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Toe pressure measurement
- May 12, 2017 at 16:58 #1244
Hey everyone, I have a question. How do we measure toe pressure? It sounds ridiculous but it’s given in my surgery book that in periferal vascular disease we sometimes need to measure the toe pressure, ankle-brachial index and sometimes even toe-brachial index. So we need to measure toe pressure. Is there any special instruments for that? Is it the lateral pressure we measure like that of brachial pressure?
- May 13, 2017 at 08:55 #1245
Actually we use a special device for this purpose. The principal is same as sphigmomanometer, in fact it’s a small sphigmomanometer. The cuff (small in size, called toe pressure cuff) is worn around the particular toe whose pressure is to be measured. In routine measurements of toe-brachial index for periferal arterial disease we commonly estimate the pressure of the big toe on both sides if it is healthy.
Then the cuff is connected to a air pump and pressure measuring device – for this we can use some automatic or manual air pump commonly used for brachial pressure measurement.
In place of stethoscope we use a photoplethysmograph – it detects blood flow through the toe and shows a graph on a sheet or digital screen.
Pressure is increased and raised 20 – 30 mm Hg above the disappearence of the waveform on the paper or screen. Then it is slowly reduced (2 mm Hg per second). The pressure corresponding to the reappearence of the waveform in the graph is noted as systolic pressure.
As you may have noted the procedure is basically similar to that of brachial pressure measurement, except the size the toe pressure cuff and replacing stethoscope with the photoplethysmograph. The exceptions are due to small size of the toe.
Same principal can be applied for the measurement of finger pressure.
So in short the answer to your questions are –
1. “How do we measure toe pressure?” – already described above.
2. “Is there any special instruments for that?” – yes, as I descrived, two differences in instruments…though it can vary depending on if you are using a commercial kit for this purpose – as they may encase multiple devices in the same cover for convenience, but the basic things are the same.
3. “Is it the lateral pressure we measure like that of brachial pressure?” – Yes, it is.
I got this image on a website called PMS instruments. here you can see two bands attached to the big toe – the upper one is photoplethysmograph and the lower one is toe pressure cuff. You can also see the waveform in the digital screen.
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