One good way to do this is by locating the femoral artery--which lies between the anterior superior iliac spine and the pubic tubercle--by feeling for the pulse. The vein is medial to the artery and the saphenofemoral junction about two fingers' breadths below the inguinal ligament. Next ask the patient to stand if he or she can. You then should place one hand on the varicosities and tap on the saphenofemoral junction. If the saphenofemoral junction is incompetent you may feel a fluid thrill. You can confirm the incompetence with a handheld Doppler ultrasonograph if you put it at the saphenofemoral junction and press on the varicosities. You should be able to hear blood flowing up the vein to the junction and with an incompetent valve at the saphenofemoral junction, you can hear the blood flowing back again. Again ask the patient to lie down, raise his or her leg, and empty the engorged varicosities. To do this, press on the saphenofemoral junction to occlude it.