Peripheral Vascular Examination Flashcards
1
Intro…
2
General inspection of the bed area for clues
Inspection of the patient (colour, build, comfort, position etc.)
3
Inspect the hands for:
-colour (pallor of the palmar creases; peripheral cyanosis)
-capillary refill
-nicotine staining
(Not in book but wouldn’t hurt to do temp)
4
Check and compare radial pulses (rate, rhythm, volume, radio-radial delay)
5
Palpate the ulnar (volume) pulses
6
Palpate the brachial (volume and character) pulses
7
Perform Allen’s test
8
Check the blood pressure in both arms
9
Palpate the carotid pulses (one at a time). Assess the character and volume.
10
Examine the eyes for:
-subconjunctival pallor (anaemia)
-corneal arcus (hyperlipidaemia)
11
Assess the lips and tongue for:
-dehydration
-central cyanosis
12
Inspect the abdomen for scars, visible masses and visible pulsations
13
Inspect the legs, feet and toes for:
-symmetry
-colour
-scars
-oedema
-trophies changes:
-loss of hair, shiny skin, wasting of subcutaneous tissues
-ulceration (describe site, depth, size, margins, ulcer bed, exudate, odour etc.)
14
Palpate the:
-aorta
-femoral pulses
-popliteal pulses
-dorsalis pedis and posterior tibial pulses
15
Check light-touch sensation and capillary refill in the toes
16
Assess power in the foot/leg
17
Auscultate:
-carotids
-subclavian arteries
-aorta (a bruit can be heard in thin healthy patients)
-femoral arteries
(Note that there is no bruit over an occluded vessel and severe stenosis can be present without an audible bruit.)
18
Perform Buerger’s test
19
Calculate the ankle-brachial pressure index (ABPI) by dividing the highest systolic blood pressure in the arteries at the ankle by the higher of the two systolic blood pressures in the arms. Significant arterial disease is indicated by an ABPI of <0.8.
20
Conclusion