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Arterial Examination (Lower Limb (Completion (Examine the rest of the…

- - - - Muscle atrophy
      - Shiny dry skin
      - Nail dystrophy and loss of hair
    - - Between toes
      - Base of 1st and 5th metatarsals
      - Heel (ask re. pain before lifting…)
    - - Medial thigh and leg
      - Vascular access (vertical groin)
      - Midline sternotomy or laparotomy
      - Axilla
  - - - Aorta: just above the umbilicus
      - Femoral: mid-inguinal point
      - Popliteal: between the heads of gastrocnemius
      - Dorsalis pedis: lat. to extensor hallux longus
        tendon (absent in ~5% of people)
      - Post tib: postero-inferior to medial malleolus
      - Graft + distal pulses: is the graft patent?
  - - - < 20 degrees = severe ischaemia
    - - reactive hyperaemia on lowering the leg
        secondary to vasodilatation of the microcirculation in
        response to ischaemia
- - - - Difference >20mmHg suggests stenosis, CoA or
        dissection.
  - - - Radial: lat. to FCR tendon @ wrist
      - Ulna: lat. to FCU
      - Brachial: medial to biceps tendon
      - Carotid: ant. to SCM at the thyroid cartilage
    - - Stenosis, coarctation, dissection