PERIPHERAL

VASCULAR SYSTEM
ASSESSMENT
By; ROMMEL LUIS C. ISRAEL
III
WHAT IS PERIPHERY
• the outermost , boundary, parts,
or surface of an area
• the outer parts of a town, city or area
WHAT IS
• The outer part or uppermost layer of
something PERIPHERY
• A place for meeting ort socializing
with others
 LEARNING OBJECTIVES
At the end of this module, the students will be able to:

• Identify the functions of the peripheral vascular system

• Discuss the different peripheral vascular diseases and
reduction of risk factors.
• Demonstrate the proper assessment of the peripheral
vascular system
• Discuss the nursing considerations in peripheral vascular
assessment
Exercise:

Explain
the Body
Circulatio
n
Exercise:

Explain
the
Cardiac
Circulatio
n
ANATOMY OF THE VASCULAR
SYSTEM
 ARTERIES
• A vessel that carries blood high in oxygen
content away from the heart to the farthest
reaches of the body
• Since blood in arteries is usually full of oxygen,
the hemoglobin in the RBC is oxygenated.
• The resultant form of hemoglobin
(oxyhemoglobin) is what makes arterial blood
look bright red.
Reference:
Definition of Artery. (n.d.). MedicineNet. https://www.medicinenet.com/artery/definition.htm
 ARTERIES
• They are part of the efferent wing of the circulatory
system
• ("Efferent" from the Latin:
"ex“ - out
"ferre“ - to bear
= to bear out or carry away

What the arteries are carrying away is blood from the

heart.
Reference:
Definition of Artery. (n.d.). MedicineNet. https://www.medicinenet.com/artery/definition.htm
 VEINS
• They are blood vessels that carry blood low in
oxygen content from the body back to the heart
• The deoxygenated form of hemoglobin
(deoxyhemoglobin) in venous blood makes it appear
dark.
• Veins are part of the afferent wing of the circulatory
system which returns blood to the heart
Reference:
Definition of Artery. (n.d.). MedicineNet. https://www.medicinenet.com/artery/definition.htm
 VEINS
• Unlike the arteries, venous network is a low -
pressure system since there is no force to
propel the blood,
- thus, its walls are thinner and larger in
diameter than the arteries to help reduce

workload on the heart.

• 70% of the blood volume is all contained in
the veins
 3 MECHANISMS FOR VENOUS
RETURN IN ORDER FOR THE BLOOD
TO TRAVEL ALONG ITS PATHWAYS.
1. Vein Structure
- Each vein contains one-way
valves to facilitate passing
through of blood in one
direction - to the heart, and
prevents blood from returning
through them in the opposite
direction.
 3 MECHANISMS FOR VENOUS
RETURN IN ORDER FOR THE BLOOD
TO TRAVEL ALONG ITS PATHWAYS.
2. Muscle contraction
- As the skeletal muscle contracts
during movement, it squeezes the
blood toward the heart through
the one-way valves.
- This is why movement, such as
walking and exercise are all
important factors to improve
one’s blood circulation.
 3 MECHANISMS FOR VENOUS
RETURN IN ORDER FOR THE BLOOD
TO TRAVEL ALONG ITS PATHWAYS.
3. Respiratory pump
- During inspiration, the
intrathoracic pressure
decreases as the lungs
expands, thereby decreasing
pressure in the right atrium of
the heart as well
-the abdominal pressure increases
and the diaphragm contracts
creating a pressure gradient,
squeezing the inferior vena cava
and pushing the blood towards the
right atrium of the heart.
 CAPILLARIES
• They are the smallest blood vessels in the body, connecting
the smallest arteries to the smallest veins.
• These vessels are often referred to as the
"microcirculation.“
• Only two layers of cells thick (endothelial cells-inner layer,
and epithelial cells-outer layer),
• approximately 5 micrometers in diameter
• the purpose/central role of capillaries:
- deliver oxygen in the blood to the tissues
- pick up carbon dioxide to be eliminated
- they are also the place where nutrients are
delivered to feed all of the cells of the body.
Reference:
Eldridge, L. (2009). Capillary Structure and Function in the Body. [online] Verywell Health. Available at: https://www.verywellhealth.com/what-are-capillaries-2249069.
 CAPILLARIES
•If all the capillaries in the human body
were lined up in single file, the line
would stretch over 100,000 miles
•From the capillaries, blood flows into
the smaller venules and then into veins,
flowing back to the heart
Reference:
Eldridge, L. (2009). Capillary Structure and Function in the Body. [online] Verywell Health. Available at: https://www.verywellhealth.com/what-are-capillaries-2249069.
The oxygenated blood travels in
the arteries and passes through CAPILLARIES
the capillaries wherein a
hydrostatic force causes the
interstitial fluid to diffuse out
from the capillaries.

These fluids release oxygen,

water and nutrients and picks
up waste products such as
carbon dioxide and other by
products of cellular metabolism.

