note the colour of the feet soles. They should be pink. Then elevate both legs to 45 degrees for more than 1 minute. Observe the soles. If there is marked pallor (whiteness), ischemia should be suspected. Next check for rubor of dependency. Sit the patient upright and observe the feet. In normal patients, the feet quickly turn pink. If, more slowly, they turn red like a cooked lobster, suspect ischemia. Brodie-Trendelenburg test (assessment of valvular competence if varicose veins are present):One leg at a time. With the patient supine, empty the superficial veins by 'milking' the leg in the distal to proximal direction. Now press with your thumb over the saphenofemoral junction (2.5 cm below and 2.5 cm lateral to the pubic tubercle) and ask the patient to stand while you maintain pressure. If the leg veins now refill rapidly, the incompetence is located below the saphenofemoral junction, and vice versa. This test can be repeated using pressure at any point along the leg until the incompetence has been mapped out. References External links http://jama.ama-assn.org/cgi/content/full/300/2/197 JAMA: Ankle Brachial Index http://circ.ahajournals.org/cgi/content/full/105/7/886 Circulation: Tools for Coronary Risk Assessment Vascular surgery Physical examination