PERIPHERAL VASCULAR ASSESSMENT

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PERIPHERAL VASCULAR ASSESSMENT
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ARTERIES

• Freshly oxygenated blood goes through arteries to
  all body tissues
• Contain elastic fibers that stretch with systole
  and recoil with diastole
• Contain muscle fibers that control how much blood
  is delivered to the tissues-
• Common arteries in arms and legs

3
VEINS

• The course of veins parallel arteries
• Common veins
• Venous flow
• Mechanism
• - contracting skeletal muscles
• - pressure gradient caused by breathing
• - intraluminal valves, one way direction
• Risk factors for venous disease

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LYMPHATICS

• Separate vessel system, retrieves excess fluid
  from tissue spaces and returns to the bloodstream
• Drain into two main trunks
• Functions
• - conserve fluid and plasma proteins
• - form major part of immune system
• - absorbs lipids from intestinal tract
• Immune system process
• Lymph nodes

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AGING ADULT

• Peripheral blood vessels become more rigid ?
  arteriosclerosis ? ? systolic BP
• Progressive enlargement of intramuscular calf
  veins ? DVTs and Pulm. Embolism
• ? lymphatic tissue? ? lymph nodes

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SUBJECTIVE DATA

• Leg pain or cramps
• Skin changes on arms or legs
• Swelling
• Lymph node enlargement
• Medications

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OBJECTIVE DATA

• Preparation
• Inspection- upper extremities, pt. sitting
• capillary refill
• symmetry
• scars
• radial and brachial pulses
• Inspection and Palpation lower extrem.
• - Inspect both legs at same time
• - Color, hair, venous pattern (varicosities),
  size (swelling, atrophy), lesions, ulcers

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Objective data cont

• Measure calf circumference if asymmetric
• Measure ankles and thigh
• Note size and location of problem areas
• Note temperature of legs down to feet
• Flex pt. knee, compress gastrocnemius muscle
  anteriorly against the tibia- Homans sign
• Palpate inguinal lymph nodes
• Palpate peripheral arteries-

9
Objective Data cont

• Check for pretibial edema- pitting vs non-pitting
• Venous system assessment- pt stands
• - check for visible, dilated, tortuous
  veins
• - manual compression test
• Motor and sensory loss
• Doppler