Vascular examination

Question 1

Systems review

Answer 1

1. CNS - headaches, dizziness, fever
2. CVS - chest pain, palpitations, orthopnoea
3. Resp - cough, SOB
4. GI - diarrhoea, N+V, reflux
5. GU - discharge. urination
6. MSK - stiffness, arthralgia, swelling, rashes, skin changes
7. Misc - heat intolerance, weight gain/loss, lumps/bumps, appetite

Question 2

Steps of exam

Answer 2

• Inspection
• Palpation
• Movement - active then passive - assess normal ROM so then you can be aware if it goes further

Question 3

Golden 5 before exam

Answer 3

• Consent
• Chaperone
• Exposure
• Privacy
• Confidentiality

Question 4

Things to check for on inspection

Answer 4

• Gait - antalgic (limping), trendelenburg, shuffling, widestepping
• Check front, back and sides

Question 5

Palpation

Answer 5

• Start with GOOD side

Question 6

Apparent vs true leg length

Answer 6

• Apparent - umbilicus to medial malleolus
• True - ASIS to medial malleolus

Question 7

Trendelenburg - what is it testing

Answer 7

• Gluteus medius and minimus - abductors
• Superior gluteal nerve
• Side that rises is the one with the problem

Question 8

Causes of haematoma on hip

Answer 8

• Trauma
• Anticoagulants
• Pathological #

Question 9

What is Buergers test?

Answer 9

• Lift leg up 15-30 degrees- see if pallor occurs
• Then lift down - is there reactive hyperaemia?

Question 10

What is Thomas test?

Answer 10

• Check for excessive lumbar lordosis with hand under back
• Ask to bring leg as far up to chest as possible - passively
• If positive - opposite leg will rise off table or abduct
• DONT perform if had hip replacement - can cause dislocation