Physiology, Physical Examination, and Major Disease Processes.

Posted: December 12th, 2022

Physiology, Physical Examination, and Major Disease Processes.

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2. Scholarly sources: Only scholarly sources are acceptable for citation and reference in this course. These include peer reviewed publications, government reports, or sources written by a professional or scholar in the field. Your textbook and lesson are not considered to be an outside scholarly source. For the discussions and reflection posts, reputable internet sources such as websites by government agencies (URL ends in .gov) and respected organizations (often ends in .org) can be counted as scholarly sources. The best outside scholarly source to use is a peer-reviewed nursing journal. You are encouraged to use the Chamberlain library and search one of the available data bases for a peer-reviewed journal article. The following sources should not be used: Wikipedia, Wikis, or blogs. These web sites are not considered scholarly as anyone can add to these. Please be aware that .com websites can vary in scholarship and quality.Physiology, Physical Examination, and Major Disease Processes. For example, the American Heart Association is a .com site with scholarship and quality. It is the responsibility of the student to determine the scholarship and quality of any .com site. Ask your instructor before using any site if you are unsure. Points will be deducted from the rubric if the site does not demonstrate scholarship or quality. Current outside scholarly sources must be published with the last 5 years. Instructor permission must be obtained BEFORE the assignment is due if using a source that is older than 5 years.
3. The length of the paper is to be no less than 1,500 words, excluding title page and reference list.
4. Create this assignment using Microsoft (MS) Word. You can tell that the document is saved as a MS Word document because it will end in “.docx.”Physiology, Physical Examination, and Major Disease Processes.
5. APA format (6th edition) is required in this assignment, explicitly for in-text citations and the reference list. Use 12-point Times New Roman font with 1 inch margins and double spacing. See the APA manual for details regarding proper citation.
6. Organize the headings and content of your paper using the outline below:
o Select a body system relevant to the lesson from the previous week for the topic of this paper – ( PERIPHERAL VASCULAR SYSTEM)
o Discuss the physiology (structure and function) of the body system including details about the major organ systems (if applicable).
o Construct relevant health history questions (subjective data) pertaining to the body system.
o Provide an overview of the objective data and expected normal physical examination findings for this body system.
o Explain special physical assessment examination techniques or procedures specific to assessing this body system
o Analyze and discuss how you might adapt your physical assessment skills or interviewing techniques to accommodate each of the following specific populations:
 Infant/pediatric
 Pregnancy
 Geriatric
o Identify one major disease or disease process that may significantly impact this body system.
o Synthesis and discuss the expected abnormal physical examination findings that may be associated with this disease or disease process.
o Summarize the key points.
o References in correct APA format

ASSIGNMENT CONTENT
Category Points % Description
Application of Knowledge, Analysis, and Clarity 10 33.33 The quality of this criterion will be evaluated based upon the following:demonstration of analysis, synthesis, and/or application of principles and concepts consistent with the principles of advanced physical assessment; relevance of content specific to the topic; expected normal findings, appropriate health history questions, and organization and clear presentation of information.

Adapted Physical Assessment Skills to Special Populations, Disease Process, Summary, and Scholarly Source 10 33.33 The quality of this criterion will be evaluated based upon the following: discussion regarding how to adapt physical assessment skills or techniques to accommodate all special populations; identification and discussion of one major disease or disease process and expected examination findings; and summation ofkey points. Must include at least one scholarly source to support the paper.
Total CONTENT Points= 20 pts
ASSIGNMENT FORMAT
Category Points % Description
Grammar, Spelling, Syntax, Mechanics,APA Format, and Word Requirement 10 33.33 The assignment has minimal grammar, spelling, syntax, punctuation and APA* errors. Direct quotes (if used) is limited to 1 short statement** which adds substantively to the post. The length of the paper is not less than 1,500 words, excluding title page and reference list.
* APA style references and in text citations are required; however, there are no deductions for errors in indentation or spacing of references. All elements of the reference otherwise must be included.
**Direct quote should not to exceed 15 words & must add substantively to the discussion

Total FORMAT Points= 10 pts
ASSIGNMENT TOTAL= 30 points

Rubric
NR509 Weeks 1-6 Alternative Writing Assignment_Sept19
NR509 Weeks 1-6 Alternative Writing Assignment_Sept19
Criteria Ratings Pts

Peripheral Vascular System: Physiology, Physical Examination, and Major Disease Processes Affecting the System

The body system selected for this paper is the peripheral vascular system. This is the system that is involved with the blood and lymphatic flow in the extremities. The lower extremities are the legs and the upper extremities are the arms. The peripheral vascular system therefore includes the arteries, veins, capillaries and the lymphatic system together with its nodes in the legs and arms (Bates’ Guide to Physical Examination and History Taking, n.d.). This particular body system is very important in terms of diagnosing pathological processes that are found in the lower and upper extremities. Some of these pathological processes include deep vein thrombosis and elephantiasis amongst others (Hammer & McPhee, 2018; Huether & McCance, 2017).Physiology, Physical Examination, and Major Disease Processes.

