Vascular examination - OSCE Flashcards
First three things to examine
TCP
Temperature
Cap refill
Pulses - femoral, popliteal, dorsalis pedis, posterior tibial
What do you auscultate
Iliac
Femoral
Popliteal
What is the Buerger’s test?
Ask pt to lift leg at 15 degrees and hold for a while
Keep lifting leg until the colour drains
Then bring leg around edge of bed and see and see how long it takes to return the leg to the normal colour
What angle of colour drainage is considered indicative of arterial insufficiency?
<15 or 20
What sign might you see in Buerger’s test and what does it suggest?
Reactive hyperemia (leg becomes bright red after leg is allowed to hang, suggests arterial insufficiency
6Ps - what do these relate to?
Acute limb ischaemia
Pain Pallor Pulseless Parasthesia Paralysis Perishingly cold
What other investigation do you do?
ABPI - ankle brachial pressure index
Doppler USS
Magnetic resonance angiography (demonstrates anatomy but nephrotoxic contrast)
Downside of ABPI
If your arteries calcify, this might skew the BP reading in the ankle and arm
Limb angina
Crampy pain
Peripheral artery diseases - name three
Claudication / limb ischemia
What does absolute claudication distance mean?
How far they can walk without having to completely stop
What’s the two types of pain you have to ask about?
Absolute
Intermittent
What’s the two types of pain you have to ask about?
Absolute
Intermittent ?
What would you ask about for hx
SOCRATES Alleviating/aggravating factors Claudication distance Effect of rest on pain Pain at night Relief by hanging Establish baseline of activities
Triad of abdo aorta blockage
Bilateral claudication
Erectile dysfunciton
Reduced femoral pulses
- Leriche’s syndrome
