Peripheral Vascular & Lymph

Assessment

100

best way to palpate lymph nodes in head and neck

pads of digits 1-3, only one hand for submental. drag fingers across the skin as moving from set to set to avoid missing anything

200

How to grade pulses

0-3+

300

How to grade pitting edema

1+ - 4+ based upon depth or time to rebound

400

This is a good assessment practice when one limb is larger than the other

measure its circumference

500

List two other variables to assess the peripheral vascular system (other than grading pulses)

color, temp, cap refill, hair distribution

Normals

100

normal peripheral pulse grade

2+

200

normal cap refill finding

brisk < 2 seconds

300

normal lymph node description

soft (if palpable at all), discrete, moveable, non tender. Malignant: enlarged, cool, hard, non tender, matted/fixed. 

Infected: enlarged, warm, tender, discrete

400

direction of lymph drainage in the head

downward, assess upstream for an infection

500

piece of equipment to use when difficult to palpate pulses

doppler ultrasound. pulses may be difficult to palpate in cases of obesity or edema, and when found with the doppler, draw an X with a marker on the spot

Abnormals

100

Cause of unilateral lower extremity redness, swelling, pain

DVT. this is a 911 and requires urgent ultrasound and anticoagulation

200

Common cause of unilateral upper limb swelling and sclerosis s/p mastectomy

lymphedema, from resection of axillary lymph nodes 2/2 breast cancer

300

Cause of pain with walking, remits with rest

arterial disease. this condition is called claudication

400

Cause of dark, ulcerated, weeping ulcers in the lower extremities

venous insufficiency/valve disease

500

The name of tortuous lower extremity veins common in pregnancy and the geriatric populations

varicosed veins. risk factor for DVT

Risk Factors/Lifespan

100

Being bedbound/immobile and malignancy are risk factors for this emergent condition

DVT

200

Cold exposure, smoking, and beta blockers are all risk factors to trigger this condition

Raynaud's

300

DVT is a risk factor for

pulmonary embolus

400

mastectomy is a common cause of this type of edema, typically unilateral

lymphedema

500

this is a normal finding in lower extremity pulses in the geriatric patient

1+. Vessels stiffen, cardiac output usually goes down. 1+ should be bilateral, and the remainder of the exam should be wnl as well- nl color, skin temp, hair distribution, and cap refill, although cap refill may be hard to elicit with dystrophic toenails