Foot lecture notes

Question 1

For people with diabetes _________ is the leading cause.

Answer 1

amputations

Question 2

Amputations is number one surgery that occurs

Question 3

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

Question 4

Why?We are preventing foot infections, which is going to prevent amputations

Anyone and everyone with diabetes could benefit from a foot exam

Question 5

When anyone is complaining of any kind of foot pain, a blister, redness whatever it might be, numbness, tingling

Question 6

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

Question 7

Now I’m going to feel for the posterior tibial pulse and its right by your ankle bone so find ankle bone theres a well dip right behind and press it.It’s the inside posterior of the posterior tibial.

Question 8

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 have hair growth which is perfectly normal which is perfectly normal that’s another sign of adequate very good blood flow to the feet. Now I’m going to take a closer look at your face I’m going to look for any dryness, ulcers,cracks in between the toes we look for signs of infection

Question 9

What infection is going to be in btwn the toes? Athlete’s foot also known as ____________

Answer 9

tinia pedis

Question 10

Making sure toenails are cut square and not rounded so those look good. Why are we cutting nail square and not round? To prevent __________

Answer 10

ingrown toenail

Question 11

Looking for cracks, ulcers in between, toenails are cut straight

Question 12

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

Answer 12

monofilament

Question 13

The bend is critical…that’s the ten grams of pressure when you have the bend

Question 14

Avoid the _______ when using monofilament

Answer 14

callus

Question 15

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

Question 16

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 handle of it

Question 17

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

Question 18

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….

Answer 18

lotion, once

Question 19

How do we grade pulses?2+ is normal….are we measuring a pulse do I want a number on this? Absolutely not because the flow is the furthest away from the heart and its not going to be accurate

Question 20

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

Answer 20

three nerves