Endocrine - Exam Flashcards
What are the physical therapy considerations for wounds?
- daily routine activities
- proper footwear
- foot deformities
- prior foot hx
- neuropathy
- any wound
- observe contralateral foot
- pain response bilaterally
PT considerations
What should we look out for with the wound?
- Location
- onset
- trauma vs insidious onset
- prior wound in the same location
- any treatments received
What are the PT exam tests and measures?
- general demographics
- integumentary system
- musculoskeletal system
- neurological system
- cardiovascular system
- medical system screening
- shoe examination
What PTs look for when observing and palpating?
- look at the lower extremities and feet
- skin appearance: color, texture, quality and hair growth
- foot deformity, blisters, calluses and nail appearance
- wound appearance
- fungual infection
- odor
Characterisitics of Ulcers
Size of ulcer
a variety which is dependent on duration from:
- onset
- degree of deformity
- location of the foot
Characterisitics of Ulcers
Shape of ulcer
typically round with a “punched out appearance”
Characterisitics of Ulcers
Depth of ulcer
Most often deep
- can even have exposed bone
Characterisitics of Ulcers
Peri-wound region of ulcer
maceration often present of edges from any drain
- callus can be present and needs to be removed to assess wound bed fully
Characterisitics of Ulcers
Wound bed of ulcer
Typically red
- unless the vascular system is compromised
-
Characterisitics of Ulcers
Drainage of ulcer
tends to be heavy drain amount
- unless would can be off-loadded properly
- drainage decreases when pressure becomes relieved
Wagner Ulcer Classification Scale
Grade 0
intact skin
pre-ulcerative lesions could exist
bony deformity present or healed ulcer
Wagner Ulcer Classification Scale
Grade 1
Superficial ulcer (no subcutaneous tissue involved)
Wagner Ulcer Classification Scale
Grade 2
deep ulcer (subcutaneous tissue involved; could have tendon or bone exposed)
Wagner Ulcer Classification Scale
Grade 3
Deep, infected ulcer (abscess, osteomyelitis, osteitis)
Wagner Ulcer Classification Scale
Grade 4
Partial-foot gangrene (digits affected)
