![]() ‘To complete my examination, I would perform a full neurovascular examination.Motor: muscle wasting, pes planus, pes cavus, Charcot joints.If they cannot tell, test more proximal joints in succession until they can. Wiggle the distal phalanx up and down a few times, then stop and ask the patient if their toe is up or down. ![]() Flex and extend the joint with the patient watching these movements and then ask them to close their eyes. Proprioception: hold the distal phalanx of the big toe with a finger on each side (while stabilising the proximal phalanx with your other hand).Start over first MTP joint and move to proximal joints if the patient cannot feel it. Then test the patients feet, placing the tuning fork on the bony joint of each. Objective: To describe the clanging tuning fork (CTF) test, a novel method for using the C 128-Hz tuning fork to test for diabetic peripheral neuropathy (DPN), to evaluate the accuracy and reproducibility of this technique, and to compare it with the 5.07 (10 g) Semmes-Weinstein monofilament test. First let patient feel the sensation on their sternum, then ask them to close their eyes and tell you when they feel a vibration on their feet and when they feel it stop (stop the vibration yourself by gripping the prongs). 128Hz Tuning fork: use your fingers to twang prongs and hold circular base on the patient’s joint.First let patient feel the sensation on their sternum, then ask them to close their eyes and tell you when they feel you touch their feet. 10g monofilament: fully extend the monofilament and press with enough force to make it bend.Sensory: show patient how each feels on sternum before and ask them to close their eyes.Capillary refill (should be Pulses: femoral, popliteal, posterior tibial, dorsalis pedis.Temperature: use dorsum of each hand to feel up legs.
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