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Flashcards in Neurovascular examination of the lower limbs Deck (9)
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1

what should you look for on a general inspection

BMI, respiration, ketones, dehydration

2

what should you measure after the general inspection

rate and rhythm at radial pulse (autonomic neuropathy)
measure BP (lying and standing if possible postural hypotension)

3

what should you look for on the lower limbs

colour, pallor, cyanosis, redness
skin: hair loss, dry, eczema, atrophic skin, pustules, abcesses, infections, fungal infections
neuropathic joints (charcot joints)
calluses

4

how should you palpate the lower limbs

assess temperature of limbs (both legs simultaneously)
check capillary refill time in the feet
assess pulse in both limbs (3)
fine touch (monofilament) in at least 5 areas of the foot
sharp and dull
vibration sense
proprioception (toe up/down)

5

what reflexes should you look for

ankle reflexes
(peripheral sensory neuropathy)

6

how should you asses gait

smoothness and symmetry
look for foot drop, broad based gait, antalgic gait
turning
examine shoes

7

how should you inspect the eyes

look with naked eyes and ophthalmoscope

8

what other investigations should you do

assess for dyslipidaemia
obs chart
urinalysis for glucose and nitrites

9

what are the stages of a neurovascular exam of the lower limbs

inspection
pulse and BP
inspection of lower limbs
palpation of lower limbs
reflexes
gait
other (eyes, obs chart, urinalysis)