Examination Of An Ulcer Flashcards
What are the five stages of examining an ulcer?
Look, feel, move, examine the regional lymphatic drainage, special tests
What are the ten stages of inspecting an ulcer?
Number of lesions, site, size, shape, margin, edge, floor, discharge, surrounding skin, whole limb
What are you looking for when looking at the number of lesions?
Single or multiple. Multiple ulcers are commonly seen in arterial disease
How do you measure the size of an ulcer?
Use a tape measure to measure the ulcer. Estimate the depth in millimetres.
What are you looking for when looking at the shape of an ulcer?
For example, varicose veins are typically vertically oval, malignant ulcers and typically irregular in shape
Give 6 examples of how the edge of an ulcer could be
Sloping, punched out, undermined, raised, rolled, everted. Note whether the marginal epithelium is attempting to grow over the surface
What are the nine examples of the floor of an ulcer
Healthy granulation tissue, unhealthy granulation tissue, slough, scab, fat, muscle, tendon, periosteum or bone
What 5 things are you looking for when assessing the discharge of an ulcer?
Quantity, consistency, colour, composition and odour
Give 4 examples of types of discharge
Serous (watery), sanguineous (bloodstained), purulent or green (which usually indicates Psuedomonas colonisation/infection)
List 5 things you are looking for in surrounding skin?
Hyperpigmentation, oedema, erythema, stretch marks and wrinkling (which may indicate resolving inflammation)
What are you looking for in the whole limb?
Venous and arterial insufficiency and neurological disease. Muscle wasting may be present
What 4 things are you checking for on palpation?
Tenderness, temperature, the edge of the ulcer for induration, whether the ulcer bleeds on gentle touch or not
Why do you palpate the edge of the ulcer for induration
A feature of chronic benign ulcers and of malignant ulcers
Why do you determine whether the ulcer bleeds on gentle touch or not
This is often a feature of malignancy
How do you move an ulcer?
Gently attempt to move the base of the ulcer using your thumb and forefinger. Fixation to deeper structures may be suggestive of malignancy