Structure and Function of the Peripheral Vascular System

The arteries of the legs get their supply from the femoral arteries on either side. On the other hand, the arms get their blood supply from the subclavian arteries. Prominent arteries in the arms include the brachial artery, the ulner artery, and the radial artery. The pulse of these arteries can be felt as they lie close to the surface and over a bone. In the legs, prominent arteries whose pulsation can also be felt are the femoral artery, the popliteal artery, the dorsalis pedis artery, and the posterior tibial artery (Bates’ Guide to Physical Examination and History Taking, n.d.). There are also veins that make up part of the peripheral vascular system. The importance of veins in the pathophysiology of the lower and upper extremities cannot be gainsaid. Indeed, veins are important in the pathology of the peripheral vascular system. For instance, it is a known fact that deep leg veins are responsible for ninety percent of the venous return coming from the legs. Veins, especially the ones in the lower extremities, normally possess valves. The function of these valves is to guard against the backflow of venous blood due to the influence of gravity. Veins in the peripheral vascular system can be either superficial or deep. In the legs, for instance, superficial veins include the small saphenous vein and the great saphenous vein. These two veins normally form anastomoses that are interconnections linking the two. The function of these anastomoses is to guarantee an alternative path for blood to return to the heart in the event that a specific section of one of the saphenous veins is blocked. There are also perforating veins that link the two saphenous veins to the deep veins. During venous return, the action of the muscle pump is normally very important because it helps to push the blood up towards the heart. Therefore, when one walks, for instance, the contraction of the calf and other leg muscles squeeze the leg veins pushing the blood in them upwards (Bates’ Guide to Physical Examination and History Taking, n.d.; Jarvis, 2018).Physiology, Physical Examination, and Major Disease Processes.

As has already been mentioned above, the lymphatic drainage system is also part of the peripheral vascular system in the upper and lower extremities. Lymphatic vessels drain lymph from the body tissues and return it into the venous system. These lymphatic vessels start in the peripheral vascular system as blind-ended capillaries. Along their lengths, there are numerous nodes whose function is to filter the lymph before it is emptied into the venous side of the circulation. It is also a well-known fact that the lymphatic system is crucial in the immune system of the human body. Cells in the lymphatic system are closely involved in the engulfing of bacteria and sequestering them from the body’s circulating blood. In the peripheral vascular system, the lymphatic nodes are significant when it comes to the physical examination and diagnosis of diseases affecting the peripheral vascular system. Lymphatic nodes are thus palpable in the lower and upper extremities with the examples being the axillary nodes and the other nodes in the arms and legs (Bates’ Guide to Physical Examination and History Taking, n.d.).Physiology, Physical Examination, and Major Disease Processes.

Relevant Health History Questions or Subjective Data of the Peripheral Vascular System

During any history taking in the course of trying to unravel the diagnosis of any patient, subjective information given by the patient is usually very important and helpful. This is also the case with the peripheral vascular system. In this system, the patient who presents with symptoms pointing to a pathological process in the lower and upper extremities is asked several questions to elicit specific subjective responses that aid in making the diagnosis. These questions can be grouped according to the concerning symptoms that the patient presents with. These are explained below.Physiology, Physical Examination, and Major Disease Processes.

Intermittent Claudication

Intermittent claudication has been known to be a pointer to disease processes in the arteries that make up the peripheral vascular system. What intermittent claudication means is that the patient gives a history of feeling a very sudden and transient pain that is intense when they engage in any physical activity. However, this pain goes away in a few minutes when they stop the physical activity that appears to cause it. This symptom could mean that the peripheral vascular system arteries are getting blocked, narrowing, or are being pressed. The symptom of intermittent claudication then arises because the arteries affected cannot supply sufficient oxygen to the muscles of the lower and upper extremities that require it due to the strenuous exercise. Lactic acid then accumulates to significant levels with the resultant pain being a result of its accumulation in the muscle tissue. The questions that can then be asked to the patient on this front include “Do you normally feel any pain in the legs when you start engaging in physical activity?” “Does the pain normally go away once you stop that physical activity?” and so on (Bates’ Guide to Physical Examination and History Taking, n.d.). Physiology, Physical Examination, and Major Disease Processes.

