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Critical limb ischemia is diagnosed by the presence of ischemic rest pain, and an ulcers that will not heal or gangrene due to insufficient blood flow. [3] Insufficient blood flow may be confirmed by ankle-brachial index (ABI), ankle pressure, toe-brachial index (TBI), toe systolic pressure, transcutaneous oxygen measurement (TcpO2 ), or skin perfusion pressure (SPP).
In a normal subject the pressure at the ankle is slightly higher than at the elbow (there is reflection of the pulse pressure from the vascular bed of the feet, whereas at the elbow the artery continues on some distance to the wrist). [citation needed] The ABPI is the ratio of the highest ankle to brachial artery pressure.
On inspection the clinician looks for signs of: trauma; previous surgery ()muscle wasting/muscle asymmetry; edema (swelling) erythema (redness); ulcers – arterial ulcers tend to be on the borders / sides of the foot, neuropathic ulcers on the plantar surface of the foot, venous ulcers tend on be on the medial aspect of the leg superior to the medial malleolus.
Peroneal nerve paralysis is a paralysis on common fibular nerve that affects patient’s ability to lift the foot at the ankle. The condition was named after Friedrich Albert von Zenker . Peroneal nerve paralysis usually leads to neuromuscular disorder, peroneal nerve injury, or foot drop which can be symptoms of more serious disorders such as ...
Intermittent claudication, also known as vascular claudication, is a symptom that describes muscle pain on mild exertion (ache, cramp, numbness or sense of fatigue), [1] classically in the calf muscle, which occurs during exercise, such as walking, and is relieved by a short period of rest.
After a few hours, the pain does subside but can return after prolonged periods of standing. Plantar fasciitis is most common in runners, obese individuals, women who are pregnant and those who wear shoes with inadequate heel support. The treatment of this agonizing disorder involves pain control, steroid injections, proper foot wear and rest.
It results in pain in the heel and bottom of the foot that is usually most severe with the first steps of the day or following a period of rest. [2] [4] Pain is also frequently brought on by bending the foot and toes up towards the shin. [3] [4] The pain typically comes on gradually, and it affects both feet in about one-third of cases. [2] [3]
A pulse pressure is considered abnormally low if it is less than 25% of the systolic value. [2] If the pulse pressure is extremely low, i.e. 25 mmHg or less, it may indicate low stroke volume, as in congestive heart failure. [3] The most common cause of a low (narrow) pulse pressure is a drop in left ventricular stroke volume.
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