circulatory lymphatic

7/28/2019 Circulatory Lymphatic

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CIRCULATORY AND

LYMPHATIC SYSTEMS


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Landmarks


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Cardiac Cycle

Systole

Ventricular contraction

Diastole

Atrial contraction


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Auscultation Sites


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Memory aid for Valves


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Normal Heart Sounds


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Extra Heart Sounds

S4 S1 S2 S3

Systole

Diastole


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Murmurs

I - Lowest intensity, barely audible

II - Low intensity, but audible

III Loud but without a palpable thrill

IV Loud with a palpable thrill

V Very Loud with palpable thrill. Audible even

with the stethoscope placed on the chest with

the edge of the diaphragm VI - Loudest with a palpable thrill. Audible even

with the stethoscope raised above chest.


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Pericardial Friction Rub

Location: left sternal border

Sound: grating, muffled, high-pitched and

transient

Cause: pericardial inflammation


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Carotid Artery Assessment

Auscultation of carotid

arteries

Bell of stethoscope

Abnormal findings Bruit

Palpable thrill


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Edema

Fluid retention in

interstitial spaces

Generalized

Localized Pitting

Nonpitting

Anasarca

Ascites


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Assessment of Pitting Edema

1+ Barely detectable - 2 mm (millimeter)

2+ Indents 2 - 4 mm

3+ Indents 5 - 6 mm

4+ Indents more than 8 mm


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Palpation of Pulses

Bilateral comparison

Grade-

+0 Absent unable to feel+1 Diminished, barely palpable

+2 Normal readily detectable

+3 Full pulse, increased+3 Bounding difficult to obliterate


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Palpating PulsesDorsalis pedis Posterior tibial

Popliteal Femoral


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Jugular Venous Distension

Normally present at

0-40 elevation

Dehydration: HOB flat

and JVD absent

Volume overload

when present at 45

How to assess


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ISCHEMIA

A temporary deficiency of blood flow to an

organ or tissue. The deficiency may be

caused by diminished blood flow either

through a regional artery or throughout thecirculation.


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ANGINA PECTORIS

An oppressive pain or pressure in the chest caused by

inadequate blood flow and oxygenation to the heart

muscle. It is usually produced by atherosclerosis of

the coronary arteries and in Western cultures is one

of the most common emergent complaints bring adultpatients to medical attention. It typically occurs after

(or during) events that increase the hearts need for

oxygen, such as increased physical activity, a large

meal, exposure to cold weather, or increasedpsychological stress.


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LYMPHEDEMA

Edema caused from blockage of lymphatic

fluid

Usually unilateral

Mastectomy complication


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Lymphadenopathy

Enlargement of lymph nodes due to

infection, allergy, or neoplasm


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Venous Stasis Ulcer

A venous stasis ulcer is an ulcer caused

by the stoppage of the normal flow of

blood.


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VARICOSE VEINS

Incompetent valves permit reflux of blood,

producing dilated, tortuous veins.

Unremitting hydrostatic pressure causes

distal valves to be incompetent andcauses worsening of the varicosity.


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HOMANS SIGN

Calf pain on dorsiflexion of the foot


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DEEP VEIN THROOMBOSIS

(DVT)

A blood clot within the deep veins usuallyof the leg (calves)

Bedrest indicated

No rubbing

Anticoagulates

circulatory lymphatic

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