Peripheral Vascular & Lymphatic

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Peripheral Vascular Lymphatic
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Arteries

• Carry freshly oxygenated blood
• Pulse all arteries have a pressure wave / can
  only be felt at sites where the artery lies close
  to the skin and over a bone
• Temporal, Carotid, Brachial, Radial, Femoral,
  Popliteal, Posterior Tibial, Dorsalis Pedis

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Ischemia

• Deficient supply of oxygenated arterial blood to
  the tissue
• Caused by obstruction of vessel
• Partial blockage may only be apparent with
  exercise
• Necrosis death to tissue from lack of oxygen,
  Irreversible

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Veins

• Parallel to the arteries but closer to the skin
• Drain the deoxygenated blood its waste products
  from the tissue return it to the heart
• No pulse, blood moves by skeletal muscle
  contraction, Inspiration, Intraluminal valves

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Lymphatics

• Separate vessel system / retrieves excess fluid
  from the tissue returns it to the bloodstream
• Edema occurs without lymphatic drainage (fluid
  would build up)

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Related Organs

• Aids to the Lymphatic System
• Spleen
• Tonsils
• Thymus gland
• Peyers Patches
• Bone Marrow

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The Aging Adult

• Arteriosclerosis blood vessel become more rigid
  causing a rise in systolic B/P
• Atherosclerosis Fatty plaque accumulation in
  the intima of arteries
• Progressive enlargement of calf veins w/prolonged
  inactivity heart failure leads to risk of DVT
  Pulm. embolism

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Inspect Palpate

• Leg pain or cramps
• Claudication (Limping) Distance - of blocks or
  stairs that produces pain
• Temp coolness is assoc. w/ arterial disease
• Edema bilateral w/ CHF (systemic) unilateral
  w/local obstruction or inflammation

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Palpate

• Homans Sign calf pain with dorsiflexion (may
  be due to DVT)
• Palpate Grade the Pulses
• Pitting Edema Bilateral occurs w/ CHF, Diabetic
  neuropathy, Hepatic cirrhosis (scale of 1 to
  4)

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Raynauds Syndrome

• Bilateral response to cold, vibration, or stress
• 1st white arteriospasm
• 2nd blue cyanosis as spasm relaxes
• 3rd red return of blood to capillaries

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Lymphedema

• Damage or removal of lymph nodes impedes drainage
  of lymph
• Unilateral swelling, non pitting

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Deep Vein Thrombosis (DVT)

• Deep vein occluded bythrombus/clot
• Sudden onset, pain w/dorsiflexion
• Positive Homans sign
• accurate lt ? of the time
• Risk for PE (Pulmonary Embolism)

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Aneurysm

• Usually caused by atherosclerosis which weakens
  lining of vessel
• Aorta most common site
• Effects of Blood Pressure causes ballooning of
  the vessel
• More common in males and men over 55 women over
  70

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Inspect Palpate

• Clubbing ,
• Capillary Refill reflects peripheral perfusion
  cardiac output lt2 sec.
• Upper arm edema lymph obstruction
• Grade Compare Pulses, 2 is normal
• Homans Sign calf pain w/

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PERIPHERAL VASCULAR SYSTEM

• Inspect palpate extremities for arterial versus
  venous problems
• Estimate the jugular venous pressure
• Check for Homans sign edema

• General condition
• Arterial assessment BP both arms, palpate
  pulses for amplitude
• Auscultate for bruit over carotid