Peripheral Vascular, Lymphatic, Heart & Neck Vessels – Review

Question-and-answer flashcards covering peripheral vascular, lymphatic, heart, and neck-vessel concepts, assessment, abnormalities, and health promotion.

What three vessel types make up the peripheral vascular (PV) system?

Arteries, veins, and lymphatics.

What is the main function of the PV and lymphatic systems?

Transport fluids (oxygen, nutrients, CO₂, waste) throughout the body.

Why are arteries considered a high-pressure system?

Their walls contain elastic and muscle fibers that contract or dilate to propel blood under pressure.

What creates the palpable arterial "pulse"?

The pressure wave that expands and contracts the arteries with each heartbeat.

What can obstruction of an artery lead to?

Ischemia and/or tissue death.

Name four easily accessible pulse sites on the head and upper body.

Temporal, carotid, brachial, radial.

If you cannot palpate a pulse, what tool should you use?

A Doppler device—never assume the pulse is present without proof.

Describe venous flow.

Low-pressure return system that carries de-oxygenated blood and waste back to the heart.

What three mechanisms assist venous return?

Contracting skeletal muscles, pressure changes with breathing, intraluminal valves.

List the three primary functions of the lymphatic system.

1) Conserve fluid & plasma proteins, 2) major immune defense, 3) absorb lipids from the small intestine.

Into what vessels does lymph ultimately drain?

Two main lymphatic trunks that empty into the subclavian veins.

Which lymph nodes drain the head and neck?

Cervical nodes.

Which lymph nodes drain the breast and upper arm?

Axillary nodes.

Where is the epitrochlear node and what does it drain?

In the antecubital fossa; drains the hand and lower arm.

What areas do the inguinal nodes drain?

Lower extremity, external genitalia, anterior abdominal wall.

State four functions of the spleen.

Destroy old RBCs, produce antibodies, store RBCs, filter microorganisms from blood.

Which organ is crucial for T-lymphocyte development in children?

The thymus.

Where do B-lymphocytes originate and mature?

In bone marrow.

Define arteriosclerosis.

Age-related hardening and loss of elasticity of arterial walls.

What happens to systolic blood pressure with arteriosclerosis?

It increases.

Peripheral Artery Disease (PAD) is most commonly caused by what?

Atherosclerosis—fatty plaque deposition in arteries.

What is claudication distance?

Number of blocks or stairs walked before extremity pain begins—indicator of PAD.

Bilateral leg edema usually suggests _.

Systemic cause such as heart failure.

Unilateral leg edema often indicates _.

Local obstruction, DVT, infection, or lymphedema.

Normal capillary refill time in fingers is _.

Less than 2–3 seconds.

Clubbing of the nails may indicate _.

Chronic cyanosis or hypoxia.

A cool upper extremity temperature points to _.

Arterial deficit.

What is the purpose of the Modified Allen Test?

Assess collateral circulation of the hand via radial and ulnar arteries.

In the Modified Allen Test, normal color return should occur in _ seconds.

Less than 7 seconds.

Hair loss on the lower legs may signify _.

Poor circulation or malnutrition.

Describe elevational pallor and dependent rubor.

Pallor when legs are elevated (arterial deficit); deep red color when legs are lowered.

Typical appearance of an arterial (ischemic) ulcer?

Punched-out, dry, well-defined edges, cool skin, diminished pulses, little bleeding.

Typical features of a venous (stasis) ulcer?

Irregular borders, edematous, brown discoloration, weeping may occur, pain worse at end of day and relieved by elevation.

Explain superficial varicose veins.

Dilated, tortuous superficial veins due to chronically high venous pressure and incompetent valves.

Key signs of a deep vein thrombophlebitis (DVT).

Sudden sharp calf pain, warmth, swelling, possible cyanosis of the limb.

Give two foot-care tips for patients with vascular disease or diabetes.

Inspect feet daily; wash, dry, and moisturize (avoid between toes); wear well-fitting shoes.

Where is the heart located?

Behind the precordium, between 2nd and 5th intercostal spaces, right sternal border to left midclavicular line.

Differentiate pulmonary and systemic circulation loops.

Pulmonary: heart -> lungs -> heart; Systemic: heart -> body -> heart.

During systole (S1), which valves close?

Atrioventricular (mitral and tricuspid) valves.

During diastole (S2), which valves close?

Semilunar (aortic and pulmonic) valves.

What causes an S3 sound?

Ventricular resistance to rapid early filling (often volume overload).

What causes an S4 sound?

Atria pushing blood into a stiff ventricle at end of diastole (e.g., CAD).

List three conditions that can produce a heart murmur.

Increased blood velocity, decreased viscosity (anemia), structural valve defects or septal defects.

Four descriptors for any heart sound.

Frequency (pitch), intensity (loudness), duration, timing (systolic/diastolic).

Outline the normal cardiac conduction pathway.

SA node → atria → AV node → Bundle of His → right & left bundle branches → Purkinje fibers/ventricles.

Name the two jugular veins.

Internal jugular and external jugular.

Age-related cardiovascular change that raises systolic BP.

Arterial stiffness (arteriosclerosis).

List five modifiable risk factors for cardiovascular disease.

High lipids, smoking, hypertension, diabetes, abdominal obesity (others: poor diet, alcohol use, inactivity, stress).

Proper technique when palpating the carotid artery.

Palpate one side at a time with gentle pressure to avoid vagal stimulation or reduced cerebral blood flow.

What is a carotid bruit?

Swishing sound indicating turbulent flow and arterial narrowing, often from atherosclerosis.

Jugular venous distention (JVD) greater than 3 cm bilaterally suggests _.

Increased central venous pressure, commonly heart failure.

Describe a normal apical impulse (PMI).

Gentle tap, 1–2 cm, in 4th/5th intercostal space at mid-clavicular line, present during exhalation/left lateral position.

What does a palpable thrill over the precordium indicate?

Turbulent blood flow, often associated with a loud heart murmur.

List the five traditional auscultatory areas (APE To Man).

Aortic, Pulmonic, Erb's point, Tricuspid, Mitral.

Define pulse deficit.

Difference between apical and radial pulse counts; indicates weak ventricular contractions or dysrhythmia.

S3 usually implies ; S4 usually implies .

Volume overload/heart failure; ventricular stiffness/coronary artery disease.

Differentiate regurgitation and stenosis in valve disease.

Regurgitation: valve fails to close, backward flow; Stenosis: valve fails to open fully, obstructs forward flow.

Key questions when assessing chest pain (name four).

Character, location, timing, severity (others: radiation, associated symptoms).

Three classic signs of left-sided heart failure.

Pulmonary congestion (crackles), dyspnea/orthopnea, fatigue.

Three classic signs of right-sided heart failure.

Peripheral edema, JVD, hepatosplenomegaly/ascites.

Two priority lifestyle changes to reduce CVD risk.

Blood pressure control and smoking cessation.

Which heart sound becomes more common in healthy older adults (age-related)?

S4.

Orthostatic hypotension is more common in _ (population).

Older adults.

How does body position help you hear extra heart sounds?

Left lateral position accentuates S3, S4, and some murmurs with the bell of the stethoscope.

What is the safest way to determine if a bilateral edema is cardiac or local in origin?

Assess for systemic signs (JVD, lung sounds) versus unilateral changes; bilateral often cardiac, unilateral local.

Why must diabetic patients inspect their feet daily?

Peripheral neuropathy and vascular disease increase risk for unnoticed injury and infection.