Lower Limb Pulses

Overview

• Strong femoral, popliteal, posterior tibial and dorsalis pulses are reassuring, while weak or absent lower limb pulses represent vascular compromise that may be limb-threatening if acute.

• • Pulses in the Lower Limb

  • Femoral - palpate within the inguinal region, halfway between the pubic symphysis and iliac crest.
  • Popliteal - bend the patient's knee to 90 degrees, gently grasp both sides of the knee joint and palpate using tips of fingers within the popliteal fossa posteriorly.
  • Posterior tibial - palpate posteriorly and inferiorly to the medial malleolus.
  • Dorsalis pedis - palpate lateral to the extensor tendon of the great toe. This can be identified by asking the patient to extend their great toe.

• • Causes of Absent Lower Limb Pulses

  • Vascular trauma
  • Compartment syndrome
  • Peripheral vascular disease
  • Abdominal aortic aneurysm
  • Shock