thoughts anyone?! this is a podiatry exam with a systemic disease.
Vascular: dorsalis pedis pulses were ¼ equal and symmetrical bilateral. Posterior tibial pulse was nonpalpable bilateral. Edema to the lower 1/3 of the leg and at the anle region bilateral. Skin temperature warm to cool proximal to distal bilateral. Evidence of both elevation of pallor and dependent rubor to the lower extremity bilateral. Stasis changes and vacosities noted.
Neurological: light touch, sharp/dull, vibratory and proprioception are in tact to the feel bilateral.
Dermatological: pedal nails one through five on the right and one through five on the left were noted to be thickened , yellow, gray, brown, crumbly, and dystrophic with subungual debris. The nails range in thickness between 0.2 and 0.4 cm. There was noted to be a foul fungal odor and tenderness upon palpation of the nail plates. Skin color and condition was noted to be thin, shiny, and atrophic. Hair growth was noted to be absent to the dorsal aspect of the feet bilateral. No evidence of any corns, calluses, open lesions, rashes, macerations, or scars.
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q7, q8, q9 modifiers......