UPPER EXTREMITY ASSESSMENT

• Observe skin over extremities for color, pallor, rubor (redness), hair distribution.
• Inspect the arms for any superficial vessels.
• Extremities should be symmetrically even in color, warmth and moisture, without swelling.
• Swelling of feet may occur after prolonged standing or sitting but will disappear readily when extremity is elevated.
• Note temperature of skin over extremities, comparing one side to the other.
• Palpate pulses – radial then brachial comparing symmetry from side to side.
• Test range of motion (ROM) and muscle strength of hands, arms, and shoulders.
• Radial pulses on both arms are present and approximately equal.
• Amplitude (Force) of the pulses 3+, increased, full, bounding
• o   2+, normal

  o   1+, weak

  o   0, absent
• The two arms should be symmetric in size.
• Cold, clammy and pale hands and arms. This signifies vasoconstriction or decreased cardiac output.
• Edema of upper extremities. This may indicate poor venous return or obstruction of lymphatic drainage.
• Full, bounding pulse (3+). This occurs with exercise, anxiety, fever, anemia, and hyperthyroidism.
• Weak, thready pulse. This occurs with shock and peripheral arterial disease.