Peripheral Vascular

Question 1

Inspection

Answer 1

Dependent rubor
Pallor with raised extremity (may also have pain)
Hair loss on leg/foot
Atrophic skin; nail changes
Ulcers
Necrosis/gangrene

Question 2

Palpation

Answer 2

-Pulses
Femoral, popliteal, posterior tibial, dorsalis pedis
-Skin temperature: Cool
-Capillary refill
Delayed (> 2 sec)

Question 3

Auscultation for bruits

Answer 3

• Abdominal aorta

- Femoral & popliteal arteries

Question 4

Venous insufficiency [varicose veins (varicosities) ]

Answer 4

Dilated, tortuous superficial veins - result from defective structure & function of the valves of the saphenous system
Symptoms include:
Dull ache or pressure sensation after prolonged standing; relieved with elevation
Dependent ankle edema may develop
Ankle ulcerations may develop
Superficial thrombosis / thrombophlebitis may occur
Support hose if prolonged sitting
E.g. Flight to Australia

Question 5

Stasis dermatitis

Answer 5

Due to chronic venous insufficiency with incompetent valves & higher pressure in capillary bed.
Tissue is damaged & inflamed
“Brawny,” non-pitting edema

Question 6

Lymphedema

Answer 6

Results from blockage of the lymph vessels that drain fluid from tissues throughout the body (& transport immune cells to where they’re needed)

Question 7

Homan’s sign

Answer 7

Testing for deep venous thrombosis
In a patient with calf pain, tenderness, &/or swelling
Passivel dorsiflex the foot
Calf pain with dorsiflexion suggests DVT
Questionable reliability & validity.
-Calf pain may be due to some other cause
-Negative test does not rule out DVT

Question 8

Specific Structure Tests:

Answer 8

Homan’s Sign (DVT)
Thompson’s Test (Achilles’ rupture)
Compression Test (fx)