I. Pain Pain is mainly caused by insufficient arterial blood supply and venous hypertension and stasis. 1, intermittent claudication – a typical symptom of chronic ischemia of the limbs Indications: insufficient arterial blood supply, venous diseases [iliofemoral vein occlusion, hip or knee arthritis] Performance: intermittent claudication, also known as locomotor pain, occurring in the calf gastrocnemius muscle area, characterized by the patient walking a distance after the affected limb appears tired, pressure, numbness, Dull pain or spasmodic sharp pain, etc., relieved after resting for a period of time, but walking the same distance here can produce the same symptoms. The shorter the walking distance, the more serious the condition. 2, resting pain – arterial blood supply is seriously insufficient or venous reflux obstruction of clinical manifestations Indications: arterial occlusion, severe venous lesions, acute arterial embolism Performance: (1) pain caused by insufficient blood supply, symptoms worsened by elevating the patient, the pain at night significantly aggravate the condition of the patients sit up and down at night holding the knees, moaning, can not sleep flat; (2) pain caused by insufficient blood supply, the symptoms worsened by elevating the patient, pain significantly aggravated at night, so that patients in serious condition sit up and down at night holding the knees, moaning. (2) venous resting pain is generally heavy, aching and swelling; (3) deep venous blood reflux and reflux disorders, pain can occur after standing for a long time; after lying down and elevating the patient, the pain can be alleviated or disappeared (2) Skin Changes (1) Color Normal skin color: reddish, glossy and elastic. Abnormal changes: redness, cyanosis, pallor Deep venous insufficiency of the lower extremities secondary to traffic venous insufficiency of the lower calf: skin trophic disorders changes in the distal calf, such as thinning of the skin, desquamation, degeneration of the toenails, thinning of the hair, hyperpigmentation, eczema, etc.; pallor of the skin of the limbs, with a decrease in the temperature of the skin – chronic arterial insufficiency of blood supply Extremities Severe pain and skin syncope – acute arterial embolism Red lines on skin of extremities – lymphangitis or thrombosed superficial phlebitis 3. Typical super red color – erythematous limb pain (ii) Ulcers Inadequate arterial blood supply and venous reflux disorders are both associated with chronic ulcers: arterial and venous ulcers Difference between arterial and venous ulcers Type of ulcers Site of origin Pigmentation Margins Depth Pain Secretions Arterial ulcers Extremities Lightly jagged Deeper More severe More venous ulcers Boot area Heavier Neater Shallow Light or absent Less (iii) Temperature 1. Acute arterial embolism- Acute arterial embolism – the plane of skin temperature decrease is one palm width below the embolic plane. 2. Chronic superficial femoral artery occlusion – the skin temperature of the knee is markedly elevated as the “warm knee sign”. 3. Strong peripheral arterial spasm – coldness of the fingertips at the onset of the attack. –The end of the finger is cold during the attack, and the skin temperature rises again after relief. 4, arteriovenous fistula of the limb – increased blood flow to the affected area and increased skin temperature. 3, sensory abnormalities or paralysis – severe blood supply ischemia of the affected limb caused by insufficient nerve ischemia. Insufficient blood supply of the affected limb caused by nerve ischemia Indications: severe arterial blood supply deficiency and acute arterial embolism or thrombosis of the affected limb Performance: mild ants on the skin; severe patients with paralysis, dullness of superficial and deep sensation or disappearance