Vascular and Neuropathic Assessment
Worried about your circulation? Peripheral artery disease (PAD) is a buildup of cholesterol and plaque in the arteries that lead to the extremities. PAD can cause discomfort in your legs and feet, limit your walking and activities, or severe PAD can progress to loss of limb. We at Dr Foot Podiatry surgery provide Vascular and Neuropathic Assessments and reports for patients. This is a 1 hour appoitment and consists of many diagnostic tests.
An ankle brachial pressure index (ABPI) is a simple non-invasive method of identifying arterial insufficiency within a limb.
It compares the ankle and brachial (arm) systolic blood pressures. An important factor determining the rate of healing of any wound is adequate arterial blood supply. In the management of leg and foot ulcers, the ABPI forms a fundamental part of the assessment. It should be noted that the ABPI should not be undertaken in isolation, but should be used in conjunction with a holistic assessment, and a medical and clinical examination of the limb.
A Doppler ultrasound test uses reflected sound waves to evaluate blood as it flows through a blood vessel. It helps evaluate blood flow through the major arteries and veins of the feet. It can show blocked or reduced blood flow through narrowing in the major arteries. It also can reveal blood clots in leg veins (deep vein thrombosis, or DVT) that could break loose and block blood flow to the lungs (pulmonary embolism).
During Doppler ultrasound, a handheld instrument (transducer) is passed lightly over the skin above a blood vessel. The transducer sends and receives sound waves that are amplified through a microphone. The doctor listens to the sounds produced by the transducer to evaluate the blood flow through an area that may be blocked or narrowed.
Neuropathy is usually diagnosed based on your symptoms, your medical history and a physical exam. During the exam, your podiatrist is likely to check your muscle strength and tone, tendon reflexes, and sensitivity to touch, temperature and vibration.
Different nerves are in charge of transmitting different sensory messages, such as temperature, touch, and vibration. Damaged nerves can’t transmit messages as well as they should, so these tests can be very helpful in narrowing down which nerves are affected.
Pulse oximetry is a noninvasive method for monitoring a person's oxygen saturation (SO2). Its reading of SpO2 (peripheral oxygen saturation) is not always identical to the reading of SaO2 (arterial oxygen saturation) from arterial blood gas analysis, but the two are correlated enough within an acceptable deviation such that the safe, convenient, noninvasive, inexpensive pulse oximetry method is valuable for measuring oxygen saturation in clinical use.
Sensation tests carried out at Dr Foot Podiatry Surgery include:
Temperature: The doctor will hold a very hot or very cold object near your skin to test how well you can feel temperature.
Touch: He or she may actually prick you with a pin to see how well your touch nerve fibers are working. These are the fibers that not only tell you when you’ve come into contact with something, but they also tell you when you’ve been hurt (e.g., developed a sore or blister, or stepped on a shard of glass).
There is another way to test the touch nerves. The doctor may use a bendable nylon filament to test how much pressure you can feel. There are different-sized filaments that require different amounts of pressure to bend. By pushing a filament against the skin—on the foot, say—the doctor can measure how much force you can feel.
If you can feel a thin filament, then you can feel anything that touches your skin. If you can’t feel when a thicker filament is pushed against your skin, you probably have some degree of nerve damage.
Vibration: Using a tuning fork, the doctor will test how well you can feel vibrations. The vibration nerves are important for balance.
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