Peripheral vascular exam

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Presentation transcript:

Peripheral vascular exam Ben Cross www.peermedics.com

INSPECTION!!! Palpation Pulses Special tests

COLOUR

2.Hair loss and shiny legs TROPHIC CHANGES 1.Pale Skin 2.Hair loss and shiny legs 3.Onychogryphosis 4.Fungal infections

Site Edge Exudate Venous Arterial Neuropathic Medial gaiter region Sloped Lots Arterial Feet/toes/lateral malleolus Punched out Little Neuropathic Pressure areas Corny edge

SCARS

Stand them up

Venous eczema

Haemosiderosis

Lipodermatosclerosis

Atrophie Blanche

PAD Management Risk factor management= ASPIRIN/STATINS Re-perfusion surgery= Stenting/bypass grafting Amputation PAD Management

Non-operative= diet + exercise, compression stockings, limb elevation Surgical=SFJ ligation, LSV stripping, SPJ ligation Endovascular=Foam sclerotherapy, Thermal ablation PVD Management

Causes of venous insufficiency Pelvic masses Previous DVT

Pain Pale Pulseless Perishingly Cold Paraesthesia Paralysis