Chapter 21: Peripheral Vascular System and Lymphatic System

Peripheral Vascular System and Lymphatic System details the physiological mechanics of the high-pressure arterial network and the low-pressure venous system, which relies on skeletal muscle pumps and intraluminal valves to maintain unidirectional blood flow back to the heart. Students will learn the clinical significance of various pulse sites across the upper and lower extremities, including the brachial, radial, popliteal, and dorsalis pedis arteries. The material provides a comprehensive guide to nursing assessments, covering subjective data like intermittent claudication and objective techniques such as the modified Allen test, capillary refill evaluation, and the grading of pitting edema. Crucial diagnostic tools like the Ankle-Brachial Index (ABI) for detecting peripheral artery disease (PAD) and the Wells criteria for assessing deep vein thrombosis (DVT) risk are thoroughly examined. Furthermore, the content addresses developmental considerations across the lifespan—from the rapid growth of lymphoid tissue in children to the increased risk of arteriosclerosis and chronic venous insufficiency in aging adults. Specialized clinical topics include the pathophysiology of lymphedema, Raynaud phenomenon, and the differentiation between ischemic, stasis, and neuropathic ulcers. The chapter concludes by highlighting health disparities in vascular care and the essential role of patient education regarding smoking cessation and diabetic foot care in preventing severe complications like gangrene and limb amputation.