Examination of the arterial system of the upper and lower limbs Flashcards
No.1
“This will involve me having a quick look at your hands and face and feeling your pulses”
Inspection of the patient (colour; build; comfort; position)
What do you inspect on general inspection of pt?
- colour
- build
- comfort
- position
After inspection of patient?
Can you put your hands out for me?
And turn them over
- Colour (pallor of the palmar creases; peripheral cyanosis)
- Nicotine staining
+ CAP REFILL
After inspection of hands and cap refill?
Radial pulses + compare radial pulses
- Rate, rhythm, volume, radio-radial delay
After radial pulses?
Ulnar and brachial pulses
After ulnar and brachial pulses?
Allen’s test
After Allen’s test (it may not actually be performed?)
Check the blood pressure in both arms
After blood pressure?
Palpate the carotid pulses (one at a time!)
After carotid pulses?
Examination of the eyes:
- Subconjunctival pallor (anaemia)
+ Ask the pt to pull their eyelids down themselves
- Corneal arcus (hyperlipidaemia)
After examination of the eyes?
Examination of the lips and tongue:
- Can you touch the roof of your mouth with your tongue?
- Dehydration
After examining face?
Inspection of the abdomen for scars, visible masses and visible pulsations
“Can I ask you to take your top off for me please so I can have a look at your abdomen?”
What do you look for on examination of the abdomen?
- Scars
- Visible masses
- Visible pulsations
After inspecting the abdomen?
Palpate the aortic pulse
After palpating the aortic pulse?
Inspection of the legs, feet and toes:
- symmetry, colour, scars, oedema
- Trophic changes: loss of hair, shiny skin, wasting of subcutaneous tissues
- Ulceration
- Look between the toes and get them to lift their legs up
After inspection of the legs?
PALPATE
- Femoral
- Popliteal
- Posterior tibial
- Dorsalis pedis