2.  Normal, diminished, or absent.  Even if pulse is normal, blood flow to the extremity may be substantially restricted.  Pulselessness

3.  Lower extremities Femoral, popliteal, dorsalis pedis, and posterior tibial pulses:.  Upper extremities The radial, ulnar, and brachial pulses  Doppler ultrasonography

4.  Palpation  Cool  Electronic thermometer

5.  Procedure:  Supine  Legs elevated for several minutes  Pallor (blanching) of the skin occurs in the feet within 1 minute or less if arterial circulation is Poor  Time is noted  Placed in a dependent Normally pinkish flush appears in the feet within several seconds With occlusive disease, a bright bluish-red color, or rubor, of the distal legs and feet occur The rubor may take as long as 30 seconds to appear.

6.  Amount of time  Walk at a slow, predetermined speed on a level treadmill (1 to 2 mph)

7.  Dopplers ultrasonography  Transcutaneous Oximetry

8.  Invasive  Injecting a radiopaque dye (contrast medium) directly into an artery  Radiographically  Prior to reconstructive arterial bypass surgery.

9.  Medical Bed rest and complete systemic anticoagulation  Physical Warming the limb by reflex heating of the torso or opposite extremity Elevating the head of the bed slightly.  Surgical Thromboembolectomy Arterial bypass graft

10.  Exercise—passive or active  Prolonged positioning during bed rest, which could cause pressure on and potential breakdown of skin  Local, direct heat on the involved extremity because of the potential for a burn to the ischemic tissue  Use of support hose, which may increase peripheral resistance to blood flow  Restrictive clothing that could compromise blood flow

11.  Medical Diabetes and hypertension  Lifestyle changes  stop smoking Limiting or avoiding salt, sucrose and alcohol  Physical  Surgical Bypass graft Sympathetic blocks or sympathectomies Amputation

12.  Graded exercise program  Aerobic walking, bicycling