Ahh yeah I forgot about the peripheral pulses and oedemas.. Btw have you got any tips for feeling for the popliteal pulse? I can never find that damn thing
Use both hands and take the weight of the patients leg. It is such a pain to feel, I didn't feel one till this year. Its strange how it is easier to feel it when you're not in a clinical examination.
Use two hands, put your thumbs on the patella, wrap fingers round the back. Bend the knee slightly. Do not do as some acquaintances of mine may have done, and look for a pulse on the patella.
I should have been infront of a firing squad several times then.
whoops.
I just think that if you randomly start touching someone's boob without warning them that you're going to do it, then they could easily get confused and think that it was inappropriate/not needed for the exam. And then you're in trouble
Plus I just think how I'd feel if a doctor did that to me, and I wouldn't be impressed
The fact that someone's working, or just that it's me of all people?
Yeah that counts.. I'm still on week one lecture notes for CR revision though
Oh and almost onto season 4 of big bang theory
No I'm scared that someone is working, because if you are working, it means most likely so is everyone else. I am just using the excuse that I'm crippled so I don't do any work need to do something I swear
No I'm scared that someone is working, because if you are working, it means most likely so is everyone else. I am just using the excuse that I'm crippled so I don't do any work need to do something I swear
There's always Simon You're crippled, therefore indoors most of the time and not going out, therefore you should be doing more work I swear you always work too much anyway during term time
There's always Simon You're crippled, therefore indoors most of the time and not going out, therefore you should be doing more work I swear you always work too much anyway during term time
Yeh at least Simon won't have worked meh I can't be bothered to go through CR, it's really not all that exciting to be honest. Nah I just get everything done which gives the illusion of me working lots in actuality I sit and watch movies and How I Met Your Mother/ Big Bang Theory/ anything else that distracts me lol
I'll have to get myself a new one of those then.. 3rd years' orders
Definitely.
Don't even bother? Just feel roughly where it should be and say you can feel it?
Well, if you're feeling methodical, sure. Otherwise I'd just bypass it and feel the dorsalis pedis and post. tibial, personally. I don't see why it's useful to palpate the popliteal. If pulses distal to it feel fine, you can deduce that peripheral perfusion is fine (and if it's not, you're not really going to be able to feel if the popliteal is weak or not, it's so challenging to feel regardless). If you suspect a popliteal aneurysm, the patient must surely have an ultrasound and consultation with a vascular surgeon (not relying on your -- probably dodgy -- palpation). *awaits getting shot down by senior student/doctor*
Well, if you're feeling methodical, sure. Otherwise I'd just bypass it and feel the dorsalis pedis and post. tibial, personally. I don't see why it's useful to palpate the popliteal. If pulses distal to it feel fine, you can deduce that peripheral perfusion is fine (and if it's not, you're not really going to be able to feel if the popliteal is weak or not, it's so challenging to feel regardless). If you suspect a popliteal aneurysm, the patient must surely have an ultrasound and consultation with a vascular surgeon (not relying on your -- probably dodgy -- palpation). *awaits getting shot down by senior student/doctor*
Unless they've done that thing where they've blocked that artery and have made an alternative route down the leg. I can't remember what it's called, but it's common with the femoral artery in smokers and then profunda femoris takes on a more prominent role in supplying the leg
Unless they've done that thing where they've blocked that artery and have made an alternative route down the leg. I can't remember what it's called, but it's common with the femoral artery in smokers and then profunda femoris takes on a more prominent role in supplying the leg
In which case my words in brackets come into play.
I spent a couple of weeks in vascular surgery earlier in the semester and got the opportunity to have a dabble at a lot of lower limb pulses. Registrars in vascular surgery sometimes struggle to get a definite popliteal pulse! It's bloody hard on most people and most students who claim to feel it are either lying or deluded in my opinion. In OSCEs it's all well and good to go through the motions with it, but I'll be doing it with a hint of resentment.
