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    (Original post by Kinkerz)
    Definitely.


    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 :holmes:
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    (Original post by xXxBaby-BooxXx)
    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 :holmes:
    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.
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    (Original post by Kinkerz)
    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 :sad:

    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 :ninja:" :p:
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    (Original post by a moist feeling)
    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..

    (Original post by Kinkerz)
    Definitely.


    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 :yep:
    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 :dontknow:

    But yeah, I'll bear what you said in mind definitely so cheers
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    (Original post by xXxBaby-BooxXx)
    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 :holmes:
    Anastomosis (with some angiogenesis)
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    (Original post by Penguinsaysquack)
    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 :yep:
    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 :dontknow:

    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.
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    (Original post by carcinoma)
    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! :erm:
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    (Original post by Kinkerz)
    Definitely.


    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)
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    (Original post by Kinkerz)
    This one of those situations in which girlfriends become very useful.
    Haha, yea deffo, but we have to draw the line at Gyne examinations.
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    (Original post by carcinoma)
    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)
    If you've got significant peripheral vascular disease that is causing symptoms (and is therefore of immediate relevance to a patient), then, most likely, you're going to exhibit a variety of signs, only one/a few of which may involve the popliteal pulse. The arteries more distal are useful in diagnosing/excluding PVD, just not necessarily with certainty (but, as you'll be well aware, this certainty lark becomes one slippery slope).
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    (Original post by carcinoma)
    Haha, yea deffo, but we have to draw the line at Gyne examinations.
    Yeah, save that one for relatives etc.
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    (Original post by Kinkerz)
    If you've got significant peripheral vascular disease that is causing symptoms (and is therefore of immediate relevance to a patient), then, most likely, you're going to exhibit a variety signs (only one/a few of which may involve the popliteal pulse). The arteries more distal are useful in diagnosing/excluding PVD, just not necessarily with certainty (but, as you'll be well aware, this certainty lark becomes one slippery slope).
    Agreed, but the popliteal pulse is useful in detecting PVD in its early stages (detecting PVD prior to the clinical symptoms does to me seem a tad premature/pointless.)
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    It's all about the TUBE/CUBE.
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    (Original post by Mushi_master)
    It's all about the TUBE/CUBE.
    Not on the standard of patients I've seen :noway:


    Some coursemates however... :sexface:
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    (Original post by Penguinsaysquack)
    Not on the standard of patients I've seen :noway:


    Some coursemates however... :sexface:
    Perhaps on a GLM then.
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    (Original post by Mushi_master)
    Perhaps on a GLM then.
    Would have thought that goes without saying?
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    Any advice on GMC/MSC guidance references I can use for a reflective essay on work-life balance and stress?
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    (Original post by Penguinsaysquack)
    Would have thought that goes without saying?
    But of course. I hear you fail OSCEs if you don't.
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    Medicine would be so much better without all these exams and work in general...
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    (Original post by gozatron)
    Medicine would be so much better without all these exams and work in general...
    Na the exams give it some excitement! lool

    Tbh I really don't mind the exams, then again our testing method is essentially Finals 4 times a year supplemented with a bucketful of clinical exams.
 
 
 
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