Examination of the lower limbs for varicose veins and chronic venous insufficiency

Question 1

No.1

Answer 1

Ask the patient to stand up and remove their trousers
‘I’m going to be examining the veins in your legs today. To inspect your legs I’ll need you to take your trousers off if that’s alright?’

Question 2

After asking the patient to remove their trousers?

Answer 2

Inspect the legs

Question 3

What are you inspecting the legs for?

Answer 3

• Scars
• Varicosities
• Venous eczema
• Oedema due to venous stasis
• Lipodermatosclerosis (scarring of the skin and fat)
• Haemosiderin deposition
• Venous ulceration

Question 4

After inspecting the legs?

Answer 4

Identify the saphenofemoral junction and look for a saphenovarix

Question 5

After identifying the saphenofemoral junction?

Answer 5

Cough test

1. Put your finger on the saphenofemoral junction and ask pt to cough
2. Palpate for thrills

Question 6

After the cough test?

Answer 6

Tap test
1. Finger on SFJ
2.Finger of other hand on any varicosities in the long saphenous vein distribution
3. Tap on SFJ
Incompetent = transmitted percussion wave in varicosities further down the leg