vascular exam

Question 1

vascular exam

Answer 1

• history
• observation: skin inspection, foot inspection, shoe inspection
• palpation: temperature, pulses (dorsalis pedis, posterior tibial, popliteal), capillary refill
• sensation: light touch/pressure, monofilament testing (5.07 monofilament = 10 grams pressure), vibration, proprioception
• gait
• special testing

Question 2

common foot deformities

Answer 2

• claw toe deformity
• bunion and overlapping toes
• rocker-bottom secondary to charcot arthropathy

Question 3

evaluation of circulation - pulses

Answer 3

• pulse quality assessment
• 3+ : full, bounding
• 2+ : normal
• 1+ : weak, thread
• 0: absent
• warmth, color, hair loss, skin lesions, callous

tibialis posterior and dorsalis pedis

Question 4

areas of monofilament testing

Answer 4

Question 5

special testing

Answer 5

• capillary refill
• ankle-brachial index
• Buergers test
• activity exam: 6MWT, use claudication scale, careful monitoring of vitals, potential for exercise-induced hypoglycemia

Question 6

ankle brachial index (ABI)

Answer 6

• ABI = foot/arm
• normally leg BP > arm

Question 7

capillary refill and buerger’s test

Answer 7

• elevation (SLR) then gravity dependent, redness that goes away in about 15s is normal
• persistent redness is (+)
• pallor then redness

Question 8

activity/6MWT

Answer 8

• time walked
• distance
• vital sign response: HR/rhythm, blood pressure, RPE/claudication scale