Peripheral Vascular Exam Flashcards
1
Q
Where on the leg do you commonly find:
- Arterial
- Venous
- Neuropathic
ulcers?
A
2
Q
What kind of ulcer is this?
A
Arterial
- The ulcer has punched-out appearance.
- It is intensely painful.
- It has gray or yellow fibrotic base and undermining skin margins.
- Pulses are not palpable.
- Associated skin changes may be observed, such as thin shiny skin and absence of hair.
- They are most common on distal ends of limbs.
3
Q
What kind of ulcer is this?
A
Venous ulcer
- Moderate pain, which improves on elevation (unlike arterial ulcers which worsen with elevation)
- Irregular, sloping edges
- “Wet” appearance
- Associated oedema, due to increased hydrostatic pressure, which contributes to ‘atrophie blanche’
- ‘Atrophie blanche’, localised loss of skin pigmentation due to death of erythrocytes and scarring
- Lipodermatosclerosis, a hardening of the skin which can lead to an “inverted champagne bottle” appearance to the leg
4
Q
What are the main differences between venous and arterial ulcers?
A
5
Q
What is this sign? What is it associated with?
A
Haemosiderosis / siderin deposits
associated with venous insufficiency
6
Q
What is this sign? What is it associated with?
A
Lipodermatosclerosis
associated with venous insufficiency
Feels hard/ woody on palpation
7
Q
What is this sign? What is it associated with?
A
Atrophie blanche
associated with venous insufficiency
8
Q
What is this sign?
A
Varicose / venous eczema
9
Q
What are the values and classifications of ABPI?
A
- >1 = normal
- 0.5-1 = intermittent claudication
- 0.3-0.5 = rest pain / critical limb ischaemia
- <0.3 = gangrene / ulceration
10
Q
What are the 6 signs of a critically ischaemia limb?
A
- Pain
- Pallor
- Pulseless
- Perishingly cold
- Paraesthesia
- Paralysis
11
Q
What are the signs of venous insufficiency?
A
- Venous eczema/ haemosiderin
deposits - Lipdermatosclerosis
- Venous ulcers
- Varicose Veins