By osmotic pressure, these

fluids will travel back through
the venous circulation towards
0SMOSIS
 MAJOR ARTERIES OF THE ARM
• Axillary
- the subclavian artery, it exits the torso and enters the
arm

• Brachial
- delivers blood to the upper region of the arm

• Radial and ulnar

- run alongside the two bones of the forearm where they
eventually divide to deliver blood to the wrist and hand
Reference:
major arteries of the arm - Search. (n.d.). Www.bing.com. Retrieved June 28, 2022, from https://www.bing.com/search?q=major+arteries+of+the+arm&cvid=e8308701370540419477e1f49e7a7575&aqs=edge.0.0l9.6977j0j1&pglt=771&FORM=ANNTA1&PC=NMTS
‌
 MAJOR ARTERIES OF THE LEGS
• Femoral
- derived from the external iliac artery
- this artery supplies blood to the thigh and divides into the
various smaller arteries that supply the legs.
• Genicular
- supplies blood to the knee region.
• Popliteal
- This is the name given to the femoral artery
- it passes below the knee.
• Anterior and posterior tibial
- derived from the popliteal artery
- supply blood to the lower portion of the leg
- when they reach the ankle , they divide further to supply the ankle and foot
region
Reference:
Healthline. (2019). Arteries of the Body: Picture, Anatomy, Definition & More. [online] Available at: https://www.healthline.com/health/arteries-
of-the-body#leg-arteries.
 MAJOR VEINS OF THE LEG
• deep veins
• superficial veins
• perforator veins

2 deep veins:
• femoral
• popliteal
- they are responsible for the 90% of
venous return from the lower
extremities
• Saphenous veins
- the superficial veins in our legs.
The photo shows the
Different location of
the major veins in our
Legs

• Femoral
• popliteal
• saphenous veins
 LYMPHATIC SYSTEM
• a subsystem of the circulatory system
• consists of a complex network of vessels, tissues, and organs
• helps maintain fluid balance in the body by collecting excess fluid
and particulate matter from tissues and depositing them in the
bloodstream
• helps defend the body against infection by supplying disease-
fighting cells called lymphocytes
Reference:
The Editors of Encyclopedia Britannica. (2019). lymphatic system | Structure, Function, & Facts. In Encyclopædia Britannica. https://www.britannica.com/science/lymphatic-system
 LYMPHATIC SYSTEM

The lymphatic
system is mainly
composed of:
• Lymphatic
capillaries
• lymphatic vessels
• lymph nodes
 LYMPHATIC CIRCULATION
• The lymphatic system can be thought of as a
drainage system, as blood circulates
through the body, blood plasma leaks into
tissues through the thin walls of the
capillaries
• The portion of blood plasma that escapes is
called interstitial or extracellular fluid, and
it contains oxygen, glucose, amino acids and
other nutrients needed by tissue cells.
Reference:
The Editors of Encyclopedia Britannica. (2019). lymphatic system | Structure, Function, & Facts. In Encyclopædia Britannica. https://www.britannica.com/science/lymphatic-system
 LYMPHATIC CIRCULATION
• Although most of this fluid seeps immediately
back into the bloodstream, a percentage of it,
along with the particulate matter, is left
behind.
• The lymphatic system removes this fluid and
these materials from tissues, returning them
via the lymphatic vessels to the bloodstream,
and thus prevents a fluid imbalance that
would result in the organism’s death.
Reference:
The Editors of Encyclopedia Britannica. (2019). lymphatic system | Structure, Function, & Facts. In Encyclopædia Britannica. https://www.britannica.com/science/lymphatic-system
 3 MAIN FUNCTIONS OF THE
LYMPHATIC SYSTEM
1. It drains excess body fluids and proteins back to the
venous system
- the excess fluids from the right part of the body will
travel through the right lymphatic duct and will be
drained in the right subclavian vein
- the excess fluid from the left part of the body will all
be
reabsorbed and travel through the thoracic duct
and
will drain in the left subclavian vein
 3 MAIN FUNCTIONS OF THE
LYMPHATIC SYSTEM
2. Filters out microorganisms, foreign materials,
dead blood cells, abnormal cells
- As the lymph travels in the lymphatics vessels,

they will pass through filters known as lymph

nodes to filter out microorganisms, foreign
materials, dead cells and abnormal cells where

they will be trapped and destroyed

- This is the reason why you will have swollen
 3 MAIN FUNCTIONS OF THE
LYMPHATIC SYSTEM
3. Absorb fats
(lipids) from
small intestine
into bloodstream
by the lymphoid
tissues in the
intestines called
Peyer’s patches.
• The gut-associated PEYER’S PATCHES
lymphoid tissue
(GALT) consists of
isolated or
aggregated
lymphoid follicles
forming Peyer's
patches.
• By their ability to
transport luminal
antigens and
bacteria, PPs can be
considered as the
• an adult has 30 to 40
Peyer’s patches on PEYER’S PATCHES
average in the region
of the small intestine
• The location of these
patches is in the
mucosa of the
intestinal lining
• usually found in
humans in the lowest
portion of the small
intestine, mainly in the
distal jejunum and the
ileum, but also could
 PEYER’S PATCHES