In which case my words in brackets come into play.
I spent a couple of weeks in vascular surgery earlier in the semester and got the opportunity to have a dabble at a lot of lower limb pulses. Registrars in vascular surgery sometimes struggle to get a definite popliteal pulse! It's bloody hard on most people and most students who claim to feel it are either lying or deluded in my opinion. In OSCEs it's all well and good to go through the motions with it, but I'll be doing it with a hint of resentment.
It's really annoying me that I can't remember what the thing's called - my anatomy teacher bangs on about it all the time
Haha don't worry I'm the same. In my knee examination OSCE it was a case of "And now I'm feeling for the popliteal pulse "
Yeh at least Simon won't have worked meh I can't be bothered to go through CR, it's really not all that exciting to be honest. Nah I just get everything done which gives the illusion of me working lots in actuality I sit and watch movies and How I Met Your Mother/ Big Bang Theory/ anything else that distracts me lol
You get things done which gives the illusion?? I'm pretty sure getting it done counts as working..
Well, if you're feeling methodical, sure. Otherwise I'd just bypass it and feel the dorsalis pedis and post. tibial, personally. I don't see why it's useful to palpate the popliteal. If pulses distal to it feel fine, you can deduce that peripheral perfusion is fine (and if it's not, you're not really going to be able to feel if the popliteal is weak or not, it's so challenging to feel regardless). If you suspect a popliteal aneurysm, the patient must surely have an ultrasound and consultation with a vascular surgeon (not relying on your -- probably dodgy -- palpation). *awaits getting shot down by senior student/doctor*
I see your point but it forgets the fact that I currently know **** all OSCEs for first years seems to me like a way of getting used to handling patients.. but if there were abnormalities we probably wouldn't notice (unless they were gross abnormalities) and even then we probably wouldn't know what it meant.. Or it could just be me
But yeah, I'll bear what you said in mind definitely so cheers
Unless they've done that thing where they've blocked that artery and have made an alternative route down the leg. I can't remember what it's called, but it's common with the femoral artery in smokers and then profunda femoris takes on a more prominent role in supplying the leg
You get things done which gives the illusion?? I'm pretty sure getting it done counts as working..
I see your point but it forgets the fact that I currently know **** all OSCEs for first years seems to me like a way of getting used to handling patients.. but if there were abnormalities we probably wouldn't notice (unless they were gross abnormalities) and even then we probably wouldn't know what it meant.. Or it could just be me
But yeah, I'll bear what you said in mind definitely so cheers
We had a patient who had had a mastectomy, and those of us who didn't notice/ask about it were failed. (this was in a combined Cardio, resp and GI examination, so the chest would have been exposed)
But were were not expected to notice abnormalities except surgical/gross abnormalities.
We had a patient who had had a mastectomy, and those of us who didn't notice/ask about it were failed. (this was in a combined Cardio, resp and GI examination, so the chest would have been exposed)
But were were not expected to notice abnormalities except surgical/gross abnormalities.
Sounds fair enough... would have thought it'd be pretty noticeable
Nice to know though. Shame will probably forget by the time it actually matters!
Well, if you're feeling methodical, sure. Otherwise I'd just bypass it and feel the dorsalis pedis and post. tibial, personally. I don't see why it's useful to palpate the popliteal. If pulses distal to it feel fine, you can deduce that peripheral perfusion is fine (and if it's not, you're not really going to be able to feel if the popliteal is weak or not, it's so challenging to feel regardless). If you suspect a popliteal aneurysm, the patient must surely have an ultrasound and consultation with a vascular surgeon (not relying on your -- probably dodgy -- palpation). *awaits getting shot down by senior student/doctor*
The femoral and popliteal arteries are the most common arteries affected by PVD, the arteries more distal may be receiving blood from alternative routes, therefore not useful in excluding PVD. (Although you could argue that medical students and doctors in early training may not have an appropriate technique to feel the popletial to begin with)