Vascular System and Lymphatic System Slide Objective Data—The Physical Exam (cont.) Additional techniques Color changes Doppler ultrasonic stethoscope Ankle-brachial index (ABI)
Elsevier items and derived items © 2008, 2004, 2000, 1996, 1992 by Saunders, an imprint of Elsevier Inc. Chapter 20: Chapter 20: Peripheral Vascular System and Lymphatic System Slide Abnormal Findings Variations in Arterial Pulse Weak, “thready” pulse – 1+ Full, bounding pulse – 3+ Water-Hammer (Corrigan’s) pulse – 3+ (collapses suddenly) Pulsus bigeminus Pulsus alternans Pulsus paradoxus Pulsus bisferiens
Elsevier items and derived items © 2008, 2004, 2000, 1996, 1992 by Saunders, an imprint of Elsevier Inc. Chapter 20: Chapter 20: Peripheral Vascular System and Lymphatic System Slide Sample Charting
Elsevier items and derived items © 2008, 2004, 2000, 1996, 1992 by Saunders, an imprint of Elsevier Inc. Chapter 20: Chapter 20: Peripheral Vascular System and Lymphatic System Slide Sample Charting (cont.)
Elsevier items and derived items © 2008, 2004, 2000, 1996, 1992 by Saunders, an imprint of Elsevier Inc. Chapter 20: Chapter 20: Peripheral Vascular System and Lymphatic System Slide Sample Charting (cont.)
Elsevier items and derived items © 2008, 2004, 2000, 1996, 1992 by Saunders, an imprint of Elsevier Inc. Chapter 20: Chapter 20: Peripheral Vascular System and Lymphatic System Slide Abnormal Findings Peripheral Vascular Disease Arms Raynaud’s syndrome Lymphedema Legs Arteriosclerosis—ischemic ulcer Venous (stasis) ulcer Superficial varicose veins Deep vein thrombophlebitis Occlusions Aneurysms
Elsevier items and derived items © 2008, 2004, 2000, 1996, 1992 by Saunders, an imprint of Elsevier Inc. Chapter 20: Chapter 20: Peripheral Vascular System and Lymphatic System Slide The relevant variable when discussing claudication with a patient is A.Related foods B.Distance C.Blood glucose D.Emotional state
Elsevier items and derived items © 2008, 2004, 2000, 1996, 1992 by Saunders, an imprint of Elsevier Inc. Chapter 20: Chapter 20: Peripheral Vascular System and Lymphatic System Slide The ABI (ankle-brachial index) should normally be A.Slightly greater than 1 B.Slightly less than 1 C.A negative number D.Less than 0.5