Foot lecture notes Flashcards
For people with diabetes _________ is the leading cause.
amputations
Amputations is number one surgery that occurs
Simply by doing a foot exam we are preventing the wound which is preventing the infection which is preventing the ulcer which is then preventing the amputation
Why?We are preventing foot infections, which is going to prevent _____________
Anyone and everyone with diabetes could benefit from a foot exam
amputations
When anyone is complaining of any kind of foot pain, a blister, redness whatever it might be, numbness, tingling
Good morning, my name is Briana and today what I would like to do is a foot exam which is important for you given your history of diabetes its important inspect your feet on a daily basis and I will show you how to do that as well
I’m going to grab a couple of tools here. The first thing I’m going to do here is find some pulses on your feet…there are two areas that we like to feel for pulses, you can just keep your feet just rested and relaxed…what I’m feeling for here is called the dorsalis pedis pulse which is pretty strong
Flex that big toe follow the ligament is on either side of it…blood is flowing to the feet (for dorsalis pedis)
Now I’m going to feel for the posterior tibial pulse and its right by your _______ bone so find ankle bone theres a well dip right behind and press it.It’s the inside posterior of the posterior tibial.
ankle
I can feel the blood flowing to your feet which is great. Now I’m going to feel the temperature.It’s nice and warm so it reinforces that the blood flow is there. I see hair growth that’s another sign of adequate very good blood flow to the feet. Now I’m going to take a look for any dryness, ulcers,cracks in between the toes we look for signs of infection
What infection is going to be in btwn the toes? Athlete’s foot also known as ____________
tinia pedis
Making sure toenails are cut square and not rounded so those look good. Why are we cutting nail square and not round? To prevent __________
ingrown toenail
Looking for cracks, ulcers in between toes
make sure toenails are cut straight
Next I’m going to use a ____________ what I’m testing for is the nerve sensation in your feet and so what I’m going to do is I’m going to ask you to close your eyes and your going to feel this small tool on your foot and when you feel it I would like you to me where you feel it and I’m just going to put it on your hand so you can actually feel…can you feel that? I can… So I’m going to do that on 4 or 5 different places on the bottom of your foot and if you could tell me the location that you feel it..and if you don’t feel anything just let me know that you don’t feel it…we are going to start here by your left foot
monofilament
The _______ is critical…that’s the ten grams of pressure when you have the bend
bend
Avoid the _______ when using monofilament
callus
You have full sensation to a 10 gram monofilament which means all of the nerves are sensing the placement of this tool on your foot so that means at this point we don’t think that there’s any nerve damage due to diabetes which is excellent
Different spots but same technique
Tuning fork will be used…when you no longer feel it vibrating I want you to tell me I don’t feel it anymore…and that will tell me whether or not there is sensation to the tuning fork and I will do it on bone of big toe… You cannot touch the U of this tool otherwise its going to stop vibrating your only touching the __________ of it
handle
Full sensation from 10 gram monofilament and tuning fork so no nerve damage from diabetes.Only recommendation would be to try to put some lotion on if it feels a little bit dry
Whats recommended for people with diabetes is if your able to at home after you get out of the shower dry the feet really well, dry between the toes, put some _________ on, hopefully you have a mirror at home if you can cross your legs and inspect your feet or put the mirror on the floor and move your foot around it but at least _______ a day you should be looking at your feet knowing that you had have good sensation….
lotion, once
How do we grade pulses?2+ is normal….are we measuring a pulse do I want a number on this? Absolutely not because the feet is the furthest away from the heart and its not going to be accurate
These are the spots your going to use the ten gram monofilament on your partner’s foot…its because we have _________ nerves that innervate our feet so testing in these spots tests all three of those nerves…for the documentation if they have a full sensation you would put a + in the spot….if they do not feel it it would be a – symbol
three nerves
