Vascular and neuropathic assessment Flashcards
What is the scale used to assess the intensity of pulses?
0 = absent
1+ = barely perceptible
2+ = diminished
3+ = normal
4+ = stronger than normal/bounding
Alternatively: 0 = absent, 1+ = diminished, 2+ = normal, 3+ = stronger/bounding
What does a pulse rating of 0 signify?
Absent
What does a pulse rating of 3 signify?
Normal
What is the purpose of the Doppler test?
To detect the presence of blood flow
Describe the procedure for the Capillary Refill Test.
Apply light pressure over distal digits for 2-3 sec and observe refill time
What is considered a normal capillary refill time?
< 3 sec
What does a capillary refill time of > 3 sec indicate?
Microcirculation disease
What is the procedure for the Rubor of Dependency test?
and what is abdnormal finding
Elevate foot passively to >30 degrees, hold for 60 sec, then place in dependent position
abnormal - If reperfusion takes 30 sec or longer and/or foot becomes bright red (reactive hyperemia) - indicates LE ischemia
What is a normal response in the Rubor of Dependency test?
Foot pinks in 15 sec
What does an Ankle-Brachial Index (ABI) test measure?
The ratio of the highest ankle systolic BP to the highest brachial systolic BP
What ABI value indicates severe arterial disease?
< 0.6
What does an ABI value > 1.3 indicate?
Possible calcified arteries
What is the purpose of the Exercise Stress Test?
To determine claudication onset time during exercise
What are the grades of claudication pain?
Grade 1: minimal, Grade 2: moderate, Grade 3: severe, Grade 4: excruciating
What does the Pitting Edema Scale assess?
Presence and severity of edema
What is a normal venous filling time in Venous fill time test?
what do the abnormal values mean?
Veins distend within ~15 sec = normal
- veins distend < 5 seconds = venous insufficiency
- veins distend >15 seconds = arterial insufficiency
What does the Homan Sign test for?
Suspected deep vein thrombosis (DVT)
What indicates incompetent valves in the Percussion test?
Palpable signal
What is the significance of segmental pressures?
To evaluate blood flow and identify blockages in leg arteries
What is the threshold for adequate healing in toe pressures?
> 50 mmHg
What does a TcPO2 value < 20 mmHg indicate?
Impaired flow, little to no healing
What is the purpose of the Light Touch test in neuropathy examination?
To assess sensory integrity
What does a response of ‘yes’ or ‘no’ indicate in the Sharp/Dull test?
Intact sensory perception
What is assessed during the Proprioception/Kinesthesia test?
Awareness of joint position
What does the 5.07 Semmes Weinstein filament test for?
Protective sensation in the foot
What is the primary indication for performing a Doppler ultrasound?
To listen for audible sounds of blood flow
What is the procedure for the Trendelenberg test?
- Mark the dorsal veins as in venous filling time.
- Pt. supine, leg passively raised to 45 degrees, for ~60 sec to allow veins to empty.
- Apply tourniquet to proximal thigh to prevent backflow from superficial veins
- Assist patient to standing after 1 minute.
- Note dorsal foot vein distention
- Remove tourniquet after noting foot veins
What does a venous filling time of > 20 sec indicate?
+ arterial insufficiency
What does a quick distention of veins after removing the tourniquet indicate?
Incompetence of superficial veins
