Diabetic foot Flashcards
1
always forget ankle reflex
Intro
“I will just be checking sensation in leg, feeling pulses in your leg and seeing you walk afterwards”
ANY PAIN IN ANKLES OR FEET
2
First of all lift your shorts up a bit
EXPOSE LEGS
inspect legs
missing toes, compare colour, ulcers, skin changes
verablise:
“I’m just going to check for any hair loss, any skin changes, any redness, any ulcers.”
3
Inspect foot
- Look in between toes
- Look on sole
- Lift foot up and look at the heel
PALPATE BONES AND JOINTS OF THE ANKLE AND FOOT for swelling and tenderness. Watch
the patients face throughout and ask them to let you know if they experience any
discomfort
4
ASSESS TEMP - start on shins
CAP REFILL
ASSESS PULSES - MIDDLE OF BIG AND SECOND TOE
AND BEHIND MALEOLUS
“I’m just going to have a feel down your leg and have a feel for the pulses as well”
5
Sensation -
Cotton wool
Filament - “I’m now going to assess the sensation at the bottom of your foot with this mono-filament. it feels like this (touch hand). I want you to tell me what foot you feel me touching, right or left each time.”
Big toe and then the 1st 3rd and 5th metatarsal heads
then they go right, left, left, right etc
6
Vibration -
tuning fork (PLACE ON THE DISTAL BONY PROMINENCE)
tell me when you feel it and when you feel it stop
normally feel it like this
7
Proprioreception -
up and down on big toe wiggle!!
up, down, down, etc
8
Reflexes
Ankle jerk reflex - lift knee up and put it out to the side. Grab the foot with one hand, make sure relaxed. then hit back of the ankle with the tendon hammer.
9
Gait
10
Check shoes - soles of the shoe
11
“today i perfomed diabetic foot examination on… there was no new vascular deficits suggestive of diabetic disease.
to complete the examination i would complete a full neurovascular examination, I’d measuring the capillary blood glucose at the bedside and advising … on approprite foot care.
- neurovascular exam
- cap blood glucose
- advise on appropriate foot care
