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Clinical Med > Foot > Flashcards

Flashcards in Foot Deck (65):
1

What are the things that tend to cause a bounding pulse?

Fever
Aortic insufficiency
Complete heart block
Thyrotoxicosis
Systolic HTN

(FACTS)

2

What is the landmark of the DP pulse?

Extensor hallucis tendon

3

What is the landmark of the PT pulse?

Medial side, midway between the malleolus and calcaneus tendon

4

Which part of the popliteal fossa is the artery found? How can this be improved?

Medial side

Flex the knee

5

What does the capillary fill time do?

Determines the state of tone of the cutaneous microcirculation

6

Where should you evaluate the capillary refill time in the feet?

Tip of the toenail

7

Decreased capillary refill may suggest what?

Vasospasm or structural changes to the large vessels

8

Is pitting edema an acute event?

No, but non pitting is

9

How do you assess for pitting?

Press for 5 seconds. Should return to normal in under 5 seconds. If not, then pitting

10

What are the possible causes of pitting edema?

Systemic disease CHF

11

What causes non-pitting edema?

Lack of protein in exudate (liver and kidney problems)

12

1+ edema measurement is how deep?

2mm

13

2+ edema measurement is how deep?

4mm

14

3+ edema measurement is how deep?

6mm

15

4+ edema measurement is how deep?

8mm

16

Are macules palpable? How big are they?

no

<0.5cm

17

Are patches palpable? How big are they?

no

>0.5 cm

18

Are papules palpable? How big are they?

Yes
<0.5 cm

19

Are nodules palpable? How big are they?

Yes
0.5 cm - 1 cm

20

Are tumors palpable? How big are they?

yes
>1 cm

21

Are plaques palpable? How big are they?

Yes

>0.5 cm

22

What are vesicles? Size? Characteristics?

Size = <0.5 cm
clear fluid filled
Palpable

23

What are bullas? Size? Characteristics?

Clear, fluid flilled
palpable
>0.5 cm

24

What are abscesses? Size? Characteristics?

Cloudy, pus filled palpable lesions, >0.5 cm

25

What are pustules? Size? Characteristics?

Cloudy, pus filled, <0.5 cm in size. Palpable

26

What are secondary lesions?

Lesions that are the result of progressive changes in the primary lesions or are caused by external causes

27

What are abscesses on the toe?

Paronychia

28

What are onychomycosis? Can you look at it and diagnose it?

Thickened nails d/t fungal infections

Need culture

29

What are the causes of thickened nails?

Trauma
Onychmycosis
Eczema
Circulatory problems
Lichen planus
Yellow nail syndrome
Psoriasis
Tumor

(TOE CLYPT)

30

What are the four causes of dry skin on the foot?

1. Insufficient sweat glands
2. Tinea pedis
3. psoriasis
4. eczema

31

What is an ulcer?

Loss of the epidermis

32

If the base of the ulcer is red, then what is the prognosis?

Good b/c there is good blood supply to the area

33

What is the scale for muscle strength? What are normal values?

0-5

5 is normal

34

You see the tendon contract, but there is no movement of the joint. Grade this muscular movement?

1/5

35

The patient is able to move foot or leg into the desired position when horizontal to exam table. Rate this MS.

2/5

36

The patient is able to perform movement with leg hanging over the side of the table or sitting. Grade this MS.

3/5

37

There is a slight decrease from normal strength. Rate this MS.

4/5

38

What is a corn?

Thickened stratum corneum in an area d/t pressure

39

What are the 3 systems evaluated in a neuro exam?

Motor
Sensory
ANS

40

What are the two pathways that sensation travel through?

1. Posterior column
2. Lateral spinothalamic tract

41

Which tract are burning or cramping pain felt in?

Spinothalamic tract

42

Which tract are pins and needles or electric shock pain felt in?

Posterior column

43

What are the small fibers of the neurosensory tract?

Spinothalamic tract

44

What are the large fibers of the neurosensory tract?

Posterior column

45

Abnormality of the touch stimuli test indicated what?

Small fiber disease

46

What is the tool that you use for the touch stimuli?

Semmes-weinstein monofilament

47

When do you do the temp test?

Iff there is abnormal pain sensation

48

Lack of temperature sensation suggests what?

Small fiber disease

49

Abnormal vibration test indicates what? What is the tool used?

Large fiber disease

128 cycle tuning fork

50

How long should the tuning fork be felt in the foot?

30 seconds but for sure more than 10

51

How do you accurately grab the great toe for a proprioception test? An abnormal test is indicative of what?

on the sides, move up and down

Abnormal = large fiber disease

52

True or false: an absent Achilles reflex after 80 yo is normal

True

53

What is the scale of tendon reflexes?

0-4

54

What are the knee reflexes innervated by?

L2, L3, L4

55

What are the ankle reflexes innervated by?

S1, S2

56

What is the innervation of the superficial reflex or plantar response?

L4, L5, S1, S2

57

How do you elicit a superficial reflex? What is the normal result?

Stroking the lateral aspect of the sole from the heel to the ball of the foot

Toes should plantarflex

58

What is the all-in-one test for the feet? What does this indicate?

hop on one foot

Indicates:
1. intact motor system of the legs
2. Normal cerebellar
3. good position sense

59

If a pt is able to stand on tiptoes, but not on the heels, what does this suggest?

Peripheral neuropathy

60

If a pt is able to stand on heels, but not on tiptoes, what does this suggest?

Spinal lesions

61

With normal vagal nerve input to the heart, the pulse at rest will (BLANK) with increase, and (BLANK) with expiration

Inspire - increase
Expiration = decrease

62

What is the Babinski response? What does this indicate?

A result of the plantar reflex response, where there is dorsiflexion of the great toe and fanning of the other toes

This indicates upper motor neuron disease

63

What type of fibers compose the posterior column? Spinothalamic? (slow/fast)

Posterior column = Fast
Spinothalamic = Slow

64

What type pain is experienced via the posterior column? Spinothalamic? (burning/cramp or electric)

PC = Electric shocks
Spinothalamic = burning

65

What nervous tract is able to sense temperature? (spinothalamic or posterior column)

Spinothalamic