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Amp/Pros > LE Amputation Etiology > Flashcards

LE Amputation Etiology Flashcards

1
Q

Rates of limb loss (decrease/increased) dramatically with age.

A

Increase

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2
Q

82% of amputations are due to what?

A

Vascular disease secondary to complications of diabetes and PAD

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3
Q

What will reduce the incidence of amputations among DM population?

A

Early patient education and proper foot care reduces the incidence of amputations

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4
Q

Majority of LE amputations due to what?

A

vascular disease

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5
Q

Majority of UE amputations due to what?

A

trauma

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6
Q

Amputations among diabetics are (declining/increasing), but the number of diabetics are (decreasing/increasing).

A

Amputations among diabetics are declining, but the number of diabetics are increasing

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7
Q

Combined illness burden of multiple co-morbidities will do what to risk of amputations?

A

Increase risk

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8
Q

Males =/> females for dysvascular and trauma related amputations

A

males > females

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9
Q

Amputations more common in what 3 groups?

A
  1. African Americans
  2. Hispanic Americans
  3. Native Americans
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10
Q

Trauma and cancer related amputations are (decreasing/increasing)

A

Decreasing

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11
Q

4 Causes of amputation:

A
  1. Diabetes and PAD (Dysvascular Disease)
  2. Trauma
  3. Cancer
  4. Congenital deficiencies
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12
Q

What is the primary complication leading to amputation?

A

non-healing diabetic ulceration

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13
Q

Describe how diabetes can lead to amputation:

A
  1. Elevated blood sugars- Damages blood vessels and nerves
  2. Loss of protective sensation
    - Ability to recognize when something is uncomfortable to feet
    - Blister or minor injury
  3. Ulceration- Non-healing
  4. Amputation
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14
Q

Clinical signs of peripheral neuropathy:

A
  1. Deficits of sensation
  2. Motor impairments
  3. Autonomic Dysfunction (changes in skin
    coloration, distal loss of hair)
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15
Q

Peripheral neuropathy leaves the foot vulnerable to what type of pressures?

A

Vulnerability of the foot to high-pressure and repetitive low-pressure traumas

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16
Q

Other diabetic complications leading to amputation:

A
  1. Severe ischemic pain
  2. Absent pulses
  3. Local necrosis
  4. Osteomyelitis (bone death)
  5. Systemic toxicity
  6. Acute embolism
  7. DVT
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17
Q

PAD -

A

Peripheral artery disease - is a common circulatory problem in which narrowed arteries reduce blood flow to your limbs

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18
Q

Intermittent claudication -

A
  • leg pain brought about activity

- Test = walking test, experience cramping that is relieved with rest

19
Q

Classic symptoms of PAD:

A
  1. Intermittent claudication

2. Loss of one or more LE pulses (dorsalis pedi, popliteal pulse)

20
Q

Risk factors for PAD:

A
  1. Poorly managed HTN
  2. High cholesterol & triglyceride levels
  3. History of tobacco use
21
Q

T/F All diabetic patients receive foot screen.

A

True

22
Q

What is included in diabetic foot screen?

A
  1. Protective sensation (10 kg monofilament)
  2. Skin Temp (palpation for elevated skin temp = underlying inflammatory mechanism)
  3. Distal pulses
  4. Visual observation:
    - Nail shape and color
    - Deformities (claw toe)
    - Swelling (poor venous return)
    - Callus formation
    - Dry skin
23
Q

Recommendations for DM patients for foot screens:

A
  1. Daily for all DM patients
  2. Can’t see feet - mirror, caregiver, work on impairments to help get in position to see feet
  3. Shoes
24
Q

What two things are the major predisposing risk factors for lower extremity amputation in individuals with DM?

A
  1. Peripheral neuropathy

2. PAD

25
Q

Amputations in the DM population are associated with

A 
Significant morbidity
Significant functional limitations
Future disability
Another LE amputation
Mortality (33% in one-year)
↑ Health care costs
26
Q

Unexpected injury to an extremity that results in immediate separation of the limb or will result in the loss of the limb as a result of accident or injury

A

Trauma

27
Q

Leading causes of trauma induced amputations:

A
  1. MVA
  2. Farming accidents
  3. Power tools
  4. Firearms
  5. Burns and electrocution
28
Q

Typical patient profile of amputation due to trauma:

A
  • MEN
  • 20-29 years old
  • Primary cause of UE amp
29
Q

T/F Trauma induced amputee will have increased psychological impact.

A

True

30
Q

Challenges of traumatic amputations -

A
  1. Limb length, shape
  2. Partial v. full amputation
  3. Multiple surgeries
  4. Tissue viability and loss
  5. Pain
  6. Other injuries
31
Q

Amputations due to cancer are a result of what?

A

osteosarcoma at or near epiphysis of long bones

32
Q

Amputations due to cancer are where?

A
  1. Distal femur
  2. Proximal tibia
  3. Proximal humerus
33
Q

Amputee cancer patients are often what sex? Age?

A

male, late childhood thru early adulthood

34
Q

Other factors to consider with cancer amputee:

A
  1. Chemo and radiation

2. Surgery

35
Q

What to look for with osteosarcoma?

A
  • Pain with weightbearing
  • Hx of worsening, deep local pain
  • Fractures
36
Q

Congenital deficiency -

A

Absence of all or part of a limb at birth (7.9 per 100K live births)

37
Q

T/F Surgical intervention less common with congenital deficiency amputee.

A

True

38
Q

Challenges of congenital deficiency amputee:

A

Rapid growth
Cosmesis
Provide for function

39
Q

T/F Dysvascular disease is leading cause of LE amputation

A

True

40
Q

T/F Females more affected than males

A

False, males

41
Q

T/F Lower limb 11x more likely than upper limb

A

True

42
Q

T/F Traumatic amputations are more likely to occur in men, 20-29 years old

A

True

43
Q

T/F Traumatic amputations is 3rd leading cause

A

False, cancer is 3rd leading cause

44
Q

T/F Congenital deformity/deficiency is less than 1% of all amputations

A

True

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