Random OSCE Flashcards by Jumatai borat

What are the types of toe walking

-Idiopathic
-Autisim, sensory stimulation
-Cerebral Palsy, Calf muscle spasticity

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When is Toe walking not considered normal

-Above the age of 3

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What are the issues associated with toe walking

-narrow calcaneus
-falls
-Knee instability
-quality of life

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What are the causes of Idiopathic Toe Walking

-Tactile Processing, response to touch sensations
-Proprioceptive processing, sense of body position in space
-Vestibular processing, maintaining balance
-Moto control, control of specific body movement
-How long and flexible the leg and foot muscle are

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What is a red flag in the birthing history

-Premature delivery

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What are the muscle changes associated with toe walking

-Shortening of gastric and soleus
-Short hamstrings
-Contracted hip flexors/adductors

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What are the traditional therapies to ITW

-Night braces
-Gait training
-serial casting
-AFO’s
-HEP
-Manual stretching
-Gait plates
-Botox
-Surgery

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What other therapies can you use

-Taping
-Orthotics
-Footwear
-Squatting

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How to treat a MSK/Sensory toe walking

-Heel lift to bring ground up to the heel
-Myofascial release
-eccentric strengthening
-Weight shifting training
-Casting

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What some exercise for toe walking

-Calf stretching
-ice skating on towels
-Foot intrinsic
-Deficit calf raises

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What would you suspect of a 7 year old new toe walker?

=tethered cord syndrome

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What are some the primitive reflexes

-Grasp
-Step
-Crawl
-Tonic neck
-moro reflex
-Tonic labyrinth

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How to rate a reflex response

0 absent
1 hypoactive
2 normal
3 brisk without clonus
4+ hyperactive with unsustained clonus
5 hyperactive with sustained clonus

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How to rate motor strength

0 no movement
1 Flicker
2 moves with gravity eliminated
3 moves against gravity but not resistance
4 moderate movement against resistance
4- slight move against resistance
4+ sub maximal movement against resistance
5 normal movement

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What are some conditions associated with hyporeflexia

-CMT
-Polio
-Muscular dystrophy
-Friedreich ataxia
-Neuropathy
-Stroke
-CP

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What are some conditions associated with hyperreflexia

-Spinal cord injury
-Cerebral Palsy
-Cerebellar ataxia
-Angelmanns syndrome

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How to rate a Gowers sign

-Mild, prolonged or rise using single hand action
-Moderate, forming prone crawl position, and using one or two hands on thigh
-Severe, using the thigh with both hands, additional aid to rise, unable to rise

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What is ankle clonus

-Series of involuntary, rhythmic contraction and relaxation

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What is an ankle clonus indicating

-Sign of neurological condition
-Upper motor neurone lesions
-associated with spasticity

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What does ANTT stand for

-Aseptic non-touch technique

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What should you be checking when using dressings

-Package intact
-Date

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How to perform Donning and doffing

Donning (put on)
-Gown
-Mask
-Glasses
-Gloves
Doffing (put off)
-Gloves
-Gown
-Glasses
-Mask

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5 hand hygiene moments

Study These Flashcards

-Before touching a patient
-Before clean/aseptic procedures
-After body fluid exposure/risk
-After touching a patient
-After touching patient surroundings

Melanomas

Study These Flashcards

A: Asymmetry
B: Borders (irregular)
C: Colour (not uniform)
D: Diameter (>.5mm)
E: Evolution

What are the Instruments and order used in IGTN Surgery

-Nail splitter -Beaver blade with handle -Elevator -Mosquito forceps -Currette -Phenol applicator

How to dress after a IGTN

-Bactigras -melonite -Gauze -Tube gauze -Hypafix

Patient instructions post-surgery

-Leave dressing on for first 24 hours, keep dry -Bleeding may be present in first 24 hours -Avoid tight fitting shoes and return to activity -Dressing change every 24 hours, keeping toe clean and dry -Paracetamol maybe needed if pain is present after LA wears off -Contact clinic or GP is bleeding does not stop, or too painful

Contraindications

-Pregnant or breast feeding -PVD -Allergies to LA -Severely infected to nails

Dosage calculation

-3mg/kg up to 200mg -20mL max dose Example: -1% lidocaine -Patient 70kg -3x70=210 -210/10=21mL -This patient max dose is 20mL -If using 2% its half the dose

Procedure types

-Partial nail avulsion -Total nail avulsion

ABI calculation

-Use higher of the two -Ankle BP/Brachial BP

ABI interpretation

>1.3: poorly compressible vessels 1.3-0.90: normal 0.90-0.80: mild arterial obstruction 0.80-0.50: moderate obstruction <0.50: severe obstruction

What are some precautions of LA

-Allergies -Local inflammation or infection -Anticoagulated patients -neuromuscular disease -Neurological disease -Renal, Liver problems -Elderly and children

Which drugs are involved in triple whammy

-ACE inhibitor or ARB -Diuretic -NSAIDs

What are the consequences of triple whammy

-Acute Kidney failure

What are some RA surgeries you can perform

-Arthroplasty -Arthrodesis -synovectomy -Tendon release surgery

Attachments to the medial tubercle

-Plantar fascia -Flexor digitorum brevis -Abductor hallucis

What is the tests for beightons score

-Elbow hyperextension -Thumb to forearm -passive extension at 5th metacarpal -Knee hyperextension -Floor touch with knees hyperextended -out of 9 score

How to interpret a Beighton’s score

-4/9 hypermobile -7/9 for children between 6-12

What is intoeing

-Internal FPA during gait -Internally rotated gait profile -Prevalence unknown, no clear data in normal population

Concerns over intoeing gait

-awkward gait -fatigue -tripping clumsiness -future concerns

What are some causes of in toeing

-Tight hip muscles -Femoral torsion -genicular bias, soft tissue contracture -Tibial torsion -Metatarsus adducts -Conditions or syndromes

What are some management strategies for in toeing

-Casting -Splinting -Gait plates -Stretches -Functional exercises -Posture modifications

Areas we need to assess for in toeing

-Gait -Hips -Femur -Genicular -Tibia -Foot -Soft tissues -Conditions

What is a normal finding for Gait

-FPA abducted to parallel

What is normal finding for hips and femur

-Lateral and medial rotation same -Femoral torsion of 15-20 degrees

What is a normal finding at Genicular

-Lateral and medial rotation 2:1 ratio -nil posterior soft tissue contracture

What is a normal findings of Tibia

-Lateral torsion developing from 0 to 20

What is a normal finding of the foot

-Rectus foot NWB and WB -may or may not be postural metatarsus adducts

What is a normal finding for soft tissues

-Normal tone, nil restrictions, functional

What is a normal finding for conditions

-Screening, tone, contractions etc

What is a example of strength program to correct intoeing?

-Big bear walks -sumo frog jumps -Cheeky crab walks -Penguin walk

What are some causes of flat feet

-Heredity -Joint laxity -Obesity -Early shoe wearing

What is the management of flexible flatfoot

-Reassurance -Education -Advice -Avoid inserts

What should you promote or encourage in flexible flat feet

-Avoiding obesity -healthy diet, limiting TV, encourage active play

When should you be concerned about flat feet in children

-Rigid -Painful -Very severe

Facts about arch height

-1 in 5 never develop an arch -Most of the time arches are low due to loose joints -Children can be different heights and that’s the same with arch height -if asymptomatic treating may cause problems

Random OSCE Flashcards

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