• named after the

17th-century
Swiss anatomist
Johann Conrad
Peyer
 LYMPHATIC SYSTEM OF THE
HEAD AND NECK

Reference:
The Editors of Encyclopedia Britannica. (2019). lymphatic system | Structure, Function, & Facts. In Encyclopædia Britannica. https://www.britannica.com/science/lymphatic-system
RELATED
ORGANS
IN
IMMUNE
SYSTEM
PULSES OF THE VASCULAR
SYSTEM
PULSES OF THE VASCULAR
SYSTEM
ASSESSING THE VASCULAR
SYSTEM
ASSESSING THE VASCULAR
SYSTEM
CAROTID PULSE
BRACHIAL PULSE
RADIAL [PULSE
FEMORAL PULSE
 ABNORMAL FINDINGS
SKIN AND HAIR ABNORMALITIES
• Warm Skin may indicate conditions
causing fever or increased cardiac
output
• Absence of body hair on the arms or
legs may indicate diminished arterial
blood flow to these areas
• Cyanosis, pallor, or cool skin may
indicate poor cardiac output and tissue
ABNORMAL FINDINGS
ABNORMAL FINDINGS
ABNORMAL
FINDINGS
ABNORMAL
FINDINGS
ABNORMAL
FINDINGS
ABNORMAL
FINDINGS
ABNORMAL
FINDINGS
ABNORMAL
PULSES
ABNORMAL PULSES
ABNORMAL PULSES
ABNORMAL
FINDINGS
ABNORMAL
FINDINGS
ABNORMAL
FINDINGS
ABNORMAL
FINDINGS
THRILL-BRUIT

Thrill' or 'buzz’
- is like a vibration caused by blood flowing
through the fistula and can be felt

'Bruit' (pronounced brew-ee)

- Listen for a sound. A 'bruit' is a whooshing
sound.
 VASCULAR
ABNORMALITIES
 VASCULAR
ABNORMALITIES
PERIPHERAL
VASCULAR
DISEASE
 AORTIC ANEURYSM
• abnormal bulge in
the aorta
• It can occur any
where in the aorta
• may be in a tube
form or round
shaped
Reference:
MSN. (n.d.). Www.msn.com. Retrieved June 28, 2022, from
https://www.msn.com/en-ph/health/condition/aortic+aneurysm?ocid=entnewsntp

• ‌
 CEREBROVASCULAR DISEASE
• refers to a group of conditions,
diseases, and disorders that
affect the blood vessels and
blood supply to the brain
• Causes:
• Atherosclerosis- narrowing of the
arteries
• Thrombosis - where a blood clot creates
a blockage in a blood vessel
• Embolic arterial blood clot - which is a
blood clot in an artery of the brain
• cerebral venous thrombosis - which is a
blood clot in a vein of the brain
Reference:
Kraft, S. (2019). Cerebrovascular disease: Causes, symptoms, and
treatment. [online] www.medicalnewstoday.com. Available at:
https://www.medicalnewstoday.com/articles/184601.
• A plaque build-up ATHEROSCLEROSIS
• made up of fat, cholesterol, calcium,
and other substances found in the
blood
• Over time, plaque hardens and
narrows your arteries
• This limits the flow of oxygen-rich
blood to your organs and other
parts of your body

Reference:
• MD, S. (n.d.). Atherosclerosis: Symptoms, Risk Factors, and Health Complications - Cardiology
Specialist Houston - Arsalan Shahzad, M.D. F.A.C.C. [online] https://www.care4heart.com/.
Available at: https://www.care4heart.com/education/heart-disease/atherosclerosis-
symptoms-risk-factors-and-health-complications [Accessed 28 Jun. 2022].
 PERIPHERAL ARTERIAL
OCCLUSIVE DISEASE (PAD)

• is chronic arterial
occlusive disease of the
lower extremities caused
by atherosclerosis.

Reference:
Aronow, W.S. (2012). State of the art paper Peripheral
arterial disease of the lower extremities. Archives of Medical
Science, [online] 2, pp.375–388.
doi:10.5114/aoms.2012.28568.
 PULMONARY EMBOLISM AND
• Pulmonary embolism (PE) VENOUS THROMBOSIS
and deep venous thrombosis
(DVT) exist on the spectrum
of venous thromboembolic
disease (VTE)
• PE results when thrombus
migrates from the venous
circulation to the pulmonary
vasculature and lodges in
the pulmonary arterial
system.
• Reference:
Turetz, M., Sideris, A., Friedman, O., Triphathi, N. and Horowitz, J. (2018). Epidemiology,
Pathophysiology, and Natural History of Pulmonary Embolism. Seminars in Interventional
Radiology, 35(02), pp.92–98. doi:10.1055/s-0038-1642036.