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Prosthetics > 3: Examination > Flashcards

3: Examination Flashcards

1
Q

Describe the technique of assessing pallor with elevation?

A

Position the pt in supine and note the color of the soles of the feet. Elevate the legs above 45 degrees for one minute and observe color

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2
Q

What is a positive pallor with elevation test indicative of?

A

Ischemia

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3
Q

How long does it take to see pallor with elevation if there is moderate arterial insufficiency?

A

30-45 seconds

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4
Q

How long does it take to see pallor with elevation if there is mild arterial insufficiency?

A

45-60 seconds

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5
Q

How long does it take to see pallor with elevation if there is no arterial insufficiency?

A

Greater than one minute

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6
Q

Describe the rubor of dependency test

A

Upon completion of the pallor of elevation test, bring the pt into sitting and observe the color of the feet

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7
Q

If the feet turn bright red during the rubor of dependency test, what is it indicative of?

A

Ischemia - causes significant vasodilation

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8
Q

How fast should normal color return during rubor of dependency if there is normal blood flow?

A

15-20 seconds

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9
Q

How will a pt respond to the rubor of dependency test if they have severe arterial insufficiency?

A

Pallor with elevation in less than 25 seconds that is followed by a bright red appearance

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10
Q

Describe how to assess venous filling time

A

Observe LE and veins to establish baseline, then elevate LE for 1 minute or until vein collapses. Bring pt to sitting and record time it takes vein to refill

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11
Q

What is considered normal venous filling time?

A

5-15 seconds

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12
Q

How long will it take for the veins to refill if the pt has arterial insufficiency?

A

Greater than 20 seconds

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13
Q

If a pt’s venous filling time is greater than 20 seconds, what is it indicative of?

A

Arterial insufficiency

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14
Q

What is indicated if a pt’s venous filling time is immediate?

A

Venous insufficiency

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15
Q

Describe how to assess capillary refill

A

Apply pressure to distal extremity and observe refill

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16
Q

What timeframe is appropriate for capillary refill?

A

Immediately

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17
Q

How is pitting edema scored?

A

0-4+ based on rebound time

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18
Q

What is considered to be a 0 on the pitting edema scale?

A

No pitting observed

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19
Q

What is considered to be a 1+ on the pitting edema scale?

A

Barely perceptible

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20
Q

What is considered to be a 2+ on the pitting edema scale?

A

Skin rebound less than 15 seconds

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21
Q

What is considered to be a 3+ on the pitting edema scale?

A

Skin rebound in 15-30 seconds

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22
Q

What is considered to be a 4+ on the pitting edema scale?

A

Skin rebound in 30 seconds or more

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23
Q

What two scales can be used to assess pulses?

A

0-4+ or 0-2

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24
Q

If you are assessing pulses with the 0-4+ scale, what does 0 indicate?

A

Unable to palpate pulse

25
Q

If you are assessing pulses with the 0-4+ scale, what does 1+ indicate?

A

Barely perceptible

26
Q

If you are assessing pulses with the 0-4+ scale, what does 2+ indicate?

A

Weak

27
Q

If you are assessing pulses with the 0-4+ scale, what does 3+ indicate?

A

Normal

28
Q

If you are assessing pulses with the 0-4+ scale, what does 4+ indicate?

A

Bounding pulse, possible charcot joint or aneurysm

29
Q

If you are assessing pulses with the 0-2 scale, what does 0 indicate?

A

Absent

30
Q

If you are assessing pulses with the 0-2 scale, what does D indicate?

A

Doppler

31
Q

If you are assessing pulses with the 0-2 scale, what does 1+ indicate?

A

Normal

32
Q

If you are assessing pulses with the 0-2 scale, what does 2 indicate?

A

Increased

33
Q

What is the ABI?

A

Ankle brachial index is a noninvasive test to diagnose peripheral artery disease

34
Q

What is the equation for the ABI?

A

Systolic at the ankle / systolic at the brachium

35
Q

What is the gold standard for assessing peripheral artery disease?

A

ABI

36
Q

What is a normal ABI value?

A

1.0 - 1.29

37
Q

What ABI value is considered to be borderline?

A

0.91 - 0.99

38
Q

What ABI value is considered to be mild PAD?

A

0.71 - 0.90

39
Q

What ABI value is considered to be medium severe PAD?

A

0.41 - 0.70

40
Q

What ABI value is considered to be severe PAD?

A

< 0.40

41
Q

What is the leading cause of foot ulceration?

A

Loss of protection sensation

42
Q

What are the two methods of conducting a sensory assessment?

A

Semmes-Weinstein monofilament and tuning fork

43
Q

What size monofilament is used to assess sensation?

A

5.07 monofilament

44
Q

How much force is applied with 5.07 monofilament?

A

10 g of perpendicular force

45
Q

What level tuning fork can be used to assess sensation?

A

128 Hz

46
Q

Which is a more sensitive assessment, tuning fork or monofilament?

A

Tuning fork

47
Q

What are 4 characteristics of an ideal residual limb?

A
  1. Durable
  2. Well-vascularized
  3. Tolerates pressure in weight bearing areas
  4. Tolerates friction in areas covered by prosthetic socket
48
Q

What is the name of this residual limb shape?

A

Bulbous

49
Q

What is the name of this residual limb shape?

A

Conical

50
Q

What is the name of this residual limb shape?

A

Cylindrical

51
Q

What is the name of this residual limb shape?

A

Dog ears

52
Q

What is the name of this residual limb shape?

A

Complicated

53
Q

What limb shape is ideal?

A

Cylindrical

54
Q

What is required prior to assessing strength?

A

MD clearance to add any resistance beyond gravity

55
Q

How long after an amputation until a pt will typically receive MD clearance?

A

7-10 days once drains and staples are removed and the wound is closed

56
Q

What are 10 methods for preventative foot care?

A
  1. Wash daily and dry
  2. Apply thin coat of moisturized daily but avoid between toes
  3. Trim nails after washing and trying feet
  4. Cut nails straight across
  5. Have podiatrist assist with thick or ingrown nails
  6. Gently use pumice stone for corns or calluses
  7. Check water temp with thermometer
  8. Wear socks at night for cold feet
  9. Sunscreen on tops of feet
  10. Health care screen
57
Q

How often should pt’s be inspecting their feet?

A

Daily

58
Q

Should pt’s walk bearfoot?

A

No - use slippers at night and special shoes on the beach

59
Q

Should pt’s wear sandals with thongs between the toes?

A

No

Prosthetics (13 decks)

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