Peripheral Vascular Examination

General Inspection  Missing limbs/digits

 Scars
 Medical equipment
 Mobility aids
 Vital signs
 Prescriptions
Upper Limb Inspection  Peripheral cyanosis
 Peripheral pallor
 Tar staining
 Xanthomata
 Gangrene
Perfusion of UL  Temperature
 CRT
Pulses  Radial pulse
 Radio-radial delay
 Brachial pulse
 Blood pressure
Neck  Carotid pulse
Abdomen  Inspection – pulsation
 Palpation – aorta
 Auscultation – aorta, renal arteries
Lower Limb Inspection  Peripheral cyanosis
 Peripheral pallor
 Ischaemic rubour
 Venous ulcers
 Arterial ulcers
 Gangrene
 Missing limbs, toes, fingers
 Scars
 Hair loss
 Muscle wasting
 Xanthomata
 Paralysis
Perfusion of LL  Temperature
 CRT
Pulses  Femoral pulse (+ auscultate)
 Radio-femoral delay
 Popliteal pulse
 Posterior tibial pulse
 Dorsalis pedis pulse
Sensation  Gross peripheral sensation assessment
Other tests  Buerger’s test – raise feet, observe colour, sit up + hang
legs
Further assessments +  Blood pressure measurement
investigations  Cardiovascular examination
 Ankle-brachial pressure index (ABPI) measurement
 Upper and lower limb neurological examination