Podcast
Questions and Answers
Which pulses are typically assessed in the lower extremities?
Which pulses are typically assessed in the lower extremities?
- Epitrochlear pulse and radial pulse
- Femoral pulse and dorsalis pedis pulse (correct)
- Superficial inguinal pulse and popliteal pulse
- Ulnar pulse and brachial pulse
What is a characteristic symptom of chronic venous insufficiency?
What is a characteristic symptom of chronic venous insufficiency?
- No initial pain and pain on dependency (correct)
- Diminished pulses in the affected limb
- Intermittent pain progressing to pain at rest
- Marked pallor on elevation
Which clinical sign indicates potential deep venous thrombosis (DVT)?
Which clinical sign indicates potential deep venous thrombosis (DVT)?
- Positive Homan’s Sign (correct)
- Erythema without swelling
- Calf/leg pain with normal pulses
- Absence of pain on dorsiflexion
What does rubor with dependency and pallor with elevation indicate?
What does rubor with dependency and pallor with elevation indicate?
What is the normal result for the Postural Color Change Test (Buerger’s Test)?
What is the normal result for the Postural Color Change Test (Buerger’s Test)?
What is the definition of pulse pressure?
What is the definition of pulse pressure?
What three pulses should be palpated when assessing the arm?
What three pulses should be palpated when assessing the arm?
What does it indicate if the hand remains white and there is no blood return after conducting an Allen’s test?
What does it indicate if the hand remains white and there is no blood return after conducting an Allen’s test?
What symptoms suggest arterial insufficiency?
What symptoms suggest arterial insufficiency?
During the postural color change test, both legs are raised to what angle?
During the postural color change test, both legs are raised to what angle?
Thin, shiny, atrophic skin is typically noted in which condition?
Thin, shiny, atrophic skin is typically noted in which condition?
What test would you use to assess DVT (Deep Vein Thrombosis)?
What test would you use to assess DVT (Deep Vein Thrombosis)?
How are pain differences characterized between chronic arterial insufficiency and chronic venous insufficiency?
How are pain differences characterized between chronic arterial insufficiency and chronic venous insufficiency?
What are two signs of arterial insufficiency?
What are two signs of arterial insufficiency?
What change occurs in blood pressure readings in chronic arterial insufficiency?
What change occurs in blood pressure readings in chronic arterial insufficiency?
What is a typical characteristic during the Postural Color Change Test for someone with chronic venous insufficiency?
What is a typical characteristic during the Postural Color Change Test for someone with chronic venous insufficiency?
What does a positive Homan's Sign indicate?
What does a positive Homan's Sign indicate?
In which condition would you most likely assess for calf or leg pain accompanied by diminished pulses?
In which condition would you most likely assess for calf or leg pain accompanied by diminished pulses?
During the Postural Color Change Test, what is observed after raising the legs to 60 degrees for 1 minute in a patient with chronic arterial insufficiency?
During the Postural Color Change Test, what is observed after raising the legs to 60 degrees for 1 minute in a patient with chronic arterial insufficiency?
Which pulse is NOT typically assessed in the lower extremities?
Which pulse is NOT typically assessed in the lower extremities?
What angle is associated with clubbed fingernails?
What angle is associated with clubbed fingernails?
Which test is used to determine the patency of the radial and ulnar arteries?
Which test is used to determine the patency of the radial and ulnar arteries?
Upon performing the Homan’s sign test, the foot is placed in which position?
Upon performing the Homan’s sign test, the foot is placed in which position?
What condition is characterized by the development of gangrene?
What condition is characterized by the development of gangrene?
Which type of chronic insufficiency is most notably characterized by edema?
Which type of chronic insufficiency is most notably characterized by edema?
What action should be performed after elevating the leg for one minute in the postural color change test?
What action should be performed after elevating the leg for one minute in the postural color change test?
A cool temperature is typically associated with which type of insufficiency?
A cool temperature is typically associated with which type of insufficiency?
What type of skin change might be observed in chronic arterial insufficiency?
What type of skin change might be observed in chronic arterial insufficiency?
Study Notes
Arm Assessment
- Palpate radial, ulnar, and brachial pulses for arm assessment.
- Epitrochlear lymph node is located in the arm.
- Abnormal findings: pallor, erythema (swelling), and cyanosis.
Nail Angles
- Clubbed fingernails exhibit an angle greater than 180 degrees.
- Normal fingernails have an angle of about 160 degrees.
Leg Assessment
- Pulses that can be taken in the legs include femoral, popliteal, posterior tibial, and dorsalis pedis.
- Superficial inguinal lymph nodes can be palpated in the legs.
