Peripheral Vascular System

Describe the structure and function of the peripheral vascular system including the lymphatic circulation.

Arteries

  • Carry oxygenated blood to the organs and capillaries

  • Brachial, radial, ulnar

  • Femoral, popliteal, dorsalis pedis, posterior tibial

Veins

  • Carry deoxygenated blood back to heart

  • Superior & inferior vena cava

  • 3 Types of veins

    • Deep

      • Femoral and popliteal

    • Superficial

      • Small and great saphenous vein

    • Perforator

      • Connect superficial to deep

Capillaries

  • Maintain equilibrium between vascular and interstitial fluid (ex: gas exchange)

Lymphatic system

  • Drains excess fluid from body and returns to venous system

  • We need it because more fluid leaves capillaries than veins can absorb

  • Plays role in immune system

  • Absorbs fats

Interview a client for an accurate nursing history of the peripheral vascular system.

  • Color, temp, or texture changes in skin?

    • Arterial insufficiency

    • Venous insufficiency

  • Pain or cramps in legs

  • Pain from walking

  • Rope-like varicose veins?

  • Woulds/sores

  • Edema

  • Swollenness

  • Sexual activity changes

Perform a physical assessment of the peripheral vascular system.

  • Upper extremities

  • Lower extremities

  • Lymph nodes

Discuss implications for using a doppler and describe the steps involved in setting up and conducting a Doppler examination.

Discuss findings frequently seen when assessing the peripheral vascular system in special populations.

Differentiate assessment findings in arterial insufficiency and venous insufficiency.

Arterial

  • Sharp and constant pain

  • Diminished or absent pulses

  • Skin is cold, dry, shiny, and losing hair

  • Painful and deep ulcers

  • Minimal edema

  • Black or gangrene

Venous

  • Aching and cramping

  • Pulses are present but may need doppler

  • Thick and tough, reddish blue-brown skin

  • Ulcers in medial mellous or anterior tibia

  • Superficial

  • Irregular border

  • Edema

  • Granulation tissues

Differentiate between abnormal and abnormal findings in the peripheral vascular system.

Analyze the data from the interview and physical assessment of the peripheral vascular system to formulate clinical judgments.