05-03: Limb Length, Girth and Volume Flashcards Preview

05 - Tests and Measurements > 05-03: Limb Length, Girth and Volume > Flashcards

Flashcards in 05-03: Limb Length, Girth and Volume Deck (25):
1

Importance of height and weight

- Pt with disorders that may result in abnormal fluid retention
- Determining BMI for overweight/obese categories

2

Disorders with abnormal fluid retention (5)

- Diabetes
- Edema
- Lymphedema
- Venous disease
- Underlying cardiopulmonary disease

3

Standing LLD (Appearance)

One LE appears longer than other, or 1 side of pelvis is elevated

4

Supine LLD (Appearance)

One LE appears longer than other
- Patella not aligned
- Malleoli not aligned

5

Lift and level pelvis

One LE appears longer

6

Assessing limb length - standing

Pelvis level (ASIS, PSIS, Iliac Crest)

7

Assessing limb length - supine

Measure (Compare both limbs, identify which is longer/shorter in relation to the other)

8

Measuring apparent LLD

- Pt supine (hips flexed, knees flexed, back)
- Measure umbilicus to medial mallelolus (inferior, most distal part of malleolus)
- Compare one side to other (if pt measured previously, measure both again to compare with previous)

9

What can alter apparent LLD measurement

- Position of foot,
- Atrophy
- Body mass
- Pelvic obiquity

10

Causes of apparent LLD

- Pelvic obiquity (ASIS and/or PSIS not level)
- Hip adduction deformity (Increased tone can drop pelvis a little bit)
- HIp flexion deformity (may appear shorter because of limb shortening

11

Measuring True LLD

- Pt supine (hips flexed, knees flexed, back)
- Measure ASIS (just inferior to ASIS) to medial mallelolus (bony prominence to bony prominence)
- Compare one side to other (if pt measured previously, measure both again to compare with previous)

*European - ASIS to lateral malleolus (thigh mass may interfere during measurement to lateral malleolus

12

Real leg length

- True leg length
- ASIS to distal medial malleolus

13

Determining location of LLD

- Pt supine, both knees flexed 90˚, feet flat
- one knee higher = longer tibia
- one knee projects further distally = longer femur

14

LLD Correction

- If difference more than 1/2 inch (1 cm), compensate by placing shoe lift in pt shoe
- If pt has weakness and difficulty with swing through, shoe lift in contralateral side (short term(

15

Reasons for limb girth measurements (3)

- Atrophy
- Hypertrophy
- Edema

16

Measuring limb girth

- Use tape measure specifically designed for measuring circumference of limb
- Measure in reference to bony landmarks (specify location, repeat measurements using same landmarks when re-assessing limb girth)
- Measure in consistent increments (multiple, the smaller the increments, the better representation)

17

Measuring Edema

- Girth measurements
- Pitting (Depth of pitting, time of refilling)
- Staging
- Grading

18

Staging Edema (Stage I)

- Reversible edema
- Elevation to reduce swelling
- Pits on pressure

19

Staging Edema (Stage II)

- Spontaneously irreversible lymphedema (fibrous)
- Minimal pitting even with moderate swelling

20

Staging Edema (Stage III)

- Lymphostatic elephantiasis (large limbs)
- Appearance of skin is elephant-like (bumps, skin changes consistency)

21

Grading Edema (all occurs within 30 sec window)

1+ = Indentation is barely detectable
2+ = Slight indentation visible when skin is depressed, returns to normal in 15 sec
3+ = Deeper indentation occurs when pressed and returns to normal within 30 sec
4+ = Indentation lasts for more than 30 sec

22

Interventions for Edema (3)

- Cryotherapy
- Compression
- Elevation

23

Archimede's Principle

Water volume displaced is equal to the volume of the object immersed in the water

24

Volumeter

Device used to measure volumes of liquids by the amount they displace

25

Volumetric measurements

- Measures edema by amount of water displaced
- Comparison with uninvolved side provides baseline
- Only appropriate for some body parts