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BPK 241 > Week 3 [not including lab] > Flashcards

Week 3 [not including lab] Flashcards

1
Q

What are the functions of the skin (4)?

A
  • protection
  • thermoregulation
  • sensation
  • excretion
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2
Q

What are the 3 layers of the skin from the surface to the deepest layer?

A
  • epidermis
  • dermis
  • subdermal adipose tissue
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3
Q

What is the epidermis made of (3)?

A
  • basal cells
  • squames
  • melanocytes
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4
Q

What are hairs and nails derived from?

A

skin

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5
Q

What are basal cells for?

A

where keratinocytes originate before they move to the outer layer of the skin

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6
Q

Define: melanocytes (and give location?)

A

cells in the bottom layer of the epidermis; produce melanin

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7
Q

Define: squames

A

a scale or flake of skin

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8
Q

Define: hyperhydrosis

  • secondary effects

- Tx

A
  • define: excessive sweating
  • secondary effects: chafing, blisters, calluses, greater chance of skin infection or fungal infection. difficulty taping these athletes
  • treatment: try and keep important areas dry with baby powder or frequently changing clothes
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9
Q

Blisters

  • cause
  • Tx
  • how can we avoid them?
A
  • cause: shearing force
  • try not to puncture it to avoid infections
  • to avoid: place vaseline on places where they’re likely to occur
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10
Q

Calluses, corns

  • cause
  • secondary effects
  • Tx
A
  • cause: shear or pressure
  • thickening skin can cause problems like tighter fitting shoes
  • treatment: soak and use pumice stone to file it; could be surgically removed
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11
Q

ingrown nail

  • causes
  • secondary effects
  • treatment
A
  • causes: trimming too close to your nail bed
  • secondary effects: can lead to infection if nail punctures skin
  • treatment: for infection use saline soap and anti fungal creams
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12
Q

Fungal infections

  • causes (4)
  • prevention
  • treatment
A

causes

  • warmth
  • darkness
  • moisture
  • contamination (direct/indirect contact)

prevention: keep workout areas clean and dry (mats, gym floors, etc), general good hygenie
treatment: anti-fungal creams, wash hands, oral medication (must exercise after to get anti-fungal medication to skin surface by sweating)

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13
Q

Describe the different varieties of fungal infections

  • Tinea corporis
  • Tinea capitis
  • Tinea cruris
  • Tinea pedis
  • Tinea unguium
A
  • Tinea corporis: body (ringworm)
  • Tinea capitis: scalp (rash & alopecia)
  • Tinea cruris: groin
  • Tinea pedis: feet
  • Tinea unguium: nail and nail beds; not responsive to topical tx
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14
Q

How many phalanges are there per foot?

A

14! 2 in the great toe, 3 in toes 2 through 5

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15
Q

Which bone is attached to the flexor hallucis brevis?

A

sesamoid bones

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16
Q

Describe the 3 areas of the foot

A
  • forefoot
  • midfoot
  • hindfoot/rearfoot
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17
Q

How much degrees of extension do you need in your metatarsal joint for normal walking-running gait?

A

45-70 degrees

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18
Q

What joint makes up the hindfoot?

A
  • subtalar (talus and calcaneus)
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19
Q

What joints are part of the midfoot?

A
  • Navicular joints (cunneiform & cuboid bones)

- Tarso-metatarsal (cuneiforms & cuboid with MTs)

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20
Q

What joints are part of the forefoot?

A
  • metatarsophalangeal (MTP)

- interphalangeals (distal DIP, interphalangeal IP, proximal PIP,

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21
Q

What is the metatarsophalangeal (MTP) responsible for?

A
  • flexion and extension and some abudction and adduction
22
Q

What are the interphalangeals (MTP) responsible for?

A
  • flexion and extension (hinge)
23
Q

Foot flexor muscles (4)

A
  • Flexor hallucis longus (FHL)
  • Flexor hallucis brevis (FHB)
  • Flexor digitorum longus (FDL)
  • Flexor digitorum brevis (FDB)
  • All flex at MTP & IP joints
  • Also assist foot plantar flexion
24
Q

Foot extensor muscles (4)

A
  • EHL
  • EHB
  • EDL
  • EDB
25
Q

Describe the foot posture names for a high arch, normal arch, and a flat foot

A
  • high arch: Pes cavus
  • normal arch: neutral
  • flat foot: Pes planus
26
Q

How can we easily test foot posture?

