Peripheral Vascular Examination

MRCS Part B OSCE Revision


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Peripheral Vascular Examination


Wash your hands
Introduce yourself, explain what you are going to do and gain consent
Assess both limbs with the patient lying on a bed.
Look around for equipment including a hand-held doppler and BP cuff


  • Tissue loss/ulcers/gangrene
  • Discoloration (rubor, cyanosis)
  • Swellings and atrophy
  • Scars – LSV harvest, groin incision
  • Test Temperature, Sensation and CRT in the limb
  • Feel for pulses in the abdominal Aorta, Femoral, Popliteal, Dorsalis Pedis, Posterior Tibial vessels
Hand-Held Doppler
  • If there pulses feel weak or you are unable to palpate them place a handheld doppler with jelly over the Femoral, Popliteal, Dorsalis Pedis or Posterior Tibial vessels and note the waveform.
Ankle-Brachial Pressure Index (ABPI)
  • The brachial and leg pressures should be compared.
  • This is recorded as the highest brachial systolic pressure against the highest ankle pressure.
  • A BP cuff is attached and doppler probe placed at the level of the artery. The cuff is then inflated until the signal disappears.
Buerger’s Test:
  • Pt lie flat – ask about pain in legs etc
  • Raise both legs to 45 and hold them for one minute
  • Sit up and hang legs over edge of bed
  • Observe
  • In PVD – elevation shows pallor as blood drains
  • Dependent – shows bluish (deoxygenated blood over passage of tissue), then flush red due to hyperaemia from post-hypoxic vasodilation (reactive rubor)


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