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2101 > Osce > Flashcards

Osce Flashcards

0
Q

Cramps

A

Involuntary, painful, self limiting contractions of skeletal muscle

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1
Q

What fibres does a hallux proprioception test

A

A-alpha fibres

Know where the foot is in space

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2
Q

Fasciculation

A

Random, painless muscle contracture

Twitch

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3
Q

Muscle atrophy

A

Muscle bulk is smaller than expected for body size

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4
Q

Muscle hyper trophy

A

Muscle bulk is larger than expected for body size

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5
Q

Muscle psuedohypertrophy

A

Muscle bulk appears larger than expected for body size-however this is due to overgrowth of fibrous or fatty tissue

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6
Q

Allodina

A

Pain evoked by a stimulus that does not normally evoke pain

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7
Q

Hyperalgesia

A

Increased pain response to a stimulus that is normally painful

(Suggested to be a consequence of peripheral and/or central sensitisation)

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8
Q

Dysthesia

A

A spontaneous or evoked unpleasant abnormal sensation

Eg; finding pins and needles unpleasant

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9
Q

Paraesthesia

A

A spontaneous or evoked, abnormal but not unpleasant sensation

(Eg; if someone finds pins and needles abnormal but not unpleasant)

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10
Q

Hyperesthesia

A

Increased sensitivity to stimulation, including diminished threshold & increased response

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11
Q

Grading reflexes

A

Absent/present/exaggerated

Note symmetry

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12
Q

Neurological assessment risk factors

A

Diabetes mellitus, alcoholic neuropathy, nerve entrapments, loss of sensation, spina bifida, cerebal palsy, muscular dystrophy, sudden falls, post surgery (eg; mortons neuroma)

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13
Q

Homocysteine

A

Amino acid - alterations in it’s metabolism are a recognised independent risk factor for PAD

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14
Q

Hypohidrotic skin is indicative of PAD

Clinically presents

A

As the metabolic need of the skin are not being met.

Clinically presents as dry flaking skin of the dorsum/plantar & extending up the leg

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15
Q

Intermittent clarification

A

Transient ischaemic muscle pain that occurs during exercise - strong indication of significant PAD

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16
Q

Rest pain

A

Typically occurs when legs are elevated.

Persistent pain that is caused by nerve ischaemia -> ischaemic neuropathy

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17
Q

Orthotic therapy

A

The use of an appliance or apparatus to support, align, prevent it correct deformity or to modify position or motion and improve the function of the moveable parts of the body

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18
Q

Orthosis

A

Orthotic device

Plural- orthoses

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19
Q

Anatomy of a non-cast insole

A

Consists of base- generally just a vehicle, can provide some cushioning
And
Padding- this will determine the function of the device (cushioning, padding, deflection, alter plantar pressures)

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20
Q

Shell material

A

Polypropylene

-3mm or 4mm

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21
Q

Polypropylene

A

Yields pressure and torque
Economical
Oven temp 180-200degrees C - 3min per mm
Copolymer polypropylene (contains up to 15% polypropylene)

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22
Q

Carbon composites shell material

A

Carbon composites make light rigid shell materials from carbon fibre composite & polypropylene

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23
Q

Ethyl vinyl acetate

A

Grinds easily
Retains shape well
Reflect body heat
Lasts 1yr

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24
Q

Shore value

A

= hardness (not density)

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25
Q

Low density EVA (220)

A

Shock absorption
Shoe uppers in temporary shoes
Stabilisers in AFO
Shore value of 25/35

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26
Q

Medium density EVA 270

A 
Heel lifts
Shoe blessings
Moulded insoles
So-rigid stabiliser
Shore value 35-50
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27
Q

High density EVA 350+

A 
Shoe lifts
Heel lift
Block heels
Wedge bottom
Rigid insole
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28
Q

EVA is mouldable at what temperature?

