Thursday, January 13, 2011

Examination of Peripheral Vascular Disease (PVD)




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History
Obtain a complete and detailed history of the patient.
Concentrate on past medical history with emphasis on diabetes mallitus, hypertension or any other cardiac diseases.
Obtain the medications and perior treatment for the current problem.
History of relevant surgical or medical.
treatment involving vascular system should be collected.
Social history should concentrate on lifestyle pattern such as use of tobacco, dietary habits, and use of alcohol, etc...
Collect details of onset of symptoms mechanism of injury, work environment, job skills.





Subjective examinations
This includes the current symptoms.
factors increasing or decreasing the symptoms
about intermittent claudication, rest pain, how positioning of
lower limb affects pain etc..




Objective Examination
On observation
check for evidence of cellulites, edema, discoloration of skin, cyanosis or pallor, loss of hair, wound, etc...

Motor Examination
Should be done to access Range Of Motion and Muscle strength.

Sensory Examination
This is done mainly for light touch and pressure, includes Semmes Weinstein monofilaments to check sensation.

Temperature
Using palpation, thermistor, test tubes etc... and compare to the other side.
Usually the temperature decreases in arterial disorders.

Girth Measurement
done for edema
measurements should be taken in reference to bony prominences, volumetric is a quantitative system to measure edema.

Vascular Examination
Palpate for the pulses especially distal pulses.
Auscultation: Auscultate for identifying turbulent blood flow called bruit.

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