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Peripheral Vascular System and Lymphatics: A

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Peripheral Vascular System and Lymphatics: A&P and Assessment Jarvis, chapter 20 Arteries High pressure system Heart is pump for system Elastic, tough, thick, strong ... – PowerPoint PPT presentation

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Title: Peripheral Vascular System and Lymphatics: A


1
Peripheral Vascular System and Lymphatics AP
and Assessment
  • Jensen, ch 20

2
Arteries
  • High pressure system
  • Heart is pump for system
  • Elastic, tough, thick, strong
  • Recoil allows stretching
  • Made of vascular smooth muscle so meds that
    affect VSM will affect arteries

3
Veins
  • Low pressure system
  • More veins than arteries
  • Large diameter allows expansion of holding of
    large amounts of blood (capacitance vessels)
  • Do not have pump, but valves
  • Valves, calf muscles, and respiratory cycle
    facilitate venous return

4
Lymphatics
  • Completely separate system of microscopic,
    open-ended tubes
  • Prevents edema by siphoning excess fluid from
    tissue spaces that is not reabsorbed by veins
  • Absorbs lipids from intestinal tract
  • Conserves fluid and plasma proteins that leak out
    of capillaries
  • Nodes are the filters
  • Flow is propelled by valves, respiratory cycle,
    muscles and lymph vessel contractions
  • Forms major part of immune system

5
Lymphatics contd
  • Two main trunks
  • Right lymphatic that drains right side of head
    and neck, right arm, right thorax and lung, right
    heart, RUQ of liver. Empties into right
    subclavian vein
  • Thoracic duct drains rest of body and empties
    into left subclavian

6
Related Organs
  • Spleendestroys old RBCs and stores new ones,
    produces antibodies, filters blood
  • Tonsilspalatine, adenoid, lingualrespond to
    inflammation
  • Thymusdevelops T lymphocytes in children

7
Developmental Considerations
  • Lymph tissue adult size by age 6
  • Twice adult size by puberty
  • Back to adult size by age 18
  • Somewhat large and palpable in children (shoddy)
    even when not inflamed, but should not be hard,
    tender, or movable
  • Vessels and nodes atrophy and vessels grow rigid
    in adults

8
Assessment History
  • Risk factors
  • Arterialsame as those for CAD
  • Venousbedrest, prolonged sitting and standing,
    hypercoagulation, vein wall trauma, genetics,
    obesity, pregnancy, BCPs

9
History contd
  • Ask about
  • Leg pain
  • Color changes (red, white, blue, brown)
  • Ulcerations
  • Edema
  • Swollen glands
  • Sx of hypertension (if any)
  • Meds (esp hormones, antihypertensives,
    anticoagulants)

10
Physical Assessment
  • Accessible arteries for examination
  • Temporal
  • Carotid
  • Brachial
  • Radial
  • Ulnar
  • Femoral
  • Popliteal
  • Pedal (dorsalis pedis, posterior tibial)

11
Assessment contd
  • Accessible lymph nodes epitroclear, inguinal
  • Accessible veins for examination
  • Jugular
  • Brachial
  • Cephalic
  • Femoral
  • Popliteal
  • Saphenous (great and small)

12
Assessment contd
  • Assess in semi-Fowlers position
  • Inspect for peripheral tissue perfusioncolor,
    clubbing, hair distribution, ulcerations
  • Auscultate temporal, carotid, and femoral
    arteries for bruits auscultate blood pressure

13
Assessment contd
  • Palpate for
  • Rate, rhythm, symmetry, amplitude
  • Edemapitting or not, grade
  • Temperature
  • Texture
  • Cap refill
  • Epitroclear and inguinal nodes
  • Measure for calf size and symmetry

14
Assessment contd
  • Tests for PV system
  • Allen test, positional color changes, and Doppler
    (arterial)
  • Homans sign (venous)
  • Doppler ultrasound and ABI (PVD)
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