| 
               Physical Exam 
  
  
  
  
 | 
          
            
               | 
          
          
| 
               Vascular 
  
  
  
  
 | 
          
            
               | 
          
          
| 
               Dorsalis pedis pulses are- Right 
  
  
  
  
 | 
          
            
               left 
  
  
  
  
 | 
          
          
| 
               tibial pulses are graded at- right 
  
  
  
  
 | 
          
            
               left 
  
  
  
  
 | 
          
          
| 
               Digital hair growth is- Right 
  
  
  
  
 | 
          
            
               left 
  
  
  
  
 | 
          
          
| 
               CFT with the leg elevated- Right 
  
  
  
  
 | 
          
            
               Left 
  
  
  
  
 | 
          
          
| 
               Evidence of ischemic skin changes? 
  
  
  
  
 | 
          
            
               Note Ischemic Changes 
  
  
  
  
 | 
          
          
| 
               Temperature, Texture, and Turgor 
  
  
  • • •
  
 | 
          
            
               | 
          
          
| 
               Edema 
  
  
  • • •
  
 | 
          
            
               | 
          
          
| 
               Vascular Free Text 
  
  
  
  
 | 
          
            
               | 
          
          
| 
               Neurologic Exam 
  
  
  
  
 | 
          
            
               | 
          
          
| 
               5.07 monofilament test displayed 
  
  
  
  
 | 
          
            
               For both feet? 
  
  
  • • •
  
 | 
          
          
| 
               Vibratory sensation is- left foot 
  
  
  
  
 | 
          
            
               Vibratory sensation is- right foot 
  
  
  
  
 | 
          
          
| 
               Proprioception is 
  
  
  • • •
  
 | 
          
            
               | 
          
          
| 
               Neurological Free Text 
  
  
  
  
 | 
          
            
               | 
          
          
| 
               Dermatologic Exam 
  
  
  
  
 | 
          
            
               | 
          
          
| 
               Xerosis 
  
  
  
  
 | 
          
            
               Xerosis Location 
  
  
  
  
 | 
          
          
| 
               Skin Thin and Tight? 
  
  
  
  
 | 
          
            
               | 
          
          
| 
               Nail Changes 
  
  
  
  
 | 
          
            
               Thickened nails 
  
  
  • • •
  
 | 
          
          
| 
               Hyperkeratotic Lesions 
  
  
  
  
 | 
          
            
               Hyperkeratotic Lesion Location 
  
  
  
  
 | 
          
          
| 
               Presence of Wound 
  
  
  
  
 | 
          
            
               Describe Wound 
  
  
  
  
 | 
          
          
| 
               Varicosities 
  
  
  
  
 | 
          
            
               Varicosity Location 
  
  
  
  
 | 
          
          
| 
               Fat Pad Atrophy 
  
  
  
  
 | 
          
            
               | 
          
          
| 
               Dermatological Free Text 
  
  
  
  
 | 
          
            
               | 
          
          
| 
               Musculoskeletal Exam 
  
  
  
  
 | 
          
            
               | 
          
          
| 
               Gait 
  
  
  
  
 | 
          
            
               Foot Type 
  
  
  
  
 | 
          
          
| 
               Dorsiflexion Muscle Strength 
  
  
  
  
 | 
          
            
               Plantarflexion Muscle Strength 
  
  
  
  
 | 
          
          
| 
               Inversion Muscle Strength 
  
  
  
  
 | 
          
            
               Eversion Muscle Strength 
  
  
  
  
 | 
          
          
| 
               1st MTPJ 
  
  
  • • •
  
 | 
          
            
               Midtarsal Joint ROM 
  
  
  • • •
  
 | 
          
          
| 
               Subtalar Joint MTPJ 
  
  
  • • •
  
 | 
          
            
               Ankle Joint ROM 
  
  
  • • •
  
 | 
          
          
| 
               Pain Upon Palpation? 
  
  
  
  
 | 
          
            
               | 
          
          
| 
               Pain Location 
  
  
  
  
 | 
          
            
               | 
          
          
| 
               Musculoskeletal Free Text 
  
  
  
  
 | 
          
            
               | 
          
          
