{"id":312,"date":"2010-12-02T13:35:31","date_gmt":"2010-12-02T13:35:31","guid":{"rendered":"https:\/\/cloverock.info\/mockosce23\/new\/palpation-of-the-venous-and-arterial-circulation\/"},"modified":"2023-01-11T23:06:37","modified_gmt":"2023-01-11T23:06:37","slug":"palpation-of-the-venous-and-arterial-circulation","status":"publish","type":"post","link":"https:\/\/www.qpercom.com\/sim\/index.php\/the-cardiovascular-examination\/periphical-circulation\/palpation-of-the-venous-and-arterial-circulation\/","title":{"rendered":"Palpation of the venous and arterial circulation"},"content":{"rendered":"<p>Examine the patient in supine position and continually compare left and right.<\/p>\n<p><strong>Temperature<\/strong><br \/>\nUsing the backs of both hands, thoroughly palpate all extremities symmetrically, including toes\/fingers, on all sides.<br \/>\nA decrease in temperature can be indicative of an arterial circulatory disorder. An increase in temperature can be indicative of inflammation or venous thrombosis.<\/p>\n<p><strong>Fluid retention<\/strong><br \/>\nPress pretibially for about 10 seconds with the thumb on the periosteum and look and feel whether a cavity develops (pitting oedema). If necessary do this in the perimalleolar region and on the dorsum of the foot.<br \/>\nPitting oedema occurs, for example, in the case of circulatory volume overload (congestive heart failure) or in the case of local venous drainage obstruction. Non-pitting oedema occurs in the case of lymph drainage obstruction.<\/p>\n<p><strong>Skin elasticity measurement<\/strong><br \/>\nTake a fold of skin between the thumb and index finger and slide it backwards and forth several times. Normally the skin returns immediately to its original shape. If a fold remains then there is reduced skin turgidity. This can occur in the case of a local circulatory disorder but also in the case of systemic underfilling (e.g. dehydration). In the case of lymph oedema no skin fold can be observed on the upper foot.<\/p>\n<p><strong>Skin compliance measurement<\/strong><br \/>\nSlide the hand ventrolaterally and ventromedially with the middlemost 3 fingers pressed firmly together with respect to the underlying layer and assess the thickness and consistency of the subcutis and muscle layer. A decrease in the subcutaneous and muscle layer can be indicative of arterial insufficiency.<\/p>\n<p><strong>Capillary refill<\/strong><br \/>\nCompress the skin in an area suspected of vascular pathology until it turns white. Upon being released, count\/measure how long it takes the skin to regain its pink colour.<br \/>\nNormally this will happen within 5 seconds. If this takes longer, it may indicate a disorder in the local or systemic arterial circulation. [Figure 24]<\/p>\n<p><span class=\"jce_caption\" style=\"display: inline-block;\"><img loading=\"lazy\" decoding=\"async\" class=\" size-full wp-image-311\" style=\"margin: auto;\" src=\"https:\/\/cloverock.info\/mockosce23\/new\/wp-content\/uploads\/2010\/12\/Cardiovascular_cv-fig-24.jpg\" alt=\"\" width=\"400\" height=\"300\" srcset=\"https:\/\/www.qpercom.com\/sim\/wp-content\/uploads\/2010\/12\/Cardiovascular_cv-fig-24.jpg 400w, https:\/\/www.qpercom.com\/sim\/wp-content\/uploads\/2010\/12\/Cardiovascular_cv-fig-24-300x225.jpg 300w\" sizes=\"auto, (max-width: 400px) 100vw, 400px\" \/><span style=\"width: 400px; display: block;\">Figure 24: Capillary refill<\/span><\/span><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Examine the patient in supine position and continually compare left and right. Temperature Using the backs of both hands, thoroughly palpate all extremities symmetrically, including toes\/fingers, on all sides. A decrease in temperature can be indicative of an arterial circulatory disorder. An increase in temperature can be indicative of inflammation or venous thrombosis. Fluid retention [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[31],"tags":[120],"class_list":["post-312","post","type-post","status-publish","format-standard","hentry","category-periphical-circulation","tag-the-cardiovascular-examination"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.4 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Palpation of the venous and arterial circulation - Qpercom | Skills in Medicine<\/title>\n<meta name=\"description\" content=\"Online Mock OSCEs with examiners, patient actors, instant results and personalised feedback. 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