Peripheral Vascular System

Question 1

location to palpate arterial pulses

Answer 1

ARMS
1. Brachial- at bend of elbow just medial to biceps tendon
2. Radial: Lateral flexor surface of wrist
3. Ulnar: medial flexor surface
LEGS:
1. Femoral: below inguinal ligament
2. Popliteal: passes medially behind the femur; behind the knee
3. Dorsalis Pedis: dorsum of foot; lateral to extensor tendon of big toe
4. Posterior Tibial: behind medial malleolus of ankle

Question 2

ROS

Answer 2

Intermittent Claudication
leg cramps 
varicose veins
clots in the veins
Raynaud's disease

Question 3

Symptoms

Answer 3

Pain in arms or legs
Intermittent Claudication
Cold, numbness, pallor in legs, hair loss
swelling in calves, legs, or feet
color change in fingertips or toes in cold weather
swelling w/ redness or tenderness
Abdominal, flank, or back pain

Question 4

Peripheral Arterial Disease ( PAD)

Intermittent Claudication

Arterial Spasms- (Raynaud’s disease )

Peripheral Venous Disease (PVD)=

Answer 4

= pain or cramping in the legs when walking or w/ ex’s

=color in cold
weather

=swelling of feet and legs, Varicosities

Question 5

Examination to extremities/ Inspect

Arms

Legs

Answer 5

size and symmetry
skin color and texture
venous pattern
 nail beds- color and capillary refill (<2sec)
Pulses- brachial, and radial

venous pattern/ enlargement
Pigmentations, rashes, scars, or ulcers
distribution of hair , feet and toes

Size, symmetry, skin color
Pulses- femoral, popliteal, dorsalis pedis, post tibial
peripheral edema

Question 6

Grading Amplitude of Arterial Pulses

Answer 6

3+= Bounding

2+= Brisk, expected= NORMAL

1+= Diminished, weaker that expected

0= Absent, unable to palpate

Question 7

Grading for Pitting Edema
Four- point scale

                         technique/locations

Answer 7

1+,2+, 3+, 4+, slight, pitting or very marked

Firmly press with thumb~ 5 secs over dorsum of each foot, behind medial malleolus and shins