Peripheral Vascular Assessment

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Sequence of Peripheral Pulse Site

Temporal, Carotid, Brachial, Radial, Ulnar, Femoral, Popliteal, Posterior Tibial, Dorsalis Pedis

Scale # for a pulse that is absent, non palpable

0

Scale # for a pulse that is weak

+1

Scale # for a pulse that is normal

+2

Scale # for a pulse that is increased, bounding

+3

Where do you inspect for peripheral edema?

In the upper & lower extremities

Palpate edema in legs for how many seconds?

At least 5 seconds

Where do you palpate for edema in the legs?

Over tibia, behind medial malleolus, and on dorsum of each foot looking for pitting (depression)

When inspecting and palpating be sure to note.

Rate, rhythm and amplitude

Inspecting upper extremities perform the following.

Capillary Refill (brisk?), Palpate radial, Ulnar, and Brachial pulses

What is the Allen's test

When using two thumbs & applying pressure of patients Ulnar artery & Radial artery, while patient makes a fist. Release pressure to ensure blood refill back in hand.

What would be considered subjective data on a patient pertaining to the lower extremities

Medication (BCP, leg pain, cramps, or tingling.

When performing physical examination of the legs be sure to

Inspect and palpate the legs, capillary refill, Homan's sign, palpate all peripheral pulses & check for pretibial & medial malleolus for edema.

What is the mechanism of venous flow?

Skeletal muscle pressure, Inspiration (Thoracic & Abdominal pressure), Intraluminal valves.

When checking temperature on the lower extremities

Check with both side at same time with dorsal region of hand.

When measuring the calf anything

Asymmetry of > 1 cm is abnormal

Homan's Sign

Flexing foot to check for signs of pain in calf.

Elevation of Pallor

Excessive palness

Doppler stethoscope

Listen to pulses when unable to listen with regular stethoscope.

ABI is an abbreviation for

Ankle-brachial Index

ABI or 90% or less indicates

Presence of PVD (Peripheral Vascular Disease)

How would you find the percentage of ABI

Ankle systolic pressure/arm systolic pressure.

In the elderly, they tend to experience

Loss of hair on legs, thin shiny skin, dorsalis pedis and posterior tibial pulses are more difficult to palpate, increased risk of venous thrombosis & Arteriosclerosis.

Arteriosclerosis can be defined as

Peripheral blood vessels more rigid. Occur in mostly the elderly.

It would be abnormal to find

Raynaud's disease, a disease that occurs from being in cold for long periods of time.

Lymphedema occurs when

Excess fluid from lymph nodes going in to other tissues of the body.

Arterial Ulcer

Compression therapy, the cornerstone of treatment for venous insufficiency, can cause tissue necrosis and ulceration in patients with underlying arterial disease.

Venous Ulcer

Blood pools in the veins of the lower leg. Fluid and blood cells leak out of the veins into the skin and other tissues. This may lead to itching, which causes more skin changes.

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