limbs examination
TRANSCRIPT
Introduction to Clinical Skills
Limbs Examination
Universidad Iberoamericana UNIBE
Introduction to Clinical Skills
Teaching Staff Dra Elizabeth Peralta Dr Marcos Núñez Dra Cristina Páez C Dr Juan Carlos Mariñez Dra Wayna Greo Dra Yun Pey Lee
Introduction to Clinical Skills
Objectives Skin and Appendages Peripheral Vascular Neurological (Peripheral)
Sensory, Motor, Reflexes
Muscle-skeletal Muscle tone, Muscle strength
Introduction to Clinical Skills
Lower Extremities
Universidad Iberoamericana UNIBE
Introduction to Clinical Skills
Skin and Appendages Embriology-Anatomy-Histology-Physiology The Health History Health Promotion and Counseling
Introduction to Clinical Skills
Skin and Appendages Embriology-Anatomy-Histology-Physiology
11 weeks
1.Periderm2. Basal layer3. Intermediate layer4. Migrating melanoblast5. Mesenchyme
Introduction to Clinical Skills
Skin and Appendages Embriology-Anatomy-Histology-Physiology
Introduction to Clinical Skills
Skin and Appendages Embriology-Anatomy-Histology-Physiology
Introduction to Clinical Skills
Skin and Appendages Embriology-Anatomy-Histology-Physiology
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
Introduction to Clinical Skills
Skin and Appendages Forefoot Types
Introduction to Clinical Skills
Peripheral vascular exam Anatomy The Health History Health Promotion and Conseling
Introduction to Clinical Skills
Peripheral vascular exam Anatomy
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
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
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 of smoking, 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
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
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
Introduction to Clinical Skills
Peripheral vascular exam Important Areas of Examination
Arterial system exam
Introduction to Clinical Skills
Peripheral vascular exam Important Areas of Examination
Arterial system exam
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
Introduction to Clinical Skills
Peripheral vascular exam Important Areas of Examination
Venous system exam
Introduction to Clinical Skills
Peripheral vascular exam Important Areas of Examination
Venous system exam
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
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”
Introduction to Clinical Skills
Peripheral neurological exam Sensory evaluation (sensory pathways) Motor exam (motor pathways) Reflexes (spinal reflexes: the deep tendon response)
Introduction to Clinical Skills
Peripheral neurological exam Sensory evaluation (sensory pathways)
Dermatomes Pinwheel
Digital nerves 2PD static
Introduction to Clinical Skills
Peripheral neurological exam Sensory evaluation (sensory pathways)
Introduction to Clinical Skills
Peripheral neurological exam Motor exam (motor pathways)
Body position Involuntary movements Muscle bulk Muscle tone Muscle strength
Introduction to Clinical Skills
Peripheral neurological exam Motor exam (motor pathways)
Introduction to Clinical Skills
Peripheral neurological exam Reflexes (spinal reflexes: the deep tendon response)
Patella Achilles tendon
Introduction to Clinical Skills
Peripheral neurological exam Reflexes (spinal reflexes: the deep tendon response)
Introduction to Clinical Skills
Peripheral neurological exam Reflexes (spinal reflexes: the deep tendon response)
Reinforcement of Knee Reflex
Introduction to Clinical Skills
Peripheral neurological exam Reflexes (spinal reflexes: the deep tendon response)
Introduction to Clinical Skills
Peripheral neurological exam Reflexes (Cutaneous stimulation reflex)
Introduction to Clinical Skills
Muscleskeletal exam Joint structure and function The Health History Health Promotion and Counseling Examination of specific joints
Spine and Hip Joints of lower extremities
Introduction to Clinical Skills
Muscleskeletal exam Joint structure and function
Introduction to Clinical Skills
Muscleskeletal exam The Health History Common or concerning Symptoms
Low back pain Monoarticular or polyarticular joint pain Inflammatory or infectious joint pain Joint pain with systemic features such fever, chills, rash, anorexia,
weight loss, weakness Joint pain with symptoms from other organ system
Introduction to Clinical Skills
Muscleskeletal exam Health Promotion and Counseling. Important Topics
Nutrition Low back: lifting biomechanics Prevneting falls Osteoporosis: screening and prevention
Introduction to Clinical Skills
Muscleskeletal exam Examination of specific joints
Introduction to Clinical Skills
Muscleskeletal exam Joint structure and function
Introduction to Clinical Skills
Muscleskeletal exam Joint structure and function
Introduction to Clinical Skills
Introduction to Clinical Skills
Upper Extremities
Universidad Iberoamericana UNIBE
Introduction to Clinical Skills
Skin and Appendages
Introduction to Clinical Skills
Skin and Appendages Embriology-Anatomy-Histology-Physiology
Introduction to Clinical Skills
Skin and Appendages Embriology-Anatomy-Histology-Physiology
Introduction to Clinical Skills
Skin and Appendages Embriology-Anatomy-Histology-Physiology
Introduction to Clinical Skills
Skin and Appendages Embriology-Anatomy-Histology-Physiology
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
Introduction to Clinical Skills
Peripheral vascular exam The Health History
Pain in the hands Intermittent claudication Cold, numbness, pallor in the hands, hair loss Swelling in arm, forearm and hand Color change in fingers in cold weather Swelling with redness or tenderness
Introduction to Clinical Skills
Peripheral vascular exam Arterial Venous Lymphatics
Introduction to Clinical Skills
Peripheral vascular exam Allen´s Test
Introduction to Clinical Skills
Peripheral vascular exam Allen´s Test
Introduction to Clinical Skills
Peripheral vascular exam Allen´s Test
Introduction to Clinical Skills
Peripheral vascular exam Allen´s Test
Introduction to Clinical Skills
Peripheral vascular exam Arterial Venous Lymphatics
Introduction to Clinical Skills
Peripheral vascular exam Arterial Venous Lymphatics
Introduction to Clinical Skills
Peripheral neurological exam Sensory
Pinwheel exam
Introduction to Clinical Skills
Peripheral neurological exam Sensory
2PD static or moving
Introduction to Clinical Skills
Peripheral neurological exam Sensory
Tinel´s sign
Introduction to Clinical Skills
Peripheral neurological exam Motor
Introduction to Clinical Skills
Peripheral neurological exam Flexion Extension Pronation Supination
Introduction to Clinical Skills
Peripheral neurological exam Ulnar deviation Radial deviation
Introduction to Clinical Skills
Peripheral neurological exam Fingers flexion Fingers extension
Introduction to Clinical Skills
Peripheral neurological exam Motor
Muscle Bulk Muscle Tone Muscle Strength
M0 –M5 Grip strength
Dynamometer
Introduction to Clinical Skills
Peripheral neurological exam Motor
Introduction to Clinical Skills
Peripheral neurological exam Motor
Introduction to Clinical Skills
Peripheral neurological exam Motor
Introduction to Clinical Skills
Peripheral neurological exam Motor
Introduction to Clinical Skills
Peripheral neurological exam Motor
Introduction to Clinical Skills
Peripheral neurological exam Reflexes
Introduction to Clinical Skills
Peripheral neurological exam Reflexes
Introduction to Clinical Skills
Muscleskeletal exam Muscles Bones Joints an ligaments
Introduction to Clinical Skills
Introduction to Clinical Skills