Examination of an ulcer Flashcards
What are the steps when examining an ulcer?
Look Feel Move Special tests Regional lymphatic drainage
What do you look for when examining an ulcer?
Number of lesions Site Size Shape Margins Edge Floor Discharge Surrounding skin Whole limb
How do you describe the edge of an ulcer?
Punched out Undermined Raised Rolled Everted
How do you describe the floor of an ulcer?
Healthy/unhealthy Slough Scab Fat Muscle Tendon Periosteum Bone
How do you describe the discharge from an ulcer?
Quantity Consistency Colour Composition Odour
How do you describe the surrounding skin?
Hyperpigmented Oedema Erythema Stretch marks Wrinkling
What should you look for when looking at the whole limb?
Signs of venous and arterial insufficiency and neurological disease
Muscle wasting
What are the symptoms of an arterial ulcer?
Red/yellow/black Deep Punched out Ankle, feet, heels, toes Tight, hairless skin Leg pain at night No bleeding Cool to touch Leg reddens when dangled and turns pale when elevated Painful
What are the symptoms of a venous ulcer?
Below knee and medial ankle Little/no discomfort Inflammation Swelling Itchy, hardened skin Scabbing/flaking Brown/black stained skin Discharge
What are the symptoms of a diabetic foot ulcer?
Swelling, discolouration and warmth
Foul-smelling discharge
Pain and firmness when wound is touched
Callused and thickened skin surrounding ulcer
What do you feel for when palpating an ulcer?
Tender?
Palpate temperature of ulcer and surrounding skin
Palpate edge of ulcer for induration (hardness)
Bleeding?
What are 2 features of malignant ulcers?
Induration
Bleeding on light touch
What do you look for when palpating an ulcer?
Attempt to move the base of ulcer using thumb and forefinger
Is it fixated?
What special tests should you do?
Palpate peripheral pulses
Examine light touch and pressure sensation
Evidence of bony involvement?
