Skill lab: vascular examination

Start with history taking:

I. greet patient
II. take patient identityname, age, address, marital status, occupation

III. chief complaint: VII. personal habits

1) what chief complaint (pain at leg/
ulcer/varicose vein)
2) Since when??? suddenly or gradually
3) Can you describe how severe is it??? Do you
have any skin discoloration, swelling in your
body or ulceration??? Is it disturbing your daily
life???
4) location
5) frequency
6) Is it worsening by something for example at
rest, exercise, and working? /
7) Factors that can influence the symptoms???
weather, menstruation, emotion
8) Any other complaint??? Ulcer, skin
discoloration, swelling if yes, plis describe!!
IV. past history
Do you have any injury before the symptoms
appear??
allergy
operation
organ illness
IV. family history
family members that have similar illness//
DM, hypertension, Cerebrovascular accident, high
triglyceride and cholesterol level, clotting
abnormality
Are you drinks alcohol???How
frequent??How many cups usually
each time you drink it?Are you
smoking???
1) since when you start smoking
2) How many cigarettes you
take everyday??
3) What brand of cigarette you
take?
VIII. proceed to PE
Ok, Mr.….from this conversation, what
I can conclude now is that may be
you have problems with your blood
vessels on your leg... so to further
confirmed and your know what actual
your problem, we need to do PE.The
procedure is simple, juz examined
your pulsation of your arteries and
then ask your to do several
movements and do reflex as
wellagree x nak proceed???
k, Mr. plis expose your lower
extremities and lying down on
examination bed
and I will wash hands with soap +
make it dry with clean and dry towel
ready to examine the patient

PE
Inspection color of the skincyanosis, hyperemic, darkenss
(both extremities ) Skin
smooth or rough
scaly/ not
ulcer present/ not
edema present/ not
Contour :
atrophy/ hypertrophyy
symmetry/ not symmetry between right and left leg
Nail :
thick/ not
smooth/ rough
have nai/ no nails
Hair : reduced/ normal
Palpation (both Temperature (using the dorsal of the handboth extremities)
exteremities )
Capillary refillwat kat finger, if da gangrene, leh wat kt palm

Look for any edemaif present, examine is it pitting/ non pitting

Reflex physologic reflex : knee reflex,

Range of motion ask patient to move the pain area (giggles the toes)

Sensory compare both extremities dpt sense x

 Pulsation
1) dorsalis pedis artery
2) posterior Tibial artery
3) popliteal artery
4) femoral artery
5) abdominal aorta
6) radial artery
7) ulna artery
8) brachial artery
9) carotid artery
Examination was Finished your can dress up now and wait for me in consultation room for further consultation
And I wash hand with soap and it dry with clean and dry towel