A 60-year-old smoking male had pain in the right calf, aggravated by walking. At pen Doppler examination Clinical Examination in the Diagnosis of Peripheral Artery Disease of the Lower Extremity the pulse sounds were normal. A triphasic pulse sound is audible over A. tibialis posterior: (1) high-pitched systolic forward flow, (2) short backward flow resulting from elasticity of a normal artery, and (3) slow diastolic forward flow. Only phases 1 and 2 are audible over A. dorsalis pedis. The ankle pressures were normal. In peripheral artery obstruction (video Measurement of Ankle Pressure and Abi) the flow is slower (low-pitched) and monophasic. The cause of the patient's symptom was found elsewhere: the absence of the right patellar reflex suggested lumbar disc herniation. Note: this video has a sound track. If no sound is audible, turn on the audio of your computer.
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