A

analyze wet foot pattern on concrete

27
Q

Describe foot pronation vs supination

A
  • over pronation leads to calcaneal valgus position/ rear foot valgus (decrease in joint angle)
  • supination leads to rear foot varus (increase in joint angle)
28
Q

Differentiate between walking and running

A
  • walking: one foot is always in contact with ground

- running: a point exists where neither foot is in contact with ground

29
Q

Describe the Windlass mechanism

A
  • tightening of the plantar fascia during dorsiflexion which shortens the longitudinal arch; allows for shock absorption and stiffness for propulsion
  • Prior to heel strike, ankle is in dorsiflexion, Plantar Fascia (PF) is taught, medial arch is high
  • During midstance PF is relaxed to allow medial arch to collapse pronation for shock absorption
  • Prior to toe-off, first toe is in extension, PF become taught again, foot is stiff for take off, medial arch is high again
  • Relies on ability of 1st toe to extend normally
30
Q

List the four different arches in the foot

A
  • medial longitudinal arch
  • lateral longitudinal arch
  • anterior metatarsal arch
  • transverse arch
31
Q

What supports the arches of your foot (4)?

A
  • bony anatomy
  • ligaments
  • tendons/ plantar flascia
  • muscle activity
32
Q

Give examples of staple support for an arch

A

staple examples: plantar and calcaneovicular ligaments

33
Q

Give examples of tie beam/cable support for an arch

A
  • FHL and plantarfascia
34
Q

Give examples of suspension support for an arch

A
  • tibialis anterior (for medial longitudinal arch) and peroneus longus (for lateral longitudinal arch)
35
Q

What are the Keystone Bones for the arches of the feet?

A
  • medial longitudinal: talus
  • lateral longitudinal: cuboid
  • anterior metatarsal: 3rd metatarsal
  • transverse: intermediate cuniform
36
Q

List all the bones that comprise the arches in the foot

  • medial longitudinal
  • lateral longitudinal
  • transverse
A
  • medial longitudinal: talus, calcaneus, navicular, medial cuneiform, first metatarsal, aproximal phalange
  • lateral longitudinal (calcaneus, cuboid, 5th metatarsal)
  • transverse arch: metatarsal bases, the cuboid and the three cuneiform bones
37
Q

Define: exostoses

  • causes
  • mechanism
  • Ssx
  • Tx
A
  • exostoses: excess bony growth on one of the tarsals bones or bones in the foot
  • causes: obesity and abnormal weight, faulty footwear, heredity
  • mechanism: without proper supportive footwear, an increase in stress on the bones causes more bone growth (bones are alwasy remodelling)
  • Ssx: bony bump, redness, pain, swelling
  • Tx: greater arch support (insoles, new shoes, cushions which will correct predisposing factors); donut pad (incircles bony growth so shoes don’t put pressure on it); surgical removal (last resort)
38
Q

Define: bunion (hallux valgus)

  • cause
  • SSx
  • Tx
A
  • define: valgus deformity at MTP1
  • cause: tight shoes, heredity
  • SSx: pain
  • Tx: warm soaks, improved footwear +/- orthoses (braces), wedge pads or taping, surgery
39
Q

Define: Plantar (Morton’s) Neuroma

  • cause
  • DDx
  • SSx
  • Tx
A
  • define: nerve tissue growth usually between MTs III and IV that feels as if you are standing on a pebble in your shoe;
  • cause: interdigital nerve becomes entrapped between metatarsal heads; running & pounding +/or tight shoes
  • DDx: anterior arch sprain
  • SSx: lateral forefoot pain: intermittent, spontaneous, reduced when barefoot, excruciating, click & pain with MT compression (this is caused by squeezing of metatarsal heads)
  • these help rule out arch
    sprains
  • Tx: metatarsal pad or cortisone injection into nerve to settle inflammation
40
Q

arch sprains

  • causes
  • Ssx
  • grades of arch sprains
  • Tx
A
  • causes: obesity, heredity, overuse, fatigue, poor footwear, hard surfaces
    Ssx:
    • Pain with use, more when barefoot
    • 1st degree – slight soreness
    • 2nd degree – inflammation, drop of arch
    • 3rd degree – fallen arch
  • Tx: POLICE, rest, rehab
41
Q

Define: periostitis

A

inflammation of the membrane enveloping a bone

42
Q

Define: turf toe

  • cause
  • Ssx
  • Tx
A
  • define: sprain of 1st MTP joint ligament and capsule due to forced hyperextension of 1st MTP joint beyond 60 degrees
  • SSx: Pain, decreased ROM, difficulty running or changing directions; 1st MTP is red, swollen, tender; pain worst at the end range of 1st toe extension
  • Tx: immobilize them, crutches, maybe even surgery, rehab; return to sport: taping to stabilize joint and limit hyperextension
43
Q

Plantar Fasciitis

- treatment/ management

A
  • rest then gradual return to sport
  • ultrasound physiotherapy
  • orthotics (soft>hard); wear all the time
  • heel cups built into orthotics
  • taping
  • night splint
  • short leg walking cast
  • achilles tendon stretching (3x a day)
  • rolling plantar surface with a rigid ball
  • rehab exercises that increase big toe dorsiflexion
  • anti-inflammatory medication
  • steroidal injection (if all other management options fail to resolve symptoms
  • strausberg sock
44
Q

Fill in the blank: Don’t do surgery for Plantar Fasciitis before 6 months of conservative treatment. ______ will resolve with 6 months of consistent nonoperative treatment.

A
  • 97%
45
Q

Define: crepitus

A

grinding/ crunching sensation in joints when moving

- can be found in fractures

46
Q

Specific foot injuries with risk of foot fractures where?

  • ankle sprains
  • fall or jump
  • crush injury
  • overuse
  • kicking injury
A
  • ankle sprains: talus, fibula, tibia
  • fall or jump: calcaneus (possible spine vertebrae?)
  • crush injury: metatarsals, phalanges
  • overuse (stress): metatarsals, tibia, fibula, calcaneus
  • kicking injury: phalanges
47
Q

Jones fracture

  • define
  • Ssx
  • Tx
  • notorious for?
A
  • define: Fracture at fifth metatarsal proximal diaphysis/metaphysis junction
  • Ssx: pain, swelling, difficulty walking
  • Tx: brace, cast or splint for 4 to 8 weeks, risk of non-union (25%), surgical repair
  • notorious for poor healing because not much blood flow to this area
48
Q

Describe some foot rehab modalities (4)

A
  • contrast bath (hot/cold)
  • ultrasound: sound waves travel to tissues causing them to heat up and dilate and increase blood flow (helps with healing
  • shockwave therapy: higher intensity than ultra sound but usually used to break down scar tissue or adhesions
  • laser therapy: alters permeability of cells; allowing different healing substrates to enter
49
Q

Describe some foot strengthening exercises

A
  • towel scrunches
  • marble pick ups
  • short foot exercises (isometric exercise where you try and contract arch muscles and hold them)
50
Q

What are some foot tape jobs we can do (2)?

A
  • low dye arch tape job

- calcaneal fat pad tape job

51
Q

Plantar fasciitis

- etiology

A
  • pes cavus or pes planus
  • running (weight on the ball of foot)
  • bursitis
  • heel spurs
  • inappropriate footwear
  • poor running technique (long strides),
  • running on soft surfaces
  • discrepancy in leg length
  • excessive pronation of the subtalar joint, inflexibility of the longitudinal arch
  • tightness of the gastrocnemius + soleus
52
Q

Plantar fasciitis

- signs and symptoms

A
  • pain the medial arch/ medial distal heel
  • pain worst in morning and with sitting
  • swelling and tenderness
  • heel spur on x ray

BPK 241 (7 decks)

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