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Lower Limb Physical Examination

Throughout the body, there are several points at which blood vessels unite. The junctions are termed anastomoses. In the simplest sense, an anastomosis is any connection (made surgically or occurring naturally) between tube-like structures. Naturally occurring arterial anastomoses provide an alternative blood supply to target areas in cases where the primary arterial pathway is obstructed. They are most abundant in regions of the body where the blood supply may can be easily damaged or blocked (such as the joints or intestines). This article focuses on the arterial anastomotic networks of the upper limb.

Peripheral arterial disease (P.A.D.) occurs when plaque (plak) builds up in the arteries that carry blood to your head, organs, and limbs. Plaque is made up of fat, cholesterol, calcium, fibrous tissue, and other substances in the blood. When plaque builds up in arteries, the condition is called atherosclerosis (ATH-er-o-skler-O-sis). Over time, plaque can harden and narrow the arteries. This limits the flow of oxygen-rich blood to your organs and other parts of your body. P.A.D. usually affects the legs, but also can affect the arteries that carry blood from your heart to your head, arms, kidneys, and stomach. This article focuses on P.A.D. that affects blood flow to the legs.

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Detailed examination of the joints is usually not included in the routine medical examination. However, joint related complaints are rather common, and understanding anatomy and physiology of both normal function and pathologic conditions is critically important when evaluating the symptomatic patient. By gaining an appreciation for the basic structures and functioning of the joint, you'll be able to "logic" your way thru the exam, even if you can't remember the eponym attached to each specific test!

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Sanjeev Dutta, MD, FACS discusses the fascinating new world of surgical technology. The pediatric general surgeon shares how medicine and technology have combined to achieve less invasive procedures and healthier outcomes for surgical patients.

Dr. Dutta is a pediatric general surgeon at Lucile Packard Children's Hospital. He is also an Associate Professor of Surgery at Stanford School of Medicine and Surgical Director of the Multidisciplinary Initiative for Surgical Technology Research.

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Please remember that this video is to be used for educational purposes. You must follow your facility or colleges' policies and procedure checklists to ensure you are completing the skill satisfactorily. Thanks for watching!

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