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Diabetic Exam
 
 
 
 
Diabetic Exam
Poor diabetic control may manifest in many different ways, with macrovascular and microvascular complications. The diabetic examination is useful for diagnosing these complications, particularly when it comes to the vascular and neurologic examination of the lower limb.
 

Carotid Pulsation

 
 

Overview

    • How to Assess

    • Palpate the common carotid arteries, located in the anterior neck medial to the sternocleidomastoid. Palpate the arteries one at a time. Care should be taken to avoid stimulating the carotid sinus.

Contour

  • Rapid rate of risePremature ventricular contraction, mitral regurg, VSD, aortic regurgitation, HOCM
  • Slow rate of rise Aortic stenosis
  • Bisferiens pulse (double beating pulse)Aortic regurgitation

Amplitude

  • Bounding pulse - strong, sustainedHypertension, hypermetabolic states
  • Waterhammer / collapsing pulse: strong pulse with sudden collapse.Aortic regurgitation, patent ductus arteriosus
  • Pulsus tardis & parvis: weak pulse with a delayed systolic peakAortic stenosis
  • Pulsus alternans: regular alternation between strong and weak beatsLeft ventricular failure
Last updated on November 28th, 2019
 
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