Anatomical and Physiological Background Knowledge
The left heart pumps oxygen-rich blood under relatively high pressure via the arterial system to the peripheral tissues. After the tissues have extracted the necessary nutrients and oxygen from the blood and excreted waste substances into the blood, the oxygen-poor blood is then returned under relatively low pressure via the venous vascular system to the right heart. Then the blood is once again enriched with oxygen in the lungs.
In vivo, part of the venous system is visible as filled or unfilled blue veins under the skin. No pulsations are felt if the venous system is palpated.
The arterial system is not normally visible. The arterial system can usually be examined by means of palpation, during which pulsations can be determined.
Besides local information about the vascular system, an examination of the arterial system mainly provides information about the pumping function of the heart. An examination of the venous system mainly provides information about the volume status of the entire circulatory system.
Aim
The aim is to gain an impression of the blood supply and venous drainage of the soft tissues, the condition of the arterial and venous blood vessels, the heart’s pump function and the patient’s vascular volume status.
Conditions
With respect to the patient:
- Sufficiently informed.
- Sufficiently undressed.
- Upper extremities – upper body exposed (bra does not need to be removed).
- Abdominal region and lower limbs – stomach and legs exposed (underwear does not need to be removed).
- Good position.
- Upper extremities – sitting.
- Abdomen/lower extremities – lying and standing.
With respect to the examiner:
- Warm, clean hands.
- Warm, clean instruments.
With respect to the examination room:
- Clean.
- Properly heated.
- Adequate lighting.
- Low noise level.