Lab 1: Examination Pt 1 Flashcards
What is the more crucial aspect of evaluation of vulnerable feet?
Thorough vascular assessment
What are the four locations to assess pulses of the LE?
- Dorsalis pedis
- Posterior tibial
- Popliteal
- Femoral
What is the equation for calculation ABI?
Systolic at the ankle / systolic at the brachium
What is the gold standard assessment for peripheral artery disease?
ABI
Should you assess both limbs for ABI, and if so, what values should you use?
Yes, assess both limbs. Use the highest value for calculating
What values are considered normal for ABI?
1.00 - 1.29
What values are considered borderline for ABI?
0.91 - 0.99
What values are considered mild PAD for ABI?
0.71 - 0.90
What values are considered medium severe PAD for ABI?
0.41 - 0.70
What values are considered severe PAD for ABI?
< 0.40
Where should you start a circumferential measurement?
Bony landmark: tibial tuberosity, ischial tuberosity, greater trochanter, acromion, olecranon
What distance should your serial measurements be when assessing girth?
3-4 cm
What areas of the limb do we need to assess girth for?
Any area of the limb that will be within the prosthesis
Describe how to perform pallor with elevation?
Start pt is supine and note colors of soles. Elevate legs > 45 degrees and note the color of the soles after one minute
What timeframe is indicative of moderate arterial insufficiency for pallor insufficiency?
Pallor with 30-45 seconds of elevation
What timeframe is indicative of mild arterial insufficiency for pallor insufficiency?
Pallor with 45-60 seconds of elevation
Describe how to assess for rubor of dependency
From the test position from pallor of elevation, bring the pt to a sitting position and observe the color of their feet
What is indicative of ischemia with rubor of dependency?
Feet turn bright red due to significant vasodilation in response to the ischemia
What is considered normal for rubor of dependency?
Normal color should return within 15-20 seconds
What is considered to be severe arterial insufficiency for rubor of dependency?
Pallor with elevation within 25 seconds followed by bright red appearance
Describe how to assess venous filling time
Establish baseline, then elevate leg for about 1 minute or until veins collapse. Then bring to sitting and record time of how long it takes veins to refill
What is considered to be normal venous filling time?
Refill in 5-15 seconds
What venous filling time would be indicative of arterial insufficiency?
> 20 seconds
What venous filling time would be indicative of venous insufficiency?
Immediate refill
What is a normal response for capillary refill?
Immediately or within several seconds
How long do you press on the affected area when assessing for pitting edema?
Two seconds
What are causes of pitting edema?
Localized problems with veins in affected area or systemic problem with heart, kidneys, liver function
What are causes of edema without pitting?
Thyroid of lymphatic dysfunction
What does a score of 0 indicate in terms of pitting edema?
Non-pitting
What does a score of 1+ indicate in terms of pitting edema?
Barely perceptible
What does a score of 2+ indicate in terms of pitting edema?
Skin rebound < 15 seconds
What does a score of 3+ indicate in terms of pitting edema?
Skin rebound in 15-30 seconds
What does a score of 4+ indicate in terms of pitting edema?
Skin rebound > 30 seconds
What are the two main methods of assessing sensation?
Semmes-Weinstein monofilaments and tuning forks
What is the most common reason for impaired sensation?
Diabetes
What monofilament is used for sensory assessment?
5.07 monofilament
How much force and in what direction is needed to bend the monofilament?
10 g of perpendicular force
What tuning fork is used to assess sensation?
128 Hz
