Upper Limb Vascular

Inspection:

• colour - pallor
• atrophic nail, pulp atrophy, muscle wasting
• ulcer, gangrene

Palpation:

• temperature
• tenderness
• capillary refill
• pulses
• radial - rate, character
• ulnar - allen's test
• brachial - medial arm
• axillary
• subclavian
• carotid
• radial-radial delay - aortic dissection
• radial-femoral delay
• stretch arm - thoracic outlet syndrome

Auscultate:

look for cause

• general attribute
• PVD
• thoracic outlet syndrome
• cervical rib
• trauma
• clavicular fracture
• hypertrophic neck muscle - swimmers