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What are the arteries of the leg?
  • femoral
  • popliteal
  • dorsalis pedis
  • posterior tibial
What are the veins in the leg?
  • femoral
  • popliteal
  • great and small saphenous
What are the arteries of the arm?
  • brachial
  • radial
  • ulnar
What three factors ensure venous return?
  1. contraction of skeletal muscles
  2. inspiration decreases thoracic pressure
  3. valves
Capacitance vessels
The veins' ability to be more distensible that artieries to hold more blood
Incompetent valves
The vein is so wide that the valves cannot approximate (close)
Two main trunks of the lymphatic system. Empties where?
  1. Right lymphatic duct -> right subclavian
  2. Thoracic duct -> drains rest of the body
What are the three main functions of the lymphatic system?
  1. conserve fluid and plasma proteins that leak out of the capillaries
  2. For a major part of the immune system that defends the body against disease
  3. Absorb lipids from the intestinal tract
The four lymph nodes that are palpable. Where are they?
  1. Cervical - head and neck
  2. Axillary
  3. Epitrochlear- antecubital fossa
  4. Inguinal - groin
What are the four functions of the spleen?
  1. Destroy old RBCs
  2. Produce antibodies
  3. Store Red Blood cells
  4. Filter microogranisms from the blood
Peripheral blood vessels becoming more rigid
Plaque buildup within the vessels
Raynaud's Phenomenon
Tricolor change of the fingers in response to cold, vibration, or stress: first white (pallor) frin arteriospasm and resulting deficit in supply; then blue (cyanosis) from slight relaxation of the spasm that allows a slow trickle of blood through the capillaries and increased oxygen extraction of hemoglobin; finally red (rubor) due to return of blood into the dilated capillary bed or reactive hypermia.
May have cold, numbness, or pain along with pallor or cyanosis stage; then burning, throbbing pain swelling along with rubor. Lasts minutes to hours; occurs bilaterally.
Epitrochlear lymph node
Tested by palpating depression above and behind medial condyle of the humerus. Do this by "shaking hands" with the person. An enlarged epitrochlear node indicates infection of the hands or forearm.
Ischemic Ulcer - arterial or venous?
Arterial - duildup of fatty plaques on intima plus hardening and calcifcation of arterial wall.
S: Deep muslce pain in calf or foot, claudication (pain when walking), pain at rest indicates worsening of condition.
O: Coolness, pallor, elevational pallor,and dependent rubor; diminshed pulses; systolic bruits; trophic skin; signs of malnutrition(thin, shiny skin, thick-ridged nails, absence of hair, atrophy of muscles); xanthoma formation; distal gangrene

Pale ischemic base, well-defined edges, and no bleeding.
Diabtetes hastens changes with generalized dysfunction in all arterial areas.
Stasis Ulcer - venous or arterial?
After acute DVT or chronic incompetent valves in deep veins.
S: Aching pain in calf or lower leg, worse at end of the day, worse with prolonged standing or sitting.
O: Firm brawny edema; coarse, thickened skin; petechiae; dermatitis. Venous stasis causes increased venous pressure which then causes RBCs to leak out of veins and into the skin. As these RBCs break dow, they leave hemosiderin (iron deposits) behind, which are the brown pigment deposits.

Ulcers occur at medial malleolus and are characterized by bleeding, uneven edges.
Superficial Varicose Veins
Incompetent valves permit reflux of blood, producing dilated, tortuous veins. Unremitting hydrostatic pressure causes distal valves to be incompetent and causes worsening of the varicosity.
Over 45 years, occurrence is 3x more likely in women than in men.
S: Aching, heaviness in calk, easy fatigability, night leg or foot cramps.
O: Dilated, tortuous veins.
Deep vein occluded by a thrombus, causing inflammation, blocked venous return. cyanosis, and edema. Cause may be prolonged bed rest; history of varicose veins; trauma; infection; cancer; and, in younger women; the use of oral estrogenic contraceptives.
S: Suden onset of intense, sharp, deep muscle pain, may increase with sharp dorsiflexion of foot.
O: increased warth; swelling; redness; dependent cyanosis is mild or may be absent; tender to papation; Homans' sign is present only in few cases.

Requires emergency referral because of risk of pulmonary embolism.
Sac formed by dilation in the artery wall. Atherosclerosis weakens the middle layer of the vessel wall. This stretches the intima and adventitia, and the effect of blood pressure creates the balloon enlargement. The most common site is the aorta, and the most common cause is atherosclerosis. The incidence increases rapidly in men over 55 years and women over 70 years; the overall occurrence is four to five times more frequent in men.
Weak "Thready" Pulse - +1
D: Hard to palpate, need to search for it, may fade in and out, easily obliterated by pressure.
A/W: Decreased cardiac output; periphearl arterial disease; aortic valve stenosis.
Full, Bounding Pulse - +3
D: Easily palpable, pounds under your fingertips.
A/W: Hyperkinetic states (exercis, anxiety, fever) anemia, hyperthyroidism
Water-Hammer (Corrigan's) Pulse - +3
D: Greater than normal force, then collapses suddenly
A/W: Aortic valve regurgitation; PDA
Pulsus Bigeminus
D: Rhythym is coupled. every other beat comes early. or normal beat followed by premature beat. force of premature beat is decreased because of shortened cardiac filling time.
A/W: Conduction disturbance (premature ventricular contraction, premature atrial contraction)
Pulsus Alternans
D: Rhythm is regular, but force varies with alternating beats of large and small amplitude
A/W: Heart failure
Pulsus Paradoxus
D: Beats have weaker amplitude with inspiration, stronger with expiration. Best determined during blood pressure measurement; reading decreases (>10 mmHg) during inspiration and increases with expiration.
A/W: Any condition that blocks venous return to the right side of the heart, or blocks left ventricular filling (e.g cardiacĀ  tamponade; constrictive pericarditis; pulmonary embolism)
Pulsus Bisferiens
D: Each pulse has two strong systolic peaks, with a dip in between. Best assessed at the carotid artery.
A/W: Aortic valve stenosis plus regurgitation
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