symptoms:
Pallor
Pulseless
Perishing cold
Pain
Paresthesia
Paralysis
Inspection:
general status
risk factors
smoking
obesity - xanthelesma/xantolomata
elderly
complications of arterial insufficiency
pallor
atrophic nails, skin, hair loss
uleration – pressure area (malleoli, between toes, sacrum and back, 5th meta-tarsal head)
gangrene
wet
dry
venous guttering
burger's test
normal angle 90
<20 = severe ischaemia
reactive hyperaemia – dilated capillary filled with de-oxygenated blood
Palpation:
temp: cold
capillary refill – 2 seconds
pulses
femoral
popliteal
post-tibial – midpoint of med malleolus and heel
dorsalis paedis – just lateral to ext hallucis longus (10% absent and replaced by peroneal art)
Auscultation:
femoral – mid point of inguinal ligatment
popliteal
adductor hiatus – 1/3 down medial aspect of thigh, sup femoral art exit from adductor hiatus
Ankle-Brachial Pressure Index – use doppler probe, on brachial art and dorsalis paedis
full cardiovascular examination
