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Clinical Med > Foot > Flashcards

Foot Flashcards

1
Q

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

A 
Fever
Aortic insufficiency
Complete heart block
Thyrotoxicosis
Systolic HTN

(FACTS)

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2
Q

What is the landmark of the DP pulse?

A

Extensor hallucis tendon

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3
Q

What is the landmark of the PT pulse?

A

Medial side, midway between the malleolus and calcaneus tendon

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4
Q

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

A

Medial side

Flex the knee

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5
Q

What does the capillary fill time do?

A

Determines the state of tone of the cutaneous microcirculation

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6
Q

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

A

Tip of the toenail

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7
Q

Decreased capillary refill may suggest what?

A

Vasospasm or structural changes to the large vessels

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8
Q

Is pitting edema an acute event?

A

No, but non pitting is

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9
Q

How do you assess for pitting?

A

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

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10
Q

What are the possible causes of pitting edema?

A

Systemic disease CHF

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11
Q

What causes non-pitting edema?

A

Lack of protein in exudate (liver and kidney problems)

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12
Q

1+ edema measurement is how deep?

A

2mm

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13
Q

2+ edema measurement is how deep?

A

4mm

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14
Q

3+ edema measurement is how deep?

A

6mm

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15
Q

4+ edema measurement is how deep?

A

8mm

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16
Q

Are macules palpable? How big are they?

A

no

<0.5cm

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17
Q

Are patches palpable? How big are they?

A

no

> 0.5 cm

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18
Q

Are papules palpable? How big are they?

A

Yes

<0.5 cm

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19
Q

Are nodules palpable? How big are they?

A

Yes

0.5 cm - 1 cm

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20
Q

Are tumors palpable? How big are they?

A

yes

>1 cm

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21
Q

Are plaques palpable? How big are they?

A

Yes

> 0.5 cm

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22
Q

What are vesicles? Size? Characteristics?

A

Size = <0.5 cm
clear fluid filled
Palpable

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23
Q

What are bullas? Size? Characteristics?

A

Clear, fluid flilled
palpable
>0.5 cm

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24
Q

What are abscesses? Size? Characteristics?

A

Cloudy, pus filled palpable lesions, >0.5 cm

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25
Q

What are pustules? Size? Characteristics?

A

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

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26
Q

What are secondary lesions?

A

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

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27
Q

What are abscesses on the toe?

A

Paronychia

28
Q

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

A

Thickened nails d/t fungal infections

Need culture

29
Q

What are the causes of thickened nails?

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

(TOE CLYPT)

30
Q

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

A
  1. Insufficient sweat glands
  2. Tinea pedis
  3. psoriasis
  4. eczema
31
Q

What is an ulcer?

A

Loss of the epidermis

32
Q

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

A

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

33
Q

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

A

0-5

5 is normal

34
Q

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

A

1/5

35
Q

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

A

2/5

36
Q

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

A

3/5

37
Q

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

A

4/5

38
Q

What is a corn?

A

Thickened stratum corneum in an area d/t pressure

39
Q

What are the 3 systems evaluated in a neuro exam?

A

Motor
Sensory
ANS

40
Q

What are the two pathways that sensation travel through?

A
  1. Posterior column

2. Lateral spinothalamic tract

41
Q

Which tract are burning or cramping pain felt in?

A

Spinothalamic tract

42
Q

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

A

Posterior column

43
Q

What are the small fibers of the neurosensory tract?

A

Spinothalamic tract

44
Q

What are the large fibers of the neurosensory tract?

A

Posterior column

45
Q

Abnormality of the touch stimuli test indicated what?

A

Small fiber disease

46
Q

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

A

Semmes-weinstein monofilament

47
Q

When do you do the temp test?

A

Iff there is abnormal pain sensation

48
Q

Lack of temperature sensation suggests what?

A

Small fiber disease

49
Q

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

A

Large fiber disease

128 cycle tuning fork

50
Q

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

A

30 seconds but for sure more than 10

51
Q

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

A

on the sides, move up and down

Abnormal = large fiber disease

52
Q

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

A

True

53
Q

What is the scale of tendon reflexes?

A

0-4

54
Q

What are the knee reflexes innervated by?

A

L2, L3, L4

55
Q

What are the ankle reflexes innervated by?

A

S1, S2

56
Q

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

A

L4, L5, S1, S2

57
Q

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

A

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

Toes should plantarflex

58
Q

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

A

hop on one foot

Indicates:

  1. intact motor system of the legs
  2. Normal cerebellar
  3. good position sense
59
Q

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

A

Peripheral neuropathy

60
Q

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

A

Spinal lesions

61
Q

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

A

Inspire - increase

Expiration = decrease

62
Q

What is the Babinski response? What does this indicate?

A

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
Q

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

A

Posterior column = Fast

Spinothalamic = Slow

64
Q

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

A 
PC = Electric shocks
Spinothalamic = burning
65
Q

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

A

Spinothalamic

Clinical Med (30 decks)

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