Question

Describe how to conduct a peripheral vascular exam. What is an Allen test and why would conduct one. What are Arterial Brachial Indexes, why would you conduct one and what results are considered normal, and what do abnormal results indicate.

Answer 1

The peripheral vascular examination is carried out on the basis of the physical examination of the components of the peripheral vascular system. It includes the inspection, palpitation and complete assesment of the arms and legs.

In case of the study of the arms and the related parts there is need to check the symmetry. Then the radial & branchial pulse examination, epitrochlear lymph node study also the radial and ulnar opening (i.e. the Allen's test).

In case of the study of the legs there is study realted to the symmetry, then femoral pulse examination and the peripheral edema assessment.

The Allen Test:

This test is carried out to assess the blood supply to the ulnar and radial parts of the hand, there are four steps to describe this process:

Firstly apply pressure is applied to the radial and ulnar arteries at the wrist, using three fingers on each artery.

Then the patient make a tight fist and then open his/her hand for almost 10 times then allowed for hand open, this results in the appearance of the white or the pale yellow color.

Furthermore it is advised to remove the pressure from the ulnar artery.

Inference of the Allen's test:

On the experimental basis it was found out that if it takes <15 seconds for color color change the test is positive.

Arterial Brachial Indexes: It is the ratio of lower extremity pressure devided by upper extremity.

Normal values: 0.9 to 1.19

When there is abnormality in this test:

If the value is > 1.2 indicates the abnormality like the arterial calcification also there may be the signs of the diabetes

Moreover if the value is < 0.50 it is the vital sign of the severe arterial disease.

Thus these parameters are used for the physical assesment offering the better understanding of the peripheral vascular examination.