palpation
Last reviewed 01/2018
Palpate the veins along their course and feel their tension. Often the veins in the lower leg lie in a gutter of indurated subcutaneous tissue.
Feel for a cough impulse at the sapheno-femoral and sapheno-popliteal junctions. A strong cough impulse indicates valve incompetence.
Feel along the medial side of the leg for tender areas, both with the patient standing and lying flat. These may signify points of defects in the deep fascia where the superficial veins connect with the deep veins. The most common sites are on the medial aspect of the leg above the medial malleolus (5, 10, 15 cm above), the short sapheno-popliteal junction, and the long sapheno-femoral junction.
Palpate for oedema and thickening of the subcutaneous tissues.
Use the Trendelenburg-Brodie tourniquet tests to identify the site of incompetence.