Peripheral Vascular Assessment
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
Scale # for a pulse that is weak
Scale # for a pulse that is normal
Scale # for a pulse that is increased, bounding
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
Flexing foot to check for signs of pain in calf.
Elevation of Pallor
Listen to pulses when unable to listen with regular stethoscope.
ABI is an abbreviation for
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.
Compression therapy, the cornerstone of treatment for venous insufficiency, can cause tissue necrosis and ulceration in patients with underlying arterial disease.
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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