limbs examination

Click here to load reader

Download Limbs examination

Post on 11-May-2015

1.428 views

Category:

Documents

0 download

Embed Size (px)

TRANSCRIPT

  • 1.Introduction to Clinical SkillsLimbs Examination Universidad Iberoamericana UNIBE

2. Introduction to Clinical Skills

  • Teaching Staff
    • Dra Elizabeth Peralta
    • Dr Marcos Nez
    • Dra Cristina Pez C
    • Dr Juan Carlos Mariez
    • Dra Wayna Greo
    • Dra Yun Pey Lee

3. Introduction to Clinical Skills

  • Objectives
    • Skin and Appendages
    • Peripheral Vascular
    • Neurological (Peripheral)
      • Sensory, Motor, Reflexes
    • Muscle-skeletal
      • Muscle tone, Muscle strength

4. Introduction to Clinical SkillsLower Extremities Universidad Iberoamericana UNIBE 5. Introduction to Clinical Skills

  • Skin and Appendages
    • Embriology-Anatomy-Histology-Physiology
    • The Health History
    • Health Promotion and Counseling

6. Introduction to Clinical Skills

  • Skin and Appendages
    • Embriology -Anatomy-Histology-Physiology
      • 11 weeks

1.Periderm 2. Basal layer 3. Intermediate layer 4. Migrating melanoblast 5. Mesenchyme 7. Introduction to Clinical Skills

  • Skin and Appendages
    • Embriology- Anatomy -Histology-Physiology

8. Introduction to Clinical Skills

  • Skin and Appendages
    • Embriology-Anatomy- Histology -Physiology

9. Introduction to Clinical Skills

  • Skin and Appendages
    • Embriology-Anatomy-Histology- Physiology

10. Introduction to Clinical Skills

  • Skin and Appendages
    • The Health History
      • Rash
      • Moles (Nevus)
    • Health Promotion and Counseling
      • Risk factors for skin cancers
      • Avoidance of excessive sun exposrure
      • Avoid skin dryness
      • Nail cutting (pedicure)
      • Shoes

11. Introduction to Clinical Skills

  • Skin and Appendages
    • Forefoot Types

12. Introduction to Clinical Skills

  • Peripheral vascular exam
    • Anatomy
    • The Health History
    • Health Promotion and Conseling

13. Introduction to Clinical Skills

  • Peripheral vascular exam
    • Anatomy

14. Introduction to Clinical Skills

  • Peripheral vascular exam
    • The Health History
      • Pain in the legs
      • Intermittent claudication
      • Cold, numbness, pallor in the legs, hair loss
      • Swelling in calves, legs or feet
      • Color change in toes in cold weather
      • Swelling with redness or tenderness

15. Introduction to Clinical Skills

  • Peripheral vascular exam
    • Health Promotion and Counseling
      • Screening for peripheral arterial disease
      • Screening for renal artery disease
      • Screening for abdominal aortic aneurysm

16. Introduction to Clinical Skills

  • Peripheral vascular exam
    • Risk factors for Lower-Extremity arterial peripheral disease
      • Age younger than 50 years with diabetes or atherosclerosis risk factor ofsmoking, dyslipidemia, hypertension, or hyperhomocysteinemia
      • Age 50 to 60 years and history of smoking or diabetes
      • Age 70 years or older
      • Leg symptoms with exertion or ischemic rest pain
      • Abnormal lower extremity pulses
      • Known atherosclerotic coronary, carotid, or renal disease

17. Introduction to Clinical Skills

  • Peripheral vascular exam
    • Important Areas of Examination
      • The Legs
        • Size, symmetry, skin color
        • Femoral pulse and inguinal lymph nodes
        • Popliteal, posterior tibialis and dorsalis pedis pulses
        • Peripheral edema

18. Introduction to Clinical Skills

  • Peripheral vascular exam
    • Important Areas of Examination
      • Arterial system exam
        • Anatomy
        • Pallor, cyanosis
        • Color and capillary refill
        • Postural changes
        • Extremity pulses ( 0 to 2+)
        • Ankle Brachial Index

19. Introduction to Clinical Skills

  • Peripheral vascular exam
    • Important Areas of Examination
      • Arterial system exam

20. Introduction to Clinical Skills

  • Peripheral vascular exam
    • Important Areas of Examination
      • Arterial system exam

21. Introduction to Clinical Skills

  • Peripheral vascular exam
    • Important Areas of Examination
      • Venous system exam
        • Anatomy
        • Skin color, pigmentattion, ulcers
        • Postural changes
        • Venous pattern
        • Competency of venous valves
        • Soft edema

22. Introduction to Clinical Skills

  • Peripheral vascular exam
    • Important Areas of Examination
      • Venous system exam

23. Introduction to Clinical Skills

  • Peripheral vascular exam
    • Important Areas of Examination
      • Venous system exam

24. Introduction to Clinical Skills

  • Peripheral vascular exam
    • Important Areas of Examination
      • Lymphatic system exam
        • Anatomy
        • Skin color
        • Postural changes
        • Edema (soft vs brawny)
        • Palpable lymph nodes
        • Painful lymh nodes
        • Red striking tracts

25. Introduction to Clinical Skills

  • Peripheral vascular exam
    • Recording your findings
      • Extremities are warm and without edema. No varicosities or stasis changes. Calves are supple and nontender. No femoral or abdominal bruits. Femoral, popliteal, posterior tibialis and dorsalis pedis pulses are 2+ and symmetric

26. Introduction to Clinical Skills

  • Periphe