Question

Prior to class, and after reading/viewing the module assignment, select one of the following and conduct an assessment.

Heart and Neck Vessels
Peripheral Vascular System
You may conduct the assessment on a fellow student, friend, or family member. Remember to secure their permission.

Collect both subjective and objective data using the process described in the textbook.

Then, document your findings and bring them to class.

Answer 1

PERIPHERAL VASCULAR ASSESSMENT

The main objective of the assessment is to assess the Peripheral Vascular system, sites of peripheral pulse and it's applied anatomy.

The peripheral vascular system is the part of the circulatory system that consists of the veins and arteries not in the chest or abdomen (i.e. in the arms, hands, legs and feet).

Illustrations of peripheral vascular system shown below:

The aorta, your body's largest artery, is attached directly to the left ventricle of your heart. The left ventricle pumps blood out of your heart through the aortic valve into the aorta. All other major arteries branch from the aorta and carry blood to the rest of your body.

1. The carotid arteries are the main arteries in your head and neck that supply blood to your brain.
2. The subclavian arteries supply blood to your arms.
3. The renal arteries supply blood to your kidneys.
4. The iliac arteries supply blood to your lower abdomen.
5. At the pelvis, the iliac arteries become the femoral arteries, which supply blood to most of your legs.
6. At your knees, the femoral arteries become the popliteal arteries, which supply blood to your lower legs.
7. At your ankles, the popliteal arteries split into tibial arteries, which supply blood to your feet.

A peripheral vascular examination is a medical examination to discover signs of pathology in the peripheral vascular system. It is performed as part of a physical examination, or when a patient presents with leg pain suggestive of a cardiovascular pathology.

Peripheral vascular disease (PVD) is a blood circulation disorder that causes the blood vessels outside of your heart and brain to narrow, block, or spasm. This can happen in your arteries or veins. PVD typically causes pain and fatigue, often in your legs, and especially during exercise. The pain usually improves with rest.

List of questions for assessing the relative risk of PAD:

• AGE. How old is the patient?
• ETHNICITY. Self-evident.
• GENDER. Self-evident.
• TOBACCO SMOKING. Does the patient smoke (current smoker) or did he ever smoke (former smoker)?
• DIABETES. Does the patient have diabetes (type 1 or 2)?
• DIAGNOSED CORONARY ARTERY DISEASE (CAD). Does the patient have CAD?
• HISTORY OF MYOCARDIAL INFARCTION (MI), STROKE OR TRANSIENT ISCHAEMIC ATTACKS (TIA). Has the patient at any time in their life experienced MI, stroke or TIA?
• DIAGNOSIS OF CHRONIC KIDNEY DISEASE (CKD). Has the patient been diagnosed with CKD or renal insufficiency in general?
• DIAGNOSIS OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD). Has the patient been diagnosed with COPD?
• HYPERLIPIDAEMIA. Does the patient suffer from abnormally elevated levels of lipids (lipoproteins)?
• HYPERTENSION. Is the patient hypertensive?
• Weight. Is the patient over- or underweight?
• INTERMITTENT CLAUDICATION. Does the patient report pain during any sort of physical exercise, even walking? Does the pain subside when he/she takes a rest? Where (body part) is the pain located?
• COLD FEET/LEGS. Does the patient report a cold feeling in his leg(s) or feet despite feeling otherwise (in other parts of the body) warm or otherwise comfortable at the current ambient temperature?
• SCALY SKIN/OF PALE OR BLUEISH HUE/DEFORMED TOENAILS. Does the patient report abnormal skin texture and colour and toenail deformation?
• OPEN WOUNDS AND SORES. Does the patient have any types of wounds or other tissue damage on his legs/feet that heals very slowly or doesn’t appear to heal at all?
• ERECTILE DYSFUNCTION (MEN). Does the patient have erectile dysfunction?
• FAMILY HISTORY. Does the patient know whether any of his relatives had or currently have.
• Older patients (over 50 years of age) are at an increased risk of PAD, which might be asymptomatic.

There are statistically significant discrepancies in PAD prevalence and morbidity in individuals of different ethnic groups. Studies have shown that black people (specifically African Americans) are at higher risk of developing PAD than white people.