Peripheral Circulation

Question 1

Inspection

Answer 1

Poor circulation:
Skin gets pale, thinner
Muscle gets thinner
Hair growth decrease
Nails are brittle and thickened

Question 2

Palpation

Answer 2

Capillary refill of big toes: press until turns white, count seconds until go back to skin color <5sec. Should be around same time in left and right.
Temperature of sole and ankles with back of hand: should be same temperature on both sides
Palpation to find pulse, diameter and consistency of artery

Question 3

Peripheral circulation upper extremities

Answer 3

Common carotid artery: next to trachea
Subclavian artery: midline clavicle, feel it from the top slightly under clavicle
Axillary artery: high in the armpit
Brachial artery: between biceps and triceps
Radial artery: thumb
Ulnar artery: little finger side

Abdomen
abdominal aorta: deep above belly button when muscle relaxed
Femoral artery: groin fold (have fingers parallel)

Question 4

Peripheral circulation lower extremities

Answer 4

posterior tibial and dorsalis pedis cannot be felt in small percentage of the population
Femoral artery: groin fold (have fingers parallel)
Poplietal artery: bent knee 45deg, use both ends, rest on tibial plateau
posterior tibial artery: under and behind malleolus. interior side of foot/leg
dorsal pedal artery: on dorsum of foot, big toe side

Question 5

Auscultation

Answer 5

Try to listen if there are murmurs
S- no murmurs
S+ murmurs
Don’t press to hard otherwise could hear murmurs that are physiological
Carotid Artery
Subclavian artery
Abdominal aorta
Renal artery (can’t be palpated upper abdominal, left and right)
External Iliac artery (can’t be palpated: 2 branches under belly button)
Femoral artery

Question 6

Oedema

Answer 6

Swallon area
Pitting: press for a few second and there is a visible indentation
non pitting: no indentation
Suitable sites: pretibial (near ankles), perimalleolar (malleolus, interior side of foot “ball”), back of foot

Question 7

Ulcer

Answer 7

Defect entire skin
Crater shaped
Arterial : very painful, poor perfusion (toes, feet), dry aspect, base white/brown/black
Venous: midly painful, base pink/red/yellow

Question 8

Poor peripheral venous circulation

Answer 8

Less blood back to heart
Blood accumulate and congest
Pressure increase
Skin: color change, hardened
Decreased muscle mass
Edema, Eczema, brown pigmentation

Question 9

Poor arterial circulation

Answer 9

Chronic arterial insufficiency
Poor oxygen and nutrients in blood
Leads to atrophy
trophic caracteristics:
skin: dry, flaky, thin
hair: reduced
Muscle: reduced
Nails: hardned, yellow, brittle