Inspection
The patient may be in pain. Observe:
- position - in severe arterial insufficiency, the patient may only be comfortable sitting with the leg hanging over the side of the bed, gravity assisting blood flow
- areas of trophic change:
- skin discoloration
- hair loss
- fissured nails
- muscle wasting - e.g. quadriceps diameter 10 cm from the pubic tubercle
- venous guttering - more significant if present without raising the legs
- pressure necrosis, especially on bony prominences
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