Exam 1: The High Risk Foot

Question 1

What term is described as a condition that is related to the dysfunction of the autonomic system that causes a progressive disorder that leads to joint dislocation, fracturs, and deformity of the foot.

Answer 1

Charco foot

Question 2

Charco foot is related to the dysfunction of the _____ system

Answer 2

autonomic

Question 3

Charco foot is a progressive disorder that leads to what 3 structural conditions of the foot

Answer 3

1. Dislocation
2. Fractures
3. Deformity of the foot

Question 4

Architectural changes due to Charco foot can cause an (increase/decrease) of pressure on the plantar surface and ulcerations if not treated

Answer 4

increase

Question 5

If left untreated, Charco foot can cause architectural changes that can cause an increase in _____ pressure and _____.

Answer 5

plantar; ulcerations

Question 6

Charco foot is most often seen in _____ patients

Answer 6

diabetic

Question 7

An individual with Charco foot will have (an extremely high/completely collapsed) arch

Answer 7

completely collapse

Question 8

How could an individual with Charco foot end up as an amputee?

Answer 8

With this condition, the arch will collapse leaving bony prominences to be in the arch. This causes skin breakdown and can lead to infection/amputee

Question 9

Charco foot is believed to be caused by two theories, Charcot’s Theory and 2nd Theory. Explain what Charcot’s theory is

Answer 9

Re-absorption of the bone is occurring due to an increase in blood flow to the bones because of an impaired autonomic system

Question 10

Charco foot is believed to be caused by two theories, Charcot’s Theory and 2nd Theory. Explain what 2nd Theory is

Answer 10

Charco foot is related to trauma in an insensate foot

Question 11

The likely patient to develop Charco foot
(will/will not) have sensory neuropathy
(will/will not) have adequate blood flow
(will/will not) have a history of trauma

Answer 11

will have sensory problems
will have adequate blood flow
Will have trauma

Question 12

What are the 4 clinical presentations of Charco foot

Answer 12

1. Erythematous
2. Edematous
3. Increase skin temp
4. Decreased sensation to nociception and pressure

Question 13

What condition does charco foot typically get misdiagnosed as

Answer 13

cellulitis

Question 14

What are two simple interventions for Charco foot

Answer 14

Immobilization and non weight bearing until signs of healing become apparent

Question 15

What are two signs of healing to look for after immobilizing a patient and requiring NWB for a patient with charco foot

Answer 15

decreased temp and decreased swelling

Question 16

What type of immobilization cast has been shown to have the fastest healing times and most success overall

Answer 16

total contact cast

Question 17

What are three other immobilization options for treating Charco foot besides a total contact cast

Answer 17

1. Posterior walking splint
2. DH pressure relief walker
3. Instant total contact cast fabricated by applying fiberglass to a removable walker

Question 18

After immobilization and signs of healing are apparent, appropriate _____ and _____ intervention are important for stabilization and decreasing plantar pressures

Answer 18

footwear and orthotic

Question 19

After immobilization and signs of healing are apparent, appropriate footwear and orthotic intervention are important for _____ and decreasing _____ _____

Answer 19

stabilization; plantar pressures

Question 20

When would surgical intervention be needed in a patient with charco foot

Answer 20

If the foot is too unstable or severely deformed with fractures and dislocation

Question 21

What 4 shoe accommodations can be made for patients with charco foot

Answer 21

Extra depth
Extra width
Custom molded shoe with custom insert or orthotic
Snug at heel to prevent pistoning

Question 22

Insert and orthotic support should be

• molded to the foot for (no/total) contact to decrease plantar pressures
• Relief for ____ if present
• Ideally a perfect balance between ____ and _____

Answer 22

total; wound; durability; cushioning

Question 23

What type of orthotic has been shown to be a good option for charco foot patients

Answer 23

A rigid shoe with a rocker bottom sole (rocker on toes) with a custom molded insert

Question 24

Are these Do’s or Don’ts of preventative foot care for skin care

1. Wash feet daily and dry them well, especially between the toes
2. Apply a thin layer of moisturizer but avoid between the toes
3. Trim toenails after washing and drying feet

Answer 24

Do’s

Question 25

Are these Do’s or Don’ts of preventative foot care for skin care

1. Cut toenails straight across and smooth any sharp edges
2. Have a podiatrist handle ingrown nails
3. Thin thick corns or calluses by gently using a pumice stone or by professional care

Answer 25

Do’s

Question 26

Are these Do’s or Don’ts of preventative foot care for skin care

1. Check water temp with a thermometer or elbow before bathing
2. Wear socks at night if feet are cold
3. Use sunscreen on the tops of feet during the summer
4. Ask health care providers to check feet at each visit

Answer 26

Do’s

Question 27

Are these Do’s or Don’ts of preventative foot care for skin care

1. Soak feet in water
2. Use moisturizer between the toes
3. Cut Corns and Calluses

Answer 27

Don’ts

Question 28

Are these Do’s or Don’ts of preventative foot care for skin care

1. Use chemical agents, corn plasters, strong antiseptics, or adhesive tape on feet
2. Use hot water bottles or heating pads

Answer 28

Don’ts

Question 29

Are these Do’s or Don’ts of preventative foot care for foot self-inspection

1. Inspect all surfaces of the feet daily
2. Report any injuries to a health care provider immediately
3. Feel for areas of increased temperature

Answer 29

Do’s

Question 30

Are these Do’s or Don’ts of preventative foot care for foot self-inspection

1. Use a mirror if necessary to see the bottom of feet
2. Have family member, friend, or health care provider check feet
3. Check for tender areas on the bottom of the feet

Answer 30

Do’s

Question 31

Are these Do’s or Don’ts of preventative foot care for foot self-inspection

1. Wait to report problems to a health care provider

Answer 31

Don’t

Question 32

Are these Do’s or Don’ts of preventative foot care for footwear

1. Wear shoes that fit the size and shape of feet and leave room for any necessary insoles
2. Ask a health care provider to recommend the correct type of shoe
3. Break in new shoes slowly, checking feet frequently for signs of irritation

Answer 32

Do’s

Question 33

Are these Do’s or Don’ts of preventative foot care for footwear

1. Keep shoes and insoles in good repair
2. Always wear socks or stockings with shoes and wear a clean pair daily
3. Before putting on shoes, check for rough areas, torn linings, or loose objects that can injure the foot

Answer 33

Do’s

Question 34

Are these Do’s or Don’ts of preventative foot care for footwear

1. Walk barefoot
2. Wear socks that are too baggy or have holes
3. Wear socks that are constricting at the top
4. Wear flip flops

Answer 34

Don’ts

Question 35

Which of the two theories that cause charco foot is the neurovascular theory

Answer 35

Charcot’s theory

Question 36

Which of the two theories that cause charco foot is the neurotraumatic theory

Answer 36

2nd theory