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Peripheral Vascular OSCE Examination Quiz
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When listening over the femoral pulse, what does a bruit most importantly suggest?
- A Complete occlusion of the femoral artery by an embolus You picked ✕
- B Turbulent blood flow within the femoral vein from incompetent venous valves You picked ✕
- C A small atherosclerotic plaque that narrows the femoral artery lumen by 10% You picked ✕
- D Smooth laminar blood flow through a healthy femoral artery You picked ✕
- E Turbulent blood flow through a narrowed aorto-iliac or femoral artery. You picked ✓
Correct!
Incorrect
The answer is E: Turbulent blood flow through a narrowed aorto-iliac or femoral artery.
Explanation
Why E is correct
See Temperature and Capillary Refill. Option E is correct. A bruit is a whooshing sound heard through a stethoscope when blood flow becomes turbulent as it passes through a narrowed vessel. Over the femoral artery in the groin, it suggests narrowing of the arteries that supply the leg, most often from atheroma, the fatty build-up in artery walls that causes peripheral arterial disease. Studies of the physical examination found that a femoral bruit gave useful information about a low ankle-brachial index and about plaque in the femoral artery. Because atheroma is usually a body-wide process, a femoral bruit should prompt you to think about the other arteries too, such as the carotids and the heart. A helpful picture is a river squeezed through a narrow channel: smooth water is quiet, rushing water is noisy.
- Bruit: a whooshing sound caused by turbulent blood flow through a narrowed vessel.
- Femoral site: it suggests narrowing of the arteries that supply the leg, most often from atheroma.
- Wider meaning: atheroma is usually body-wide, so think about the carotids and the heart too.
Why the other options are incorrect
- A. Complete occlusion of the femoral artery by an embolus: A bruit requires blood to pass through a narrowed segment to generate turbulent flow; complete occlusion abolishes flow, so the blocked segment is silent. Your answer
- B. Turbulent blood flow within the femoral vein from incompetent venous valves: A femoral bruit is an arterial sound heard over the femoral pulse; venous reflux in the femoral vein does not produce an arterial bruit. Your answer
- C. A small atherosclerotic plaque that narrows the femoral artery lumen by 10%: A bruit indicates turbulent flow through a significant narrowing; a minor 10% plaque is not enough to create the audible turbulent flow of a femoral bruit. Your answer
- D. Smooth laminar blood flow through a healthy femoral artery: Smooth laminar flow is silent; a bruit is produced by turbulent flow, so a healthy artery with laminar flow would not have a bruit. Your answer
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More questions from this set. Start the quiz to answer them and see each explanation.
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1
What counts as a positive Buerger's test when assessing the blood supply to the leg?
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2
Which statement best describes safe assessment of the carotid pulse?
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