Causes of Edema
- Causes include deep venous thrombosis (DVT), chronic venous insufficiency, lymphedema, orthostatic edema, and congestive heart failure.
Allen's Test
- Conducted to determine the patency of the radial and ulnar arteries.
- If the hand remains white with no blood return, this indicates occlusion of the artery not being compressed.
DVT Assessment
- Homan’s sign test is used to assess DVT; it involves dorsiflexion of the foot.
- Pain during dorsiflexion may indicate DVT.
Arterial Insufficiency Symptoms
- Symptoms suggesting arterial insufficiency include calf/leg pain and diminished pulses.
- Postural color change test (Buerger’s Test) assesses arterial insufficiency.
Postural Color Change Test
- Legs are elevated to an angle of 60 degrees for one minute.
- After elevation, the patient should sit up with legs dangling down.
- Abnormalities indicating arterial insufficiency include marked pallor on elevation, longer refill time, and persisting rubor on dependency.
Rubor and Pain Differences
- Rubor refers to skin redness due to inflammation or increased blood flow.
- Chronic arterial insufficiency presents with intermittent pain progressing to pain at rest, while chronic venous insufficiency starts without pain and shows pain on dependency.
- Pulses in chronic venous insufficiency are present, unlike in arterial insufficiency.
Skin and Ulceration Signs
- Thin, shiny, atrophic skin is noted in chronic arterial insufficiency.
- Gangrene may develop in chronic arterial insufficiency.
- Ulceration on the sides of the ankles, particularly medially, indicates chronic venous insufficiency.
Other Key Points
- Signs of arterial insufficiency include pallor with elevation and rubor with dependency.
- Widening of pulse pressure in older adults is caused by increased systolic pressure while diastolic remains the same.
- Extra heartbeats are common in older adults.
Arm Assessment
- Assess three pulses: radial pulse, ulnar pulse, and brachial pulse.
- Epitrochlear lymph node is located in the arm.
- Abnormal findings in the arm include pallor, erythema (swelling), and cyanosis (white, red, blue).
Nail Examination
- Clubbed fingernails exhibit an angle greater than 180 degrees.
- Normal fingernails have an angle of 160 degrees.
Leg Assessment
- Pulses that can be palpated in the legs include femoral pulse, popliteal pulse, posterior tibial pulse, and dorsalis pedis pulse.
- Palpable lymph nodes in the legs include superficial inguinal nodes.
Edema and Tests
- Causes of edema: deep venous thrombosis (DVT), chronic venous insufficiency, lymphedema, orthostatic edema, and congestive heart failure.
- Allen’s Test checks for radial and ulnar artery patency.
- If the hand remains white with no blood return during Allen's test, it indicates occlusion of the non-compressed artery.
DVT Assessment
- Homan’s Sign test is used to assess deep vein thrombosis (DVT).
- During the Homan’s Sign test, the foot is firmly and abruptly dorsiflexed.
- Patients with DVT will feel pain when the ankle is dorsiflexed.
Arterial Insufficiency
- Symptoms suggesting arterial insufficiency: calf/leg pain and diminished pulses.
- Postural Color Change Test (Buerger’s Test) detects arterial insufficiency.
- In the postural color change test, raise both legs to an angle of 60 degrees for one minute.
- After elevating the legs, the patient should sit up with legs dangling down.
- Observing marked pallor on elevation, prolonged time to fill, and persistent rubor on dependency indicates arterial insufficiency.
Additional Terminology and Conditions
- Rubor refers to redness of the skin, often linked to inflammation or increased blood flow.
- Chronic arterial insufficiency presents with intermittent pain that progresses to pain at rest.
- Chronic venous insufficiency shows no initial pain and pain upon dependency.
- Chronic venous insufficiency maintains a pulse, while chronic arterial insufficiency does not.
Skin and Ulcers
- Thin, shiny, atrophic skin is noted in chronic arterial insufficiency.
- Gangrene may develop in individuals with chronic arterial insufficiency.
- Ulcers on the medial sides of the ankles suggest chronic venous insufficiency.
Circulatory Changes in Older Adults
- Two signs of arterial insufficiency: rubor with dependency and pallor with elevation.
- Widening of pulse pressure in older adults is due to increased systolic blood pressure, with diastolic blood pressure remaining the same.
- Extra heartbeats are common in older adults.
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Description
Test your knowledge on the assessment of peripheral vascular health. This quiz covers crucial topics, such as pulse palpation in the arms and legs, lymph nodes, and signs of abnormalities like clubbed fingers and edema. Take this quiz to ensure you understand the essential elements of peripheral vascular evaluation.
