Blue boxes: foot

Question 1

Describe plantar fasciitis

Answer 1

• Inflammation of the plantar facia often caused by overuse
• Causes pain on the plantar surface of the foot and heel – most severe after sitting down and getting up in the morning
• Calcaneal spur may protrude from the medial tubercle which would cause pain when walking

Question 2

Describe a contusion of the extensor digitorum brevis

Answer 2

Can result in a hematoma which can create edema anteromedially to the lateral malleolus

can be mistaken for an ankle sprain

Question 3

Describe the anesthetic block of the superior fibular nerve

Answer 3

• After the superficial fibular nerve pierces the facia and becomes cutaneous, it branched into medial and intermediate cutaneous
• Injections of anesthetic agent around these branches in the ankle region (anterior to fibula) anesthetize skin on the dorsum of the foot – better than local injections on the dorsum itself

Question 4

Describe the plantar reflex

Answer 4

• L4-S2 tested on the lateral aspect of the dorsum of the foot by stroking a blunt object beginning at the heel and crossing to the big toe
• Flexion of the toes is a normal response – fanning of lateral 4 toes and dorsiflexion of big toe is an abnormal response (Babinski sign indicating brain injury)

Question 5

How do you palpate for the dorsalis pedis pulse?

Answer 5

• Palpated with feet slightly dorsiflexed; lateral to the flexor hallicus longus tendon usually

Question 6

What are the 5 Ps of an acute arterial occlusion in the foot? (dorsalis pedis)

Answer 6

• 5 P signs of acute arterial occlusion are: pain, pallor, paresthesia, paralysis, and pulselessness

Question 7

Describe lymphadenopathy

Answer 7

• Infections of the foot may spread proximally, causing enlargement of the popliteal and inguinal lymph nodes
• Infections on the lateral side of the foot produce enlargement of popliteal lymph nodes
• Infection on the medial side of the foot will show inguinal lymphadenopathy without popliteal – however it does not necessarily indicate medial foot infection since it can be caused by so many other regional infections

Question 8

Which lymph nodes will be affected with infections to the lateral foot?

Answer 8

popliteal lymph nodes

Question 9

Which lymph nodes will be affected on the medial side of the foot

Answer 9

inguinal lymphadenopathy without popliteal; but this is hard to say that the inflammation is due to the foot infection because the inguinal lymph nodes can be affected by many things