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  • Vascular Examination

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    This document provides guidance on examining the vascular system. It outlines the steps to examine varicose veins which include inspection, palpation, percussion, and tests like the Trendelenburg test. Signs of venous issues like pigmentation, eczema, and ulceration are noted. Examining chronically ischemic limbs includes inspection for pale, atrophic skin and pulses. Specific pulses like femoral, popliteal, posterior tibial and dorsalis pedis are located. The Buerger's angle and test are described but noted one should not perform. An ankle-brachial pressure index is recommended to complete the examination. Practice is emphasized to improve examination skills.

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    Pemeriksaan ekstremitas vaskular

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    This document provides guidance on examining the vascular system. It outlines the steps to examine varicose veins which include inspection, palpation, percussion, and tests like the Trendelenburg test. Signs of venous issues like pigmentation, eczema, and ulceration are noted. Examining chronically ischemic limbs includes inspection for pale, atrophic skin and pulses. Specific pulses like femoral, popliteal, posterior tibial and dorsalis pedis are located. The Buerger's angle and test are described but noted one should not perform. An ankle-brachial pressure index is recommended to complete the examination. Practice is emphasized to improve examination skills.

    Copyright:

    © All Rights Reserved
    Scarica in formato PPT, PDF, TXT o leggi online su Scribd
    Segnala contenuti inappropriati
    80 visualizzazioni22 pagine

    Vascular Examination

    Caricato da

    Novita
    This document provides guidance on examining the vascular system. It outlines the steps to examine varicose veins which include inspection, palpation, percussion, and tests like the Trendelenburg test. Signs of venous issues like pigmentation, eczema, and ulceration are noted. Examining chronically ischemic limbs includes inspection for pale, atrophic skin and pulses. Specific pulses like femoral, popliteal, posterior tibial and dorsalis pedis are located. The Buerger's angle and test are described but noted one should not perform. An ankle-brachial pressure index is recommended to complete the examination. Practice is emphasized to improve examination skills.

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    © All Rights Reserved
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    di 22

    The Vascular

    Examination

    As with any
    examination
    I
    P
    E
    E
    P

    Introduce
    Permission
    Explanation
    Exposure
    PAIN

    Varicose vein
    examination

    Inspection
    With patient standing, comment on:
    - The patient has
    Distribution
    tortuous varicosities in the distribution of
    the long/short saphenous vein"

    Signs of poor skin nutrition

    Venous stars (venulectasias).


    Superficial thrombophlebitis, which shows as a red, painful lump
    The brown pigmentation of haemosiderin deposition
    characteristic of increased venous pressure
    Venous eczema
    Ulceration and scarring from previous ulceration, especially in
    the gaiter area
    Lipodermatosclerosis
    Scars from previous vein surgery

    Palpation
    Run hand up veins feeling for
    increased warmth

    Palpate varicosities to assess


    Hard/soft
    Tenderness

    Percussion

    Tap top of vein and feel how far

    down you can feel repercussions

    Saphenofemoral
    junction
    Trendelenberg

    Lie patient down and empty veins


    place 2 fingers on SFJ
    Ask patient to stand
    If varicosities dont fill, SFJ incompetent
    If varicosities fill, incompetence lower down
    on releasing fingers, veins fill quickly = SFJ
    incompetent

    Can also do tourniquet test

    Similar to Trendelenberg
    Place tourniquet around leg
    If veins fill, incompetence is lower
    Move tourniquet down until filling
    controlled

    To complete
    examination
    To complete my examination I
    would like to...

    Doppler ultrasound - duplex

    Examination of the
    Chronically
    Ischaemic Limb

    Inspection
    Pale
    Atrophic skin - shiny/red/dry
    Ulcers - punched out, distal toes, in
    between toes

    Missing parts!

    Palpation
    Run back of hand from toes to groin
    Feel warm/cold
    Palpate pulses

    Femoral
    Midway between pubis symphysis
    and anterior superior iliac spine

    Midpoint of the inguinal canal

    Popliteal
    Place thumbs on tibial tuberosity
    part heads of gastrocnemius with
    finger of both hands

    press against back of tibia

    Posterior Tibial

    Midway between medial malleolus


    and tip of calcaneus

    Dorsalis Pedis

    Lateral to tendon of extensor


    hallucis longus

    Buergers
    Angle/Test

    Should not do!


    If asked:

    elevate leg
    estimate angle at which leg becomes pale Buergers angle (<45)

    Re-elevate to 45 for 1-2 minutes until pale


    Hang leg off end of bed
    If becomes blue then red (reactive
    hyperaemia) Buergers test is positive

    To complete
    examination
    To complete my examination I would
    like to........

    ABPI

    BP in brachial artery
    BP in dorsalis pedis using ultrasonic probe

    1= normal
    0.6-0.9 = claudication
    0.3-0.6 = Rest pain
    <0.3 = critical ischaemia

    Practice makes
    perfect

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