a brief history taking and physical examination by Happy Friday Knight

1. VASCULAR SURGERY
FOR DUMMIES:
CLINICAL EVALUATION
HAPPY FRIDAY KNIGHT

2. PATIENT CLINICAL EVALUATION IN VASCULAR
DISEASE
• Use patient history and physical examination to tell if the
patient has arterial, venous, or lymphatic disease
• Arterial: ตีบ (stenosis, occlusion) หรือ โป่ง แตก (aneurysm)
• Venous: patent and competent
• Lymphatic: obstruction/compression/absence of lymphatic
channel  lymphedema

3. CLINICAL PRESENTATION
• Patients usually come with
• Pain
• Weakness
• Neurosensory complaint: wam,
cool, numbness, hyperesthesia
• Discoloration
• Swelling
• Ulceration
• varicosities
• History taking:
• Initial onset: acute or chronic
• Progression or changes
• Location: unilateral/bilateral,
proximal/distal
• Character and quality of
complaints
• Extent of disability
• Precipitating factors
• Relieving factors
• Associated or risk factors: MI,
stroke, DM, HT, DLP, smoking

4. PHYSICAL EXAMINATION: ARTERIAL
DISEASE
INSPECTION
1.Skin changes: pale,
cyanosis, rubor,
mottling
2.Hair distribution
3.Nail growth
4.Edema
5.Ulceration and
cellulitis
PALPATION
1. Temperature and
sensation: compare
with another side
2. Pulse: compare both
sides
• Neck: carotid and
temporal a.
• Upper extremities:
subclavian, axillary,
antecubital fossa,
wrist
• Abdominal aortic
pulse
AUSCULTATION
• Usually nothing
• But if present, it can
be bruit = stenosis