Pain in the Arms and/ or Legs

The other symptom that patients with disease processes in the peripheral vascular system may present with is pain in the arms and legs. The patient should be asked questions like “where does the pain originate from in the legs/ arms?” and “does the pain impair your ability to use that arm or leg?” and so on. In asking these questions, however, the clinician must be aware that pain in the arms and legs can also be caused by other disease processes that are not linked to the peripheral vascular system. Thus the pain could also have originated from the skin, the musculoskeletal system, or the nervous system. In fact, even visceral pain such as that due to myocardial infarction can radiate to the shoulders and arms. It is therefore imperative for the clinician to be aware of these intricacies and exclude them systematically as they continue with the history taking and physical examination (Bates’ Guide to Physical Examination and History Taking, n.d.). Physiology, Physical Examination, and Major Disease Processes.

Cold, Numbness, and Pallor in the Arms and Legs

The patient could be asked whether they are feeling cold or numb in the legs and/ or arms. They could also be asked to report whether they have observed any pallor on their arms and legs. These are symptoms that point to notable disease processes in the peripheral vascular system (Bates’ Guide to Physical Examination and History Taking, n.d.).

Swelling in the Calves, Legs, or Feet

It is a common sign for patients with pathological processes in the peripheral vascular system to present with swelling of the legs, feet, or the calf. The questions could include “For how long has the calf been swollen?” and “Is the swelling getting worse or it is getting better?” (Bates’ Guide to Physical Examination and History Taking, n.d.). Physiology, Physical Examination, and Major Disease Processes.

Change of Color in the Fingertips or Toes in Cold Weather Conditions

There are times that the extremities become blue in color when the weather is cold. This may indicate that not enough blood is reaching the extremities, as cold weather constricts blood vessels that bring blood to the extremities. The patient could be asked if the blue discoloration is accompanied by numbness (Bates’ Guide to Physical Examination and History Taking, n.d.). Physiology, Physical Examination, and Major Disease Processes.

Swelling with Redness and / or Tenderness

This is the last symptom that the patient may have to answer questions about. The clinician could ask whether the patient has experienced any redness or tenderness in the area of the lower or upper limbs that is not well.Physiology, Physical Examination, and Major Disease Processes.

Objective Data and Normal Physical Examination

The peripheral vascular system should not show any signs of inflammation on examination (redness, pain, and swelling). There should be no guarding when the calf is palpated, for instance.

Special Physical Assessment

For the arms, the skin color, the symmetry, and size are checked. The radial and brachial pulses are also felt. Lastly, the lymph nodes are palpated. For the legs, the skin color, symmetry, and size are also checked. Femoral and inguinal nodes are palpated, edema is checked, and the pulses are checked (Bates’ Guide to Physical Examination and History Taking, n.d.).

The physical assessment skills can be adapted to pediatrics by taking into account that their arteries and veins are still small and may not be prominent, to pregnancy by remembering that pregnancy causes physiological changes such as leg swelling, to geriatrics by taking into account the degenerative changes of old age such as atherosclerosis.Physiology, Physical Examination, and Major Disease Processes.

One major disease process that may impact this system is deep vein thrombosis. This disease process will cause pain on palpation of the calf area and significant swelling of the calf. The superficial veins may also be visible to the naked eye.Physiology, Physical Examination, and Major Disease Processes.

Summary

The peripheral vascular system is important in that disease processes in it can be assessed in a particular way using specific physical examination techniques and history taking questions. The questions are specific to elicit the desired subjective information from the patient.

Requirements:
NOTE: Complete the NR 509 Alternative Writing Assignment ONLY if you did not attend or do not plan to attend Debriefing for the given week.
1. This paper will be appraised on the quality of the information, inclusion of at least one evidence-based scholarly source, use of citations, use of Standard English grammar, and organization based on the required components (see the paper headings and content details below).
2. Scholarly sources: Only scholarly sources are acceptable for citation and reference in this course. These include peer reviewed publications, government reports, or sources written by a professional or scholar in the field. Your textbook and lesson are not considered to be an outside scholarly source. For the discussions and reflection posts, reputable internet sources such as websites by government agencies (URL ends in .gov) and respected organizations (often ends in .org) can be counted as scholarly sources. The best outside scholarly source to use is a peer-reviewed nursing journal. You are encouraged to use the Chamberlain library and search one of the available data bases for a peer-reviewed journal article. The following sources should not be used: Wikipedia, Wikis, or blogs. These web sites are not considered scholarly as anyone can add to these. Please be aware that .com websites can vary in scholarship and quality. For example, the American Heart Association is a .com site with scholarship and quality. It is the responsibility of the student to determine the scholarship and quality of any .com site. Ask your instructor before using any site if you are unsure. Points will be deducted from the rubric if the site does not demonstrate scholarship or quality. Current outside scholarly sources must be published with the last 5 years. Instructor permission must be obtained BEFORE the assignment is due if using a source that is older than 5 years.
3. The length of the paper is to be no less than 1,500 words, excluding title page and reference list.Physiology, Physical Examination, and Major Disease Processes.
4. Create this assignment using Microsoft (MS) Word. You can tell that the document is saved as a MS Word document because it will end in “.docx.”
5. APA format (6th edition) is required in this assignment, explicitly for in-text citations and the reference list. Use 12-point Times New Roman font with 1 inch margins and double spacing. See the APA manual for details regarding proper citation.
6. Organize the headings and content of your paper using the outline below:
o Select a body system relevant to the lesson from the previous week for the topic of this paper – (PERIPHERALVASCULAR SYSTEM)
o Discuss the physiology (structure and function) of the body system including details about the major organ systems (if applicable).
o Construct relevant health history questions (subjective data) pertaining to the body system.
o Provide an overview of the objective data and expected normal physical examination findings for this body system.
o Explain special physical assessment examination techniques or procedures specific to assessing this body system
o Analyze and discuss how you might adapt your physical assessment skills or interviewing techniques to accommodate each of the following specific populations:Physiology, Physical Examination, and Major Disease Processes.
 Infant/pediatric
 Pregnancy
 Geriatric
o Identify one major disease or disease process that may significantly impact this body system.
o Synthesis and discuss the expected abnormal physical examination findings that may be associated with this disease or disease process.
o Summarize the key points.
o References in correct APA format

