peripheral vasculation and lymphatics

Question 1

inspect hands and palpate arms as part of a peripheral vasculation and lymphatics examination

Answer 1

• inspect hands and arms
• test capillary refill
• palpate radial pulses
• palpate brachial pulses
• check epitrochlear lymph nodes

Question 2

inspect and palpate legs as part of the peripheral vasculation and lymphatics examination

Answer 2

• inspect legs
• check temperature
• check for Homan’s sign
• palpate inquinal lymphs
• palpate arteries of the leg
• check for pretibial edema
• assess for colour changes

Question 3

test capillary refill as part of periphery vascular examination

Answer 3

patients hands near level of heart

depress nail bed until it blanches

see how long it takes for colour to return

should take 1-2 seconds

Question 4

palpate the radial pulses as part of peripheral vascular exam

Answer 4

palpate radial pulses bilaterally at the same time

grade force of pulsation on 4 point scale, 0 being absent, 2+ being moderate

rate should be between 60 and 100 bpm

steady rhythm

vessels should feel elastic

pulses bilaterally symmetrical

Question 5

palpate the brachial pulses as part of peripheral vascular exam

Answer 5

palpate each, force should be equal and 2+

rhythm and rate should also be bilaterally symmetrical

Question 6

check epitrochlear lymph nodes as part of peripheral vascular exam

Answer 6

use handshake position

palpate depression above and behind the medial condyle of the humerus aka groove between biceps and triceps muscle

normally lymphs are not palpable

Question 7

inspect the legs as part of peripheral vascular and lymphatic exam

Answer 7

drape genitalia while exposing legs

note skin colour - no skin discolouration, ulcers, gangrene, lesions

look at hair distribuition - should be even

examine venous pattern - should be no tortuosities or vericosities

inspect size - note swelling or atrophy, none is expected. should be bilaterally symmetrical

Question 8

when and how should temperature be taken as part of the peripheral vascular and lymphatic exam?

Answer 8

temperature is tested with dorsa of hands over length of leg

Question 9

how is homan’s sign checked for and when is it done?

Answer 9

homan’s sign is pain when the calf muscle is pressed into the tibia

it is a sign of deep vein thrombosis

checked for as part of palpation of legs in peripheral vascular and lymphatic exam