Examination of Peripheral Vascular System

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Examination of Peripheral Vascular System

  • introduction , permission,

  • Exposure (both legs)

Look

  • end of bed

  • pressure points

    • lateral side of foot

    • head of 1st metatarsal

    • heel

    • malleoli

  • observe gangrene

    • tips of toes

    • between toes

Feel

  • temperatures

  • capillary refill time

  • pulses

    • femoral

      • halfway between anterior superior iliac spine and symphisis pubis

    • popliteal

    • dorsalis pedis

      • lateral to extensor hallucis longus

    • posterior tibial

      • medial malleolus

Listen

  • bruits

Further tests

  • venous guttering - 15º

  • Buerger's angle (angle at which leg becomes pale)

  • Buerger's test

    • hang leg over side of bed to get reactive hyperaemia

    • also assess venous filling time

  • ? Examination of Varicose Veins

"I would like to examine...

  • the rest of the peripheral vascular system
  • the heart
  • the abdomen for an aortic aneurysm"

Rest of peripheral vascular system

  • Pulses
    • radial
    • carotid
    • radio-femoral delay
  • Listen
    • carotid bruit
    • subclavian bruit

Completion

  • ensure patient comfortable
  • cover legs
  • present findings
 

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