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Chapter 20
Peripheral Vascular system and Lymphatic system
| Question | Answer |
|---|---|
| Arteries | The artery walls are strong, tough, and tense to withstand pressure , Arteries contain elastic fibers, Allows artery walls to stretch with systole and recoil with diastole, Contain muscle fibers (vascular smooth muscle or VSM), Control the amount of bloo |
| Temporal Artery | Palpated in front of the ear |
| Carotid Artery | Palpated in the groove between the sternomastoid muscle and the trachea |
| Brachial artery | major artery supplying the arm, Located in the biceps triceps furrow of the upper arm and surfaces at the antecubital fossa in the elbow medial to the biceps tendon,Immediately below the elbow the brachial artery bifurcates |
| Ulnar and radial arteries | Radial pulse lies just medial to the radius at the wrist, Ulnar artery is in the same relation to the ulna (deeper) |
| Arteries in the Leg | Femoral artery, Popliteal artery, Anterior tibial artery, becomes the dorsalis pedis , Posterior tibial artery becomes the plantar arteries, |
| Ischemia | A deficient supply of oxygenated arterial blood to a tissue which may be caused by obstruction of a blood vessel, A complete blockage leads to death of the distal tissue, A partial blockage creates an insufficient supply, The ischemia may be apparent onl |
| Veins | The course of veins parallels that of arteries, The body has more veins, Lie closer to the skin surface, They have one way valves |
| Veins in the Arm | Each arm has two sets of veins: Superficial and Deep, The superficial veins are in the subcutaneous tissue and are responsible for most of the venous return |
| Veins in the Leg Three types of veins | Femoral and popliteal veins, Deep veins run alongside the deep arteries and conduct most of the venous return from the legs, As long as these veins remain intact, the superficial veins can be excised without harming the circulation (vein stripping), Grea |
| The superficial veins | The great saphenous vein, The small saphenous vein, Perforators , Connecting veins that join the two sets |
| Venous Flow | Veins drain the deoxygenated blood and its waste products from the tissues and return it to the heart, Low pressure system |
| Movement of blood is accomplished by | Contracting skeletal muscles that “milk” the blood proximally, back toward the heart, Pressure gradient caused by breathing, Intraluminal valves |
| Venous Return The "calf pump," or "peripheral heart” | While walking, the calf muscles alternately contract (systole) and relax (diastole), In the contraction phase, the gastrocnemius and soleus muscles squeeze the veins and direct the blood flow proximally, Because of the valves, venous blood flows one way |
| Walls of the veins are thinner than those of the arteries | Veins have a larger diameter and are more distensible, A compensatory mechanism to reduce stress on the heart, Because of this ability to stretch, veins are called capacitance vessels |
| Venous Return Dependent on | Contracting skeletal muscles, Competent valves in the veins, Patent lumen |
| Venous stasis At risk for venous disease | Undergo prolonged standing, sitting, or bedrest , Hypercoagulable states and vein wall trauma are other factors that increase risk for venous disease, Dilated and tortuous (varicose) veins create incompetent valves |
| Lymphatics | The lymphatics form a completely separate vessel system |
| Lymphatics Purpose | retrieves excess fluid from the tissue spaces and returns it to the bloodstream (see slide) |
| The functions of the lymphatic system | Conserve fluid and plasma proteins that leak out of the capillaries, Form a major part of the immune system that defends the body against disease, Absorb lipids from the intestinal tract,The vessels drain into two main trunks, which empty into the venous |
| Lymph nodes | Small oval clumps of lymphatic tissue located at intervals along the vessels, Most nodes are arranged in groups, both deep and superficial in the body |
| Lymph Node Function | Nodes filter the fluid before it is returned to the bloodstream and filter out microorganisms that could be harmful to the body |
| The superficial groups of nodes are accessible to inspection and palpation | Cervical nodes drain the head and neck, Axillary nodes drain the breast and upper arm, Epitrochlear node is in the antecubital fossa and drains the hand and lower arm, Inguinal nodes in the groin drain most of the lymph of the lower extremity, the extern |
| The spleen, tonsils, and thymus aid the lymphatic system | (blank) |
| The spleen | Four functions:Destroy old red blood cells, , Produce antibodies, Store red blood cells, Filter microorganisms from the blood |
| The tonsils (palatine, adenoid, and lingual) | Located at the entrance to the respiratory and gastrointestinal tracts and respond to local inflammation |
| The thymus | Flat, pink gray gland located in the superior mediastinum behind the sternum and in front of the aorta, Large in the fetus and young child and atrophies after puberty, Important in developing the T lymphocytes of the immune system in children, but it ser |
| Grade the force (amplitude) on a four point scale | 4+, bounding Full, bounding pulse (3 or 4) occurs with hyperkinetic states (exercise, anxiety, fever), anemia, and hyperthyroidism, 3+, increased, 2+, normal , 1+, weak Weak, "thready" pulse occurs with shock and peripheral arterial disease, 0, absent |
| If pitting edema is present, grade it on the following scale | 1+ Mild pitting, slight indentation, no perceptible swelling of the leg, 2+ Moderate pitting, indentation subsides rapidly, 3+ Deep pitting, indentation remains for a short time, leg looks swollen, 4+ Very deep pitting, indentation lasts a long time, leg |
| Summary Checklist: Peripheral Vascular Exam | Inspect arms for color, size, any lesions, Palpate pulses: radial, brachial, Check epitrochlear node, Inspect legs for color, size, any lesions, trophic skin changes, Palpate temperature of feet and legs, Palpate inguinal nodes, Palpate pulses: femoral, |
Created by:
holtanmir
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