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Lusardi Chapter 17 - Etiology of Amputation 1 (Beginning - Diabetes and PAD)

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Section 1

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Traumatic Amputation

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7 years ago

Date created

Mar 1, 2020

Cards (40)

Section 1

(40 cards)

Traumatic Amputation

Front

This is most common cause of amputation in the young adult age group. The leading causes are machinery, power tools and appliances, firearms, and motor vehicle crashes as well as military injuries.

Back

Nerve Damage

Front

This causes peripheral neuropathy, a condition of loss of sensation to the feet.

Back

Peripheral Artery Disease

Front

The presence of this condition in people with diabetes is 4x greater than in people without it.

Back

Diabetes and Smoking

Front

These are the strongest risk factors for developing peripheral artery disease. Other risk factors include advanced age, hypertension and hyperlipidemia.

Back

Amputation

Front

The number of persons living with this will more than double in the next 45 years.

Back

Dysvascular Disease (2)

Front

This is is the most common health condition related to amputation, including PVD and PAD complicated by neuropathy.

Back

Foot Ulceration

Front

Peripheral neuropathy is one of the most crucial precursors of this, especially with the presence of dysvascular disease. Nonhealing or neuropathic ulcers precede approximately 80% of nontraumatic LE amputations in individuals with diabetes.

Back

Peripheral Artery Disease

Front

The major risk factors for the development of this condition are; - poorly managed hypertension - high serum cholesterol history of tobacco use

Back

Amputation (5)

Front

Currently, the most likely reasons for amputation are poor wound healing associated with diabetes and dysvascular disease, trauma or cancer.

Back

Primary Bone Cancers

Front

These are very rare and include 1) osteosarcoma, 2) chondrosarcoma and 3) Ewing sarcoma.

Back

Arteriosclerosis Obliterans

Front

In this condition, at least one major arterial pulse (dorsalis pedis - ankle, popliteal-knee, femoral - groin) is often absent or markedly impaired.

Back

Congenital Limb Deficiencies

Front

These, as well as the amputations used to adjust or correct them are rather rare and not much has changed over time in the prevalence of these deficiencies.

Back

Trauma

Front

This is the second leading cause of amputation.

Back

Peripheral Neuropathy

Front

This is the most common risk factor for foot ulcers in people with diabetes.

Back

Vascular Insufficiency

Front

Two symptoms of this condition are intermittent claudication and loss of one or more lower extremity pulses.

Back

Diabetes (3)

Front

Peripheral neuropathy and peripheral artery disease are major predisposing factors for lower extremity amputation in individuals with this condition.

Back

Dysvascular Disease (3)

Front

This typically affects both lower extremities and therefore individuals will often undergo amputation of both lower extremities.

Back

Neuropathy

Front

This is a major contributor to diabetic amputations.

Back

Bony Deformity

Front

Motor neuropathy and associated weakness and atrophy contribute to the development of this of the foot.

Back

Healthy People 2020 Goals

Front

(1) to attain high-quality, longer lives free of preventable disease, disability, injury, and premature death; (2) to achieve health equity, eliminate disparities, and improve the health of all groups; (3) to create social and physical environments that promote good health for all; and (4) to promote quality of life, healthy development, and healthy behaviors across all life stages

Back

Diabetes

Front

This is the leading cause of nontraumatic lower extremity amputation.

Back

Diabetic Peripheral Neuropathy (2)

Front

There is no gold standard for diagnosing this, its symptoms are similar to those of regular neuropathy and include numbness or reduced ability to feel pain, muscle weakness, difficulty walking and serious foot issues

Back

Osteosarcoma (2)

Front

Amputation is no longer the primary intervention for this disease and the current rate of amputation is less than 1% for this condition.

Back

Blood Vessels

Front

Health conditions that affect these - peripheral vascular disease - peripheral artery disease - diabetes are the leading causes of amputation.

Back

Neuropathy (2)

Front

This is as important and powerful as dysvascular disease as a predisposing factor for lower extremity amputations.

Back

PPeripheral Artery Disease

Front

The clinical presentation of this can be variable and may not produce symptoms of limb pain. It can produce typical claudication pain, atypical leg pain or critical limb ischemia.

Back

Diabetes (2)

Front

The leading cause of new cases of nontraumatic lower extremity amputations among adults.

Back

Blood Sugars

Front

When these are elevated due to diabetes, they damage blood vessels and nerve fibers and impair circulation.

Back

Peripheral Neuropathy

Front

This condition is suspected when 1 or more of the following clinical signs are present; (1) deficits of sensation (loss of Achilles and patellar reflexes, decreased vibratory sensation, and loss of protective sensation), (2) motor impairments (weakness and atrophy of the intrinsic muscles of the foot), (3) autonomic dysfunction (inadequate or abnormal hemodynamic mechanism, tropic changes of the skin, and distal loss of hair).

Back

Amputation (4)

Front

This can be performed as a disarticulation of a joint or a transection through a long bone. The level is named by the joint or major bone through which it has been made.

Back

Amputation (2)

Front

Predisposing factors for this include; - diabetes - hypertension - dylipidemia

Back

Amputation (3)

Front

This is no longer the primary intervention for osteosarcoma because of new surgical techniques, advancements in chemo and radiation. It will only be done if the tumor is located in the anatomic region not amendable to limb salvage.

Back

Lower Limb Amputations (2)

Front

Clinical factors that contribute to this in people with diabetes include lower extremity infection due to nonhealing neuropathic foot ulcers, severe ischemic pain, absent or decreased pulses, local necrosis, osteomyelitis, systemic toxicity, acute embolic disease, and severe venous thrombosis.

Back

Diabetic Peripheral Neuropathy

Front

This is defined by the American Diabetes Association as the presence of symptoms/signs of peripheral nerve dysfunction in people with diabetes after the exclusion of other causes.

Back

Cancer

Front

This is the third cause of limb loss.

Back

Amputation Surgeries

Front

These surgeries that are most commonly performed involve the lower extremity below the knee.

Back

Osteosarcoma

Front

This is the tumor most commonly associated with amputation and primarily affects children in the 11-20 age group.

Back

Dysvascular Disease

Front

The leading cause of amputation

Back

Intermittent Claudication

Front

This is significant cramping pain, usually in the calf, that is induced by walking or another prolonged muscle contraction and is relieved by a short period of rest.

Back

Upper Limb

Front

Because of teh nature of skilled hand function, prosthetic substitution for this limb doesn't typically restore function to the same degree.

Back