Examination Of Diabetic Foot Flashcards
What are the four aspects of the examination?
Inspection, palpation, vascular examination, neurological examination
What should you do before starting the examination ?
Wash your hands, introduce, inform, consent, ask about pain in their ankles or feet, both legs should be exposed from the knee down to the feet
What four things do you inspect?
Gait. Patients shoes. Skin of patients feet. Inspect the feet.
What do you inspect on the patients shoes?
Uneven wear, presence of foreign objects
What 7 things are you inspecting on the skin of the patients feet for?
Trophic changes, rubor at pressure points, skin ulceration, diabetic dermopathy over shins, infection, webspaces, toe nails
What 4 trophic changes are you looking for on the patients feet?
Hairlessness, pallor, decreased sweating, dry cracked skin
What is diabetic dermopathy?
Brown macules
What infection are you looking for?
Cellulitis (erythema, swelling), gangrene
What 4 things are you looking for in the webspaces?
Cracked, infected, ulcers, maceration
What four things are you looking for in the toe nails?
Dystrophic, in-growing toenails, paronychia, onychomycosis
What four things are you looking for in the feet?
Deformities, intrinsic muscle wasting (clawed, hammer toes), pes planus (flat foot), pes cavus (high arch)
How do you palpate the foot?
Palpate the 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.
What three things do you check for in the vascular examination?
Temperature, pulses and capillary refill
How do you measure the temperature?
Use the back of your hand, compare shins to feet bilaterally. Temperature should decrease slightly as you move distally.
Which pulses do you feel in a diabetic foot exam?
Femoral (omit in the osce), popliteal (if foot pulses absent), posterior tibial, dorsalis pedis
