Lower Limb 2.2

Question 1

How do you find arterial pulses?

Answer 1

felt in any artery that lies near the surface of the body especially when it can be compressed against bone or any firm structure

Question 2

How do you palpate an arterial pulse?

Answer 2

use the index and the middle finger (also the ring finger- optional) to palpate the pulse. You must not use your thumb or little finger

Question 3

What do you look for when palpating an arterial pulse?

Answer 3

1. Pulse rate
2. Rhythm
3. Character and volume
4. Symmetry
5. Radio-femoral delays between major arteries

Question 4

What do you look for in pulse rate?

Answer 4

usually assessed by palpating right radial pulse and expressed in pulses per minute

Question 5

What do you look for in rhythm?

Answer 5

1. usually assessed by palpating right radial pulse
2. The rhythm can be regular or irregular
3. Irregular rhythm is usually due to cardiac problems such as atrial fibrillation or ectopic beats

Question 6

What do you look for in character and volume?

Answer 6

usually assessed by palpating the right carotid artery pulse which is closest to the heart than the radial pulse

Question 7

What do you look for in symmetry?

Answer 7

of radial, brachial, carotid, femoral, popliteal, and pedal pulses can be assessed by comparing pulses on both sides

Question 8

What are the 4 pulses to palpate in the lower limb?

Answer 8

1) Femoral artery pulse
2) Popliteal artery pulse
3) Dorsalis pedis artery pulse
4) Posterior tibial artery pulse

Question 9

Where is the posterior tibial pulse?

Answer 9

Just behind the medial malleolus (of the tibia) between the medial malleolus and calcaenal tendon

Question 10

Where is the dorsalis pedis pulse?

Answer 10

On mid-dorsum of foot, just lateral to the tendon of flexor hallucis longus

Question 11

What are the boundaries of the femoral triangle?

Answer 11

1. Inguinal ligament
2. Adductor longus
3. sartorius

Question 12

How do you find the femoral pulse?

Answer 12

1. Located at mid inguinal point
2. Subject index finger is pointing the symphysis pubis
3. Examiners’s left index finger at the ASIS
4. Examiners right middle finger on the femoral artery
5. In a supine subject, it is easier to find the pulse if the thigh is slightly abducted and the examining finger lies along the inguinal crease line

Question 13

How do you find the popliteal pulse?

Answer 13

1. In the depth of the popliteal fossa with knee semi flexed
2. Use middle three fingers of both hands probing deeply in the inferior part of the fossa where the artery may be compressed against the posterior surface of the tibia
3. Rest both of your thumbs over the tibial tuberosity

Question 14

When else can you feel the pulsation of the popliteal artery?

Answer 14

With the knee fully extended with the content of the popliteal fossa fully stretched

Question 15

Why are the superficial veins of clinical importance?

Answer 15

1. become frequently varicosed
2. very long and can be harvested for vascular grafts elsewhere in the body
3. On dorsum of the foot, when they are readily visible, can be used for venous infusion

Question 16

What viens should you be able to identify?

Answer 16

1) Dorsal venous arch on the dorsum of the foot
2) Small (short) saphenous vein
3) Great (long) saphenous vein

Question 17

Where does the small spahenous vein run and arise from?

Answer 17

1. arises from the dorsal venous arch of the foot
2. runs behind the lateral malleolus, superiorly to the midline on the back of the calf 3. to the popliteal fossa where it pierces popliteal fascia to join the popliteal vein

Question 18

What is the longest vein in the body?

Answer 18

great saphenous vein

Question 19

Where does the long saphenous vein arise from?

Answer 19

1. arises from the dorsal venous arch of the foot
2. runs in front of the medial malleolus
3. ascends along the medial side of the leg
4. lies behind the medial condyles of the tibia and femur, about a hand’s breadth
5. ascends to the groin to enter the saphenous opening to join the femoral vein

Question 20

where is the saphenous opening?

Answer 20

3 – 4 cm below the inguinal crease, medial to the femoral artery pulse

Question 21

What are landmarks of the great saphenous vein?

Answer 21

1. Posterior to the medial border of the patella about a hands breadth
2. Anterior to medial malleolus 2cm

Question 22

What are landmarks of the short saphenous vein?

Answer 22

1. Joins popliteal vein in the popliteal fossa

2. Posterior to lateral malleolis