14. Peripheral arterial and venous

Question 1

where can the femoral pulse be felt?

Answer 1

at the mid-inguinal point

(halfway between ASIS and pubic symphisis)

Question 2

inspection of legs, feet and toes Peripheral vasucalr exam

Answer 2

Symmetry
o Colour
o Scars
o Oedema
o Trophic changes
▪ Loss of hair
▪ Shiny skin
▪ Wasting of subcutaneous tissues
o Ulceration (describe site, depth, size, margins, ulcer bed, exudate, odour etc.)

Question 3

how to describe an ulcer

Answer 3

site, depth, size, margins, ulcer bed, exudate, odour

Question 4

what is buergers test a test for

Answer 4

critical ischaemia

Question 5

how do you perform buergers test?

Answer 5

1. pt supine, elevate legs to 45 and hold for two mins
   - pallor of feet indicates ischaemia
2. ask pt to hang legs off the bed
   - blue –> red

Question 6

how do you calculate ABPI

Answer 6

dividing the highest systolic
blood pressure in the arteries at the ankle by the higher of the two systolic blood
pressures in the arms.

Significant arterial disease is indicated by an ABPI of <0.8.

Question 7

Introduction peripheral vascualr exam

Answer 7

“today I’ve been asked to examine you to check how the blood vessels are working in your arms, abdomen and legs…”

“this will involve having a look at your arms, tummy and legs, checking your pulses and blood pressure and checking the sensation and strength in your legs.. does that sound okay?”

“in order to examine you properly I will need you to remove your clothes so you are down to bra and pants… is that okay?” “this examiner will be acting as a chaperone for this examiantion for your comfort today”