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What is a physiologic arterial exam?

What is a physiologic arterial exam?

A physiologic arterial exam is a type of ultrasound exam used to assess blood flow through the arteries of the arms and legs. These exams can be used to study the upper or lower extremities for arterial insufficiency, or reduced blood flow within the arteries. Physiologic arterial exams can also help determine if peripheral artery disease, or PAD, is present. 

Peripheral artery disease is a common condition characterized by reduced blood flow, specifically in the lower extremities. It is caused by the buildup of fatty plaque along the arterial walls (atherosclerosis). Symptoms of arterial insufficiency and/or PAD include limb pain, muscle pain with aches and fatigue (claudication), and non-healing or slow-healing wounds. Risk factors include older age, smoking, diabetes, obesity, and family history. 

A physiologic arterial exam of the lower extremities consists of measuring the blood pressure at the ankles, which can then be compared to blood pressure measured in the arms. A Doppler ultrasound is also conducted to visualize the speed and direction of blood flow. The exam can determine which blood vessels are affected and how severely. 

Arterial disease in the upper extremities is less common than in the lower extremities. The physiologic arterial exam of the arms is similar to that of the legs, including a blood pressure measurement compared to that of the ankle. In addition, there is a blood pressure evaluation of the fingers. 

Ultrasound exams often serve as the first line of testing because they are accurate, painless, and noninvasive. For physiologic arterial exams, no patient preparation is needed. These exams are performed by Registered Vascular Technologists (RVTs). During the exam, the RVT will use a handheld device called a transducer to press on the skin and compress the arteries being examined. The transducer emits harmless soundwaves that help create images of what is happening inside the arteries. During the exam, the RVT will also take blood pressure measurements. Results will be evaluated by an interpreting physician and sent to the referring provider for diagnosis. 


  1. Lower Extremity Physiologic Testing. UC Davis Health.
  2. Peripheral Arterial Disease (PAD). UC Davis Health.
  3. Upper Extremity Arterial Testing: The Diagnostic Criteria for Physiologic Examination. Altawan, A., Golchian, D., Iljas, J. et al. Journal for Vascular Ultrasound. 2017;41 (2).