Anterior Tibial Artery Palpation

The anatomy of (he radial, brachial and carotid pulses have been described I p. 83).

Femoral artery. The I'emoral artery is situated just below the inguinal ligament, midway between the anterior superior iliac spine and the pubic symphysis (mid-inguinal point). It is immediately lateral to the femoral vein and medial to the femoral nerve. In the obese it can be difficult to feel.

Popliteal artery. At the level of the knee crease, the artery lies deep in the popliteal fossa and the pulse is sometimes difficult to feel, even by the experienced clinician.

Examination sequence

Posterior tibial artery. This is located 2 cm below and posterior to the medial malleolus where it passes beneath the flexor retinaculum between flexor digitorum longus and flexor hallucis longus.

Dorsalis pedis artery. This is the continuation of the anterior tibial artery on the dorsum of the fool. It passes lateral the tendon of the extensor hallucis longus and is best fell at the proximal exlcnt of the groove between the first and second metatarsals. It may be absent or abnormally sited in 10% of normal subjects, sometimes being 'replaced' by a palpable perforating peroneal artery.

Individual pulses should be recorded as follows:

normal +

reduced ± absent aneurysmal ++

Fig. 3.38 Examine the femoral artery, simultaneously while checking for radiofemoral delay.

Femoral

□ With the patient supine, firmly press down and cephalad in the groin crease (Fig. 3.38) using two or three extended fingers.

□ Auscultate for a bruit.

□ Check for radiofemoral delay.

Popliteal

□ Flex the knee to 30 degrees and make sure the patient is relaxed.

Examination of pulses

If the examiner is in any doubt aboul which pulse is beins; felt, it is useful for the clinician lo palpate his or her own pulse at the same time. Lack of synchronisation implies that it is the patient's pulse.

General

□ Examine the radial, brachial and carotid pulses (p. 83). Measure the blood pressure in both arms.

I Palpate and auscultate over the abdominal aorta in any patient with suspected vascular disease.

□ Inspect the legs and feet for changes of ischaemia including changes in temperature and colour,

□ Note any scars from previous vascular or non-vascular surgery and the position, margin, depth and colour of any ulceration.

□ Specifically look between the toes and at the heel.s lor ischaemic changes.

Fig. 3.39 Examination of the popliteal artery. Feel the popliteal artery with the fingertips, having curled both hands into the popiiteal fossa.

Dorso Flexi Pedis

Fig, 3.40 Examination oi E the posterior tibial artery and IB the dorsal is pedis artery.

□ With the thumbs in front and the fingers behind, press firmly over the popliteal artery.

Feel for (he pulse in the midline 3^1 cm below the knee crease where the artery can be compressed against the posterior aspect of the tibia as il passes under the soleal arch (Fig. 3.39).

Posterior tibial

□ f-'eel 2 cm below and 2 cm behind the medial malleolus (Fig 3.40A).

Dorsalis pedis

□ Feel in the middle of the dorsum of the foot just lateral to the tendon of extensor hallucis longus (Fig. 3.40B).

Buerger's test

□ With the patient lying supine, stand at the foot of the bed. Raise the feet and support the legs at 45 degrees to the horizontal.

□ Then ask (he patient to sit up and swing the legs over the edge of the bed.

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Responses

  • luce
    Where is the posterior tibial artery located?
    7 years ago
  • fesahaye alem
    What arteries are difficult to palpate?
    7 years ago
  • Tiffany
    What passes anterior to the soleal arch?
    7 years ago
  • paciano
    Where to feel posterior tibial artery?
    6 years ago
  • pasquale
    How to palpate anterior tibial artery?
    6 years ago
  • Melilot
    Which artery can be palpated below the knee?
    3 years ago
  • johannes
    How to examine anterior tibial artery?
    3 years ago
  • carlton
    How to examine anterior tibial pulse?
    3 years ago
  • jukka
    Where anterior tibial artery is palpated?
    3 years ago
  • CELESTE
    How to check anterior tibial pulse?
    3 years ago
  • ulrich
    How to feel anterior tibialartery pulse?
    3 years ago
  • meghan
    How to check anterior tibial artery pulsations exactly?
    2 years ago
  • kenzie
    How to palpate ant.. tebial artery?
    2 years ago
  • Lea
    How to palpate anterior tibial pulsations?
    2 years ago
  • mhret
    Where is the anterior tibial pulse found video?
    2 years ago
  • Nikola
    Is anterior tibial artery palpable?
    2 years ago
  • joel
    Is anterior tibial artery palpable in the foot?
    2 years ago
  • Lucas
    Is dorsal pedius artery isabsent then which arter supply the fool?
    2 years ago
  • elliott
    Where to palpate ant and post tibial artery?
    2 years ago
  • robert
    How to palpate anterior tibial and posterior tibial artery?
    2 years ago
  • christian
    How to feel femoral pulse?
    2 years ago
  • jyri
    How to find an anterior tibial pulse?
    2 years ago
  • fiyori
    What pulse felt in tibia?
    2 years ago
  • ANGELIKA
    Where to feel for tibial pulse?
    1 year ago
  • juhani
    What artery is located on the posterior aspect of the knee and can be palpated with an E semiflexed?
    1 year ago
  • rita
    How to find anterior tibial artery location?
    1 year ago
  • Virgilio
    Can we plapate anterior tibial artery?
    1 year ago
  • hilda banks
    Can you doppler anterior tibial pulse?
    9 months ago
  • jole ferri
    Why assess anterior tibialis pulse?
    8 months ago
  • arto
    How to palpate the peroneal foot artery?
    3 months ago
  • mathias eisenberg
    Where do you palpate eht eanterior tibial?
    3 months ago
  • Negassi
    Where is the pulse felt in the anterior tibial artery?
    2 months ago
  • Sandra
    Where to feel anterior tibial artery pulse?
    2 months ago
  • Alfred
    How to check posterior tibial pulse?
    7 days ago

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