A

120-170* C depending on density with an oven time of 2minutes per mm

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29
Q

PPT

A

Lining material

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30
Q

Open cell polyurethane memory foam

A

PPT

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31
Q

PORON

A

4000
92 ultra soft
94 slow memory
Dual layer

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32
Q

Plastazote

A

Lining material

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33
Q

Coverings

A

Vinyl

Cambrelle

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34
Q

Types of padding

A

Corrective padding
Compensatory padding
Palliative padding

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35
Q

Corrective padding

A

Used to realign musculoskeletal components of the foot and restore function

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36
Q

Compensatory padding

A

When correcting is not possible (when correction is not possible) padding compensates for the loss of function

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37
Q

Palliative padding

A

Used to cushion or redistribute load away from a specific area

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38
Q

Padding principles

A

Use stretch of materials
Bevels
Allow function

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39
Q

Strapping

A

Rounded ends
Never end in a double thickness
Should not interfere with normal foot function (except splint)
Should not overlap tendons or interfere with function
Avoid peri-ungual tissue
Avoid nail plate
Half the strap on the pad and half on the skin

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40
Q

Felt

A

2, 3, 5, 7, 10mm
Matted wool
Material of choice for corrective padding- most durable

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41
Q

Fleecy foam

A

Soft foam with strength of fleece.
Cushion & protect areas from stress and pressure.
Highly compressible, instant recovery, ideal for light cushioning

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42
Q

Foams

A

Molefoam - latex foam bonded with a brushes surface
Absorbs pressure
Instantaneous recovery
Ideal for cushioning & plantar pressure redistribution

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43
Q

Fleecy web

A

100% cotton padding with a raised fleecy surface.
Transverse stretch allows the padding to conform to the skin which prevents creasing
Conforms well to difficult areas (bony prominences)

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44
Q

Bevelling appropriate angle

A

45*

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45
Q

Before you apply a pad you should

A

Check for allergy
Use a barrier wipe
Precut your pad and strapping tapes before applying to the patient

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46
Q

Types of digital pads

A 
Digital covers 
Digital props
Digital crescent
Horseshoe pad
Interdigital cover or wedge
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47
Q

Basic pad shapes

A

Crescent pad- used on digits to protect IPJs
Digital cover or oval pad- usually used in conjunctions with a cavity or aperture- used to hold medicaments or protect bony prominence

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48
Q

Replaceable toe prop

A

Can be used to straighten toes of reduce the pressure on the apices of toes

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49
Q

Horseshoe pad

A

I-shaped pad used to deflect pressure away from either IPJs

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50
Q

Plantar pads

A 
PMP
Plantar cover
Shaped metatarsal bar
Straight metatarsal bar
Valgus pad
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51
Q

Plantar cover

A

Anterior border- follows the webbing of 1-5
Posterior border- thumbs width distal from the styliod
Follow the medial and lateral lines of the foot

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52
Q

Wing

A

Material is removed from the pad leaving a back-beveled crescent shape cut-out to accommodate a lesion, usually either under the 1st or 5th or both MPJs

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53
Q

Straight Metatarsal bar

A

Short plantar cover with a straight distal edge

- usually used to assist propulsion if the is a problem at the MPJs

54
Q

Shaped met bar

A

Used the same way as a straight met bar.
Follows the metatarsal formula (parabola)
Can be used to offload the met heads

55
Q

Hammer toe

A

Fixed flexion deformity of the proximal IPJ

56
Q

Mallet toes

A

Fixed flexion deformity of the distal IPJ

57
Q

Claw toes

A

Fixed flexion deformity of the proximal and distal IPJs

58
Q

Adducto varus

A

Congenital flexor tightness

(Curly toes) distal IPJ is flexed and varus

59
Q

Anatomical landmarks relevant for the manufacture of orthoses

A

Webbing 1-5
Styloid process
Sustentaculum tali
Calcaneal bisection

60
Q

Four orthotic materials used for corrections

A 
High density EVA 350+
Medium density EVA 270
Polyethylene 
Polypropylene 
Carbon composites
61
Q

Covering options for orthoses

A

Vinyl

Cambrelle

62
Q

Sterilisation

A

Rendering an item free of all living microorganisms

63
Q

Disinfection

A

Reducing the level of micro organisms to a level which is harmless to health

64
Q

Antisepsis

A

The destruction or inhibition of microorganisms on living tissue

65
Q

Asepsis

A

The absence of infection resulting from contamination

Achieved through sterilisation & disinfection

66
Q

Endogenous

A

From the patient

67
Q

Exogenous

A

Infection from an external route

68
Q

Nosocomial

A

Hospital acquired infection
48hrs after administration
30days after discharge

69
Q

Steps to reduce risk of infection

Minimum

A 
Hand hygiene
PPE
Sharps handling by and disposal
Reprocessing 
Cough hygiene
Aseptic non-touch technique
Waste management
70
Q

Hand hygiene how long?

A

15-20 seconds for routine hand wash or alcohol was
30seconds for aseptic procedure
5minutes for surgical

71
Q

5moments of hand hygiene

A 
Before touching patient
Before procedure
After procedure/body fluid exposure
After touching a patient
After touching a patients surroundings
72
Q

Invasive treatment on a patient why PPE do you wear

A

Gloves
Apron
Eyewear
Face mask

73
Q

When do we wear gloves

A

When there is risk of exposure to blood or bodily fluid, skin that is not intact or mucus membranes
Handling waste
When performing invasive procedure

74
Q

Cleaning the treatment area includes

Cleaning with neutral detergent

A 
Patient chair
Operator chair
Work top trolley
Nail drill
Diagnostic equipment
75
Q

When cleaning he patients foot fr toe to heal with alcohol or chlorhexidine we must assess:

A

Nail size & shape
Skin quality & colour skin temp
Presence of hair
Neuro responsiveness

76
Q

Limitations of a mod root technique

A

Maximum correction of 8-12degrees with extrinsic stabilisers
Limited effect on a greater amount of rear-foot control is needed or a forefoot varus/valgus is present

77
Q

When will you use a mod root technique orthotic

A

Where mid foot and moderate rear-foot control is required

78
Q

What is a modified root device

A

Slightly altering the forefoot plaster additions and the shape of the orthotic shell of the root balance technique to allow for greater rear-foot inversion with gentle forefoot control and emphasised mid tarsal control. This is tolerated much more readily in shoes.

79
Q

Assessing the negative cast

A 
Forefoot to rearfoot relationship
Lateral border (straight)
Toe positions (PF /DF)
Skin contact (esp MLA)
Suitability for pouring 
Finger impression (4&5)
80
Q

Right ventricle failure presents

A

Peripheral oedema

81
Q

Left ventricular failure presents as

A

Pulmonary oedema

82
Q

Positive clinical test for lymphoedema

A

Inability to pinch the skin

83
Q

PAD symptoms

A 
Cramp-like pain
Tightness
Tiredness
Impotency
Rest pain
84
Q

Pink skin indicates

A

Healthy normal circulation

85
Q

Blue skin indicates

A

Venous stasis
Cassis plastic disorder
Cold chilblains

Hazy blue may indicate infection/necrosis

86
Q

Brown skin indicates

A

Hamosiderosis

Wet gangrene

87
Q

Black skin indicates

A

Necrosis

External shoe dyes/bruise

88
Q

Pale skin

A

Cold
Cardiac failure
Vasspastic disorder

89
Q

White with demarcation line indicates

A

Ischaemia

90
Q

Red skin indicates

A

Infection
Cellulitis
Heat inflammation
Cacao spastic disorders

91
Q

Doppler assessment sound interpretation

A

Assess: phase volume clarity

92
Q

Pathological artery sound interpretation

A

Monophonic
Low volume
Whooshing or knocking

93
Q

Non-pathological artery sound interpretation

A

Multiple phases
High volume
Clearly defined audio absent of whooshing

94
Q

Management for normal results for a TBI >0.75 with risk factors

A

Rescreen in 1year

95
Q

Management for ABI 0.5-0.9 &/or signs and symptoms of PAD including waveform analysis

A

Rescreen in 3months & of ABI still <0.9 with other signs and symptoms refer to GP for intensive risk factor modification

96
Q

TBI <0.70 & other signs and symptoms

A

Rescreen in 3months and if TBI is still<0.70 with other symptoms then refer to GP for intensive risk factor modification

97
Q

Reason ABI is not suitable in people with diabetes mellitus

A

Arterio-venous shunting & reducing tissue percussion while large artery flow remains adequate
Medial arterial calcification
More distal location of atherosclerosis
Distal atherosclerosis associated with medial arterial calcification

98
Q

Cellulitis

A

Is a diffuse bacterial infection of the skin and subcutaneous tissues.
Produces redness, heat swelling & itching may cause systemic reactions such as fever

99
Q

If a patients pain/symptoms get worse as the day goes on or are exacerbated by heat and relieved with leg rest elevation what is that indicative of?

A

CVI

100
Q

ABI <0.4 is defined as

A

Critical limb ischaemia

101
Q

ABI of 0.40-0.8 is

A

Intermittent claudication

102
Q

ABI of less than .90

A

Pathology

103
Q

Hyperkeratosis caused by

A 
Intermittent ischaemia 
Reactive hyperaemia
Accelerated proliferation of epidermal cell
Increased cell adhesion 
Reduced desquamation
--> hyperkeratosis
104
Q

Common locations of a heloma durum

A 
IPJs
Plantar aspect of the MPJs
Extensor hallux longus tendon
Styloid process
Medial 1st MPJ
105
Q

What makes a shoe safe?

A 
Firm heel counter
Beveled heel
Broad flared heel
Laces or fastening
Thin firm midsole
Textured sole
106
Q

What makes an unsafe shoe?

A 
Soft or stretched uppers
High heels
Narrow heels
Lack of laces
Slippery or worn soles
107
Q

Meissners corpuscle

A

Touch and low frequency vibration

108
Q

Merkles disc

A

Primarily involved in touch

109
Q

Ruffini ending

A

Detects heavy continuous touch & high frequency vibrations; largest of encapsulated nerve endings

110
Q

Asepsis

A

The absence of infection resulting from contamination.

111
Q

Antisepsis

A

The destruction or inhibition of microorganisms on living tissues

112
Q

Disinfection

A

The process of reducing the level of microorganisms to one which is harmless to health

113
Q

Sterilisation

A

The process of rendering an item free of all living microorganisms

114
Q

Podiatry clinical area includes

A

Patient chair, operator chair, work top trolley, nail still, diagnostic equipment

115
Q

Blood or bodily substance comes in contact with skin

A

Wash with soap and water

- report exposure to supervisor

116
Q

Blood or bodily substances comes into contact with non-intact skin

A

Wash with soap and water & cover all skin breaks with water resistant occlusive dressing

  • report the exposure to your supervisor
  • incident report
  • follow up with GP
117
Q

Sharp/needle stick injury

A

Wash wound with water & let it bleed freely for a few seconds

  • report exposure to your supervisor
  • incident report
  • Follow up appointment with GP
118
Q

Blood or bodily substance is the eye

A

Irrigate with water while flushing the eyelids up and down

  • report the exposure to your supervisor
  • incident report
  • follow up appointment with GP
119
Q

Blood or body substance splashes into the mouth

A

Spit the substance out, rinse with water several times

  • report the exposure to your supervisor
  • incident report
  • follow up appointment with GP
120
Q

Myotomes that plantar flex

A

S1

121
Q

Myotonia that dorsiflex

A

L4

122
Q

Myotomes that wiggle the toes

A

L5

123
Q

Myotomes that straighten the knee

A

L3

124
Q

Neuro vascular risk category assessment group 3A

A

Ulcer history

125
Q

Neuro vascular risk category group 3B

A

Amputation

126
Q

Neuro vascular risk category group 2B

A

PAD

127
Q

Group 2A neuro vascular risk category

A

Peripheral neuropathy & deformity

No PAD

128
Q

What risk category would a peripheral neuropathy, no PAD, no deformity be classed as?

A

Group 1

129
Q

Neuro vascular risk category group 0

A

No peripheral neuropathy, no PAD

130
Q

What is the final forward flow of a triphasic waveform representive of?

A

Late diastole elastic recoil of the artery

131
Q

Venous stasis dermatitis

A

Eczematous process that develops due to insufficient venous return.
Erythemathous
Pruritic plaques on the leg

132
Q

Haemosiderin

A

Yellow to brown iron rich pigments caused through the breakdown of red blood cells.
Usually an indicator of underlying pathology

2101 (7 decks)

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