Lower Limb 2.2 Flashcards
How do you find arterial pulses?
felt in any artery that lies near the surface of the body especially when it can be compressed against bone or any firm structure
How do you palpate an arterial pulse?
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
What do you look for when palpating an arterial pulse?
- Pulse rate
- Rhythm
- Character and volume
- Symmetry
- Radio-femoral delays between major arteries
What do you look for in pulse rate?
usually assessed by palpating right radial pulse and expressed in pulses per minute
What do you look for in rhythm?
- usually assessed by palpating right radial pulse
- The rhythm can be regular or irregular
- Irregular rhythm is usually due to cardiac problems such as atrial fibrillation or ectopic beats
What do you look for in character and volume?
usually assessed by palpating the right carotid artery pulse which is closest to the heart than the radial pulse
What do you look for in symmetry?
of radial, brachial, carotid, femoral, popliteal, and pedal pulses can be assessed by comparing pulses on both sides
What are the 4 pulses to palpate in the lower limb?
1) Femoral artery pulse
2) Popliteal artery pulse
3) Dorsalis pedis artery pulse
4) Posterior tibial artery pulse
Where is the posterior tibial pulse?
Just behind the medial malleolus (of the tibia) between the medial malleolus and calcaenal tendon
Where is the dorsalis pedis pulse?
On mid-dorsum of foot, just lateral to the tendon of flexor hallucis longus
What are the boundaries of the femoral triangle?
- Inguinal ligament
- Adductor longus
- sartorius
How do you find the femoral pulse?
- Located at mid inguinal point
- Subject index finger is pointing the symphysis pubis
- Examiners’s left index finger at the ASIS
- Examiners right middle finger on the femoral artery
- 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
How do you find the popliteal pulse?
- In the depth of the popliteal fossa with knee semi flexed
- 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
- Rest both of your thumbs over the tibial tuberosity
When else can you feel the pulsation of the popliteal artery?
With the knee fully extended with the content of the popliteal fossa fully stretched
Why are the superficial veins of clinical importance?
- become frequently varicosed
- very long and can be harvested for vascular grafts elsewhere in the body
- On dorsum of the foot, when they are readily visible, can be used for venous infusion
What viens should you be able to identify?
1) Dorsal venous arch on the dorsum of the foot
2) Small (short) saphenous vein
3) Great (long) saphenous vein
Where does the small spahenous vein run and arise from?
- arises from the dorsal venous arch of the foot
- 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
What is the longest vein in the body?
great saphenous vein
Where does the long saphenous vein arise from?
- arises from the dorsal venous arch of the foot
- runs in front of the medial malleolus
- ascends along the medial side of the leg
- lies behind the medial condyles of the tibia and femur, about a hand’s breadth
- ascends to the groin to enter the saphenous opening to join the femoral vein
where is the saphenous opening?
3 – 4 cm below the inguinal crease, medial to the femoral artery pulse
What are landmarks of the great saphenous vein?
- Posterior to the medial border of the patella about a hands breadth
- Anterior to medial malleolus 2cm
What are landmarks of the short saphenous vein?
- Joins popliteal vein in the popliteal fossa
2. Posterior to lateral malleolis
