Peripheral Vascular Flashcards
Describe the order of a peripheral vascular nerve examination
Hands/Arms
- Look
- Capillary refill
- Feel pulses - radial, ulnar, brachial, subclavian
- Assess for radial-radial delay
Neck
- Feel carotid pulse
- Auscultate over the carotids
Abdomen
- Look
- Feel for pulsations
Legs
- Scars
- Look
- Feel distal pulses - femoral, popliteal, dorsalis pedis, posterior tibialis
- Sensation of lower limbs
What would you do to complete a peripheral vascular examination
Would like to do:
A cardiovascular examination
Capillary glucose
Fundoscopy
Ankle brachial pressure index (ABPI)
Offer Perths test, tap test
Describe what you are looking for in a peripheral vascular examination
Peripheral cyanosis
Tar staining
Anaemia in palmar creases
Describe peripheral cyanosis
Blue fingertips due to not reiceving enough blood flow
Describe what would be seen in tar staining
Typically 2nd and 3rd digits - indicative of long smoking history
How is capillary refill tested
= rapid test used fort assessing the blood flow through peripheral tissues
Compress nail bed for approx. 5 seconds until it turns white and record time taken for colour to return to the nail bed
> 3 seconds = abnormal
How long would a capillary refill test be classed as abnormal
> 3 seconds
Why do you assess for radial radial delay
= radial pulses in both arms are not in sync with each other
Caused by coaracation of aorta (narrowing between branches of the brachiocephalic and left subclavian arteries)
To do - compare the radial pulses in both arms at the same time
Why do you auscultate over the carotids in peripheral vascular examination
For any carotid bruits
What abdominal pulsations are you feeling for in a peripheral vascular examination
Abdominal aorta
What is a key scar you are looking for on a peripheral vascular examination
Great saphenous vein
Harvesting for a coronary artery bypass
What vein is harvested for a coronary artery bypass
Great saphenous vein
What skin changes are key to identify on a peripheral vascular examination
Haemosiderin deposition
Varicose eczema (statis dermatitis)
Atrophie blanche
Describe haemosiderin deposition
Haemosiderin = protein helps body to store iron. Discolouration of skin is due to excess iron storage
Causes = liver failure, diffuse alveolar storage
Describe varicose eczema (stasis dermatitis)
Lower legs become darker and red, often become stained brown.
Happens when pressure in the veins of the leg increases