Total FORMAT Points= 10 pts
ASSIGNMENT TOTAL= 30 points

Rubric
NR509 Weeks 1-6 Alternative Writing Assignment_Sept19
NR509 Weeks 1-6 Alternative Writing Assignment_Sept19
Criteria Ratings Pts
This criterion is linked to a Learning OutcomeAssignment Content Possible Points = 20 Points
Criterion 1

Application of Knowledge, Analysis, and Clarity

Must demonstrate the following elements:

Select an appropriate topic or focus for the assignment;

Demonstrate analysis, synthesis, and/or application of principles and concepts
consistent with advanced physical assessment;

Provide appropriate health history questions;

Identify the expected normal findings;

Content is specific to the topic;

Paper is organized and clearly presented.

(6 Required Elements) 10.0 pts
Excellent
Demonstrates all elements of the Criterion 9.0 pts
V. Good
Missing 1 element of the Criterion 8.0 pts
Satisfactory
Missing 2 elements of the Criterion 5.0 pts
Needs Improvement
Missing 3 elements of the Criterion 0.0 pts
Unsatisfactory
Missing 4 or more elements OR No assignment
10.0 pts
This criterion is linked to a Learning OutcomeCriterion 2 Adapted Physical Assessment Skills to Special Populations, Disease Process, Summary, and Scholarly Sources
Must demonstrate the following elements:

Discuss how to adapt physical assessment skills or techniques to accommodate all special populations;

Identify one major disease or disease process and expected examination findings;

Demonstrate appropriate knowledge of physical assessment examination techniques or procedures;

Identify abnormal findings;

Summarize key points

Must include at least one scholarly source

(6 Required Elements) 10.0 pts
Excellent
Demonstrates all elements of the Criterion 9.0 pts
V. Good
Missing 1 element of the Criterion 8.0 pts
Satisfactory
Missing 2 elements of the Criterion 5.0 pts
Needs Improvement
Missing 3 elements of the Criterion 0.0 pts
Unsatisfactory
Missing 4 or more elements OR No assignment
10.0 pts
This criterion is linked to a Learning OutcomeAssignment Format Possible Points = 10 Points
Format Criterion 1

Grammar, Spelling, Syntax, Mechanics, APA Format, and Word Requirement

NOTE: Failure to comply with the word requirements for this assignment will result in the grade of zero (0) for this Criterion. 10.0 pts
Excellent
0-1 errors in grammar, syntax, spelling, punctuation, mechanics, and APA format 9.0 pts
V. Good
2-3 errors in grammar, syntax, spelling, punctuation, mechanics, and APA format 8.0 pts
Satisfactory
4-5 errors in grammar, syntax, spelling, punctuation, mechanics, and APA format 5.0 pts
Needs Improvement
6-7 errors in grammar, syntax, spelling, punctuation, mechanics, and APA format 0.0 pts
Unsatisfactory
8 or more errors in grammar, syntax, spelling, punctuation, mechanics, and APA format Or Less than 1,500 words, excluding title page and reference list OR No assignment
10.0 pts
This criterion is linked to a Learning OutcomeLate Penalty Deductions
Students are expected to submit assignments by the time they are due. Assignments submitted after the due date and time will receive a deduction of 10% of the total points possible for that assignment for each day the assignment is late. Assignments will be accepted, with penalty as described, up to a maximum of three days late, after which point a zero will be recorded for the assignment. Quizzes and discussions are not considered assignments and are not part of the late assignment policy. 0.0 pts
Minus Points 0.0 pts
Minus Points
0.0 pts
Total Points: 30.0

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