1 / 18

Peripheral Vascular System Examination

giorgio
Download Presentation

Peripheral Vascular System Examination

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

    1. Peripheral Vascular System Examination

    2. The 6 Ps of critical ischaemia Pallor Pulseless Perishingly cold Paraesthesiae Paralysis Pain

    3. Arterial, Neurogenic and Venous Claudication

    4. Arterial vs venous ulcers

    6. Overview Introduction Inspection Palpation Auscultation Presenting the findings

    7. Introduction You (name, role) Confirm patient details (name, age, DOB) Consent Expose (lying, lower arms and legs)

    8. General Inspection Around the room (mobility aids, cigarettes, oxygen, medications) From the end of the bed (scars, cyanosis, ulcers/gangrene, cyanosis, pallor, muscle atrophy)

    9. Closer Inspection I Hands (Temperature, tar staining, capillary refill, tendon/palmar xanthoma) Eyes (xanthelasma, conjunctival pallor, corneal arcus) Mouth (central cyanosis, angular stomatitis) Abdomen: (obvious pulsations, masses, scars)

    10. Closer Inspection II Legs (dressings, signs of (pre) gangrene, ulceration, non-healing injuries around pressure points, skin changes, hair loss, pallor, damage from previous ulcers, scars from operations, varicosities) Toes (Ischaemic changes and guttering between toes and heels?) Ask patient to wiggle toes

    11. Palpation I Arms: Radial pulse (+radial-radial delay) Brachial pulse BP Neck: Carotid pulse Abdomen: Abdominal aorta (>3cm?)

    12. Palpation II Legs (distal? proximal) Tenderness? Temperature Sensation Capillary refill Pulses Femoral (together and with radial) Popliteal (flexed and extended) Posterior tibial Dorsalis Pedis Buerger’s test

    13. Burguer’s test Part 1: Raise legs 45degrees and hold 1-2mins Part 2: Sit patient down and ask them to hang their legs over bed (90degrees) What would happen in ischaemia?

    14. Auscultation Femoral Aortic Renal Carotids

    15. Completing the examination Ankle/brachial pressure index What happens in ischaemia? Examine the foot for sensation

    16. Presenting the findings: “I examined Mr(s) X, a ...-year old lady/gentleman. The patient was calm, comfortable and conscious at rest. There were no parephenalia suggestive of vascular disease, or peripheral stigmata of vascular disease.”

    17. On inspection there were no ulcers, skin changes, hair loss, scars or pallor. On palpation, pulses were normal and the temperature and sensation in the legs were normal. Berger’s test was normal. On auscultation, there was no evidence of bruits.

    18. Venous System Legs whilst standing and supine Inspection- long saphenous or short saphenous? Palpation (temperature) Elevate limb to 15 degrees and note the rate of venous emptying Trendelenberg test

    19. Trendelenberg test

More Related