Vascular

Question 1

assess areas for characteristics of lower legs, also checking fingers & lips

Answer 1

palor, cyanosis, coolness, paresthesia, atrophy, mottling, rubor on dependency

Question 2

inspect and palpate the pretibial, tibial, and pedal areas

Answer 2

edema, venous dilation, pain, tenderness, ulceration, thickening

Question 3

compare bilaterally at 7 sites using palpation (simultaneously whenever possible)

Answer 3

rate, rhythm, contour, amplitude, symmetry and obstructed blood flow

Question 4

estimate capillary refill time

Answer 4

> 2 seconds (fingers), >5 seconds, big toe

Question 5

arterial insufficiency test (Buerger’s test)

Answer 5

+ marked pallor on elevation, + marked pallor after 10-15 seconds on dependency, + persistent rubor on dependency

Question 6

Allen test

Answer 6

+ persistent pallor >3-5 seconds after releasing the fist

Question 7

Ankle brachial index

Answer 7

+ ration outside of 0.90 - 1.30

0.41 - 0.90 = mild- moderate PAD

0.00-0.41 = severe PAD

Question 8

Measure the JVP

Answer 8

> 3-4 cm is a positive

Question 9

assess hepatojuglar reflex

Answer 9

+ jugular vein pulsation notably rises and only falls upon release

Question 10

demonstrate DVT screening / Homan’s sign

Answer 10

+ presence of tenderness or venous cords (DVT)
+ popliteal or calf pain (Homan’s)

Question 11

evaluation of edema *if present

Answer 11

+ differences between R and L sides is <1 cm (above malleoli) + difference between R and L sides is > 2 cm (below patella)

Question 12

perform Trendelenberg Test

Answer 12

+ rapid filling of the superficial veings upon standing, + sudden additional venous filling upon tourniquet release

Question 13

perform perthe’s test

Answer 13

+ filling of the superficial veins upon muscular action