Archive:Diabetic Foot Exam: Difference between revisions
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===General=== | ===General=== | ||
*gait, shoes, heels | *gait, shoes, heels | ||
{{ntnes}} | |||
===Skin=== | ===Skin=== | ||
*vascular insufficiency - hairlessness, pallor | *vascular insufficiency - hairlessness, pallor | ||
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===Other=== | ===Other=== | ||
*webspaces: cracked, infected, ulcers | *webspaces: cracked, infected, ulcers, maceration | ||
*toe nails: dystrophic, in grown, [paronychia], [Onychomycosis] | *toe nails: dystrophic, in-grown, [[wikipedia:paronychia|paronychia]], [[wikipedia:Onychomycosis|Onychomycosis]] | ||
==Palpation== | ==Palpation== | ||
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===Temperature=== | ===Temperature=== | ||
*use back of hand, compare shin to feet, bilaterally | *use back of hand, compare shin to feet, bilaterally | ||
*temperature should decrease slightly as you get toward the toes | |||
===Other=== | ===Other=== | ||
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===Motor=== | ===Motor=== | ||
*intrinsic muscle wasting (clawed, hammer toes) | *intrinsic muscle wasting (clawed, hammer toes) | ||
*[Pes planus], [Pes cavus] | *[[wikipedia:Pes planus|Pes planus]], [[wikipedia:Pes cavus|Pes cavus]] | ||
*'''Charcot joints''' (medial and laterial deviation at subtalar joint) | *'''Charcot joints''' (medial and laterial deviation at subtalar joint) | ||
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*DTR: ↓ ankle jerk | *DTR: ↓ ankle jerk | ||
==Other OSCE modules== | |||
{{OSCE2}} | {{OSCE2}} | ||
[[Category: | [[Category:Clinical Skills]][[Category:OSCE]][[Category: Endocrinology]] | ||
Latest revision as of 05:48, 7 June 2009
Inspection
General
- gait, shoes, heels
Skin
- vascular insufficiency - hairlessness, pallor
- rubor at pressure points
- skin breakdown (portal for infections)
- diabetic dermopathy (brown macules) over shins
- infection: cellulitis (erythema, swelling), gangrene
Other
- webspaces: cracked, infected, ulcers, maceration
- toe nails: dystrophic, in-grown, paronychia, Onychomycosis
Palpation
Pulses
- femoral
- popliteal
- posterior tibial
- dorsalis pedis
Temperature
- use back of hand, compare shin to feet, bilaterally
- temperature should decrease slightly as you get toward the toes
Other
- Capillary refill
Ascultation
- Bruits: femoral, popliteal
Neurological
Sensory
- ↓ vibration (1st modality to loose, 128 Hz)
- ↓ light touch (microfilament)
- ↓ pin prick
- ↓ proprioception
- ↓ temperature
- (loss in glove and stocking distribution)
Autonomic
- ↓ sweating
- dry cracked skin
Motor
- intrinsic muscle wasting (clawed, hammer toes)
- Pes planus, Pes cavus
- Charcot joints (medial and laterial deviation at subtalar joint)
Reflexes
- DTR: ↓ ankle jerk
Other OSCE modules
Acute Confusion - Acute Coronary Syndrome Orders - Anemia - Arterial Blood Gasses - Asthma - Blood Pressure - Chest pain - Chest XRay - CHF - Coma - COPD - Cranial Nerves - Diabetic History - Diabetic Foot - Dysphagia - EKGs - Gallbladder and Liver - Liver Disease - Gait and Balance - Headache - Hematemesis - Hypertension - Jugular Venous Pulses - Knee Exam - Lymph Nodes - Community Acquired Pneumonia - Parkinson Disease - Peripheral Arterial Insufficiency - Pneumonia Examination - Precordial Exam - STD's - Spleen - Swollen Leg Exam - Thyroid Exam - Upper vs Lower Motor Neuron Lesions - Urinary